This page about prednisone for gout pain treatment was last reviewed, or updated, on 22 July 2016
Prednisone or other corticosteroids may be used for fast gout pain treatment if NSAIDS (including indomethacin) and colchicine fail to deliver gout pain relief, or if patients are unable to tolerate them because of other medical conditions. They are also more likely to be used if more than one joint is affected and for the elderly.
You might be given corticosteroids if you take your gout pain to the emergency department, ED, ((Accident and Emergency unit (A & E)) of a general hospital. In some cases of emergency gout pain relief, prednisone, triamcinolone or corticotrophin are injected into the attack site(s), if there are two or less. This should make them work faster and deliver pain relief in a few hours. Then you could be back to normal in 24.
Corticosteroids are the strongest anti inflammatory medication and are being increasingly used to treat gout pain and flares. Prednisone is the most commonly prescribed corticosteroid. Others for gout pain relief include prednisolone, triamcinolone, and corticotrophin (ACTH, see below).
Don't confuse corticosteroids with anabolic steroids. They are not the same.
What is the difference between prednisone and prednisolone ? Prednisone is an inactive drug precursor that is converted to prednisolone in the liver to become active.
How do they work ? They work by modifying the body's immune system response to gout flares and decrease gout’s inflammation. It may be similar to that old gout stalwart colchicine.
How do they compare with NSAIDS? NSAIDS are meds such as indomethacin, etoricoxib, (Arcoxia) and paracetamol (acetaminophen). They are widely used for gout pain. In recent years a number of studies have tried to find out how corticosteroids, often prednisolone, compare to NSAIDs. The usual finding is that they are just about as effective as each other, but corticosteroids cause fewer adverse events.
How long before there is pain and other symptoms’ reduction ? They usually work within a few hours – four is often mentioned.
In one of these studies (1), according to participants own assessment of their pain, prednisolone, etoricoxib (NSAID) and indomethacin (NSAID) reduced pain most in Day 1 and carried on reducing it by declining amounts through Day 5. This same pattern was also true for the four discomforts associated with these gout flares – tenderness, erythema (reddening of the skin), swelling, and joint seizures or stiffness. Just one difference – the reduction in the swelling was better with prednisolone than indomathecin.
Prednisone for gout pain - likely dosage Orally as a tablet. Take 10 - 60 mg first day, followed by tapered down dosages. Only the lowest dosage is used, and as infrequently as possible, because prednisone and other corticosteroids suppress the immune system.
The dose is based on the size of the affected joint (s) and the extent of the inflammation. Likely length of time of use – 5 days.
Your doctor may prescribe prednisone/prednisolone tablets for emergency treatment when travelling. If you are taking corticosteroids, make sure you follow the doctor's instructions accurately, or any other gout drug for that matter.
Possible side effects include Colds and fevers; slow wound healing; increased levels of blood sugar; increased appetite and weight gain; poor sleep; heart failure; higher blood pressure, diarrhoea (diarrhea); headache; nausea and others. The longer you take them, the more likely are the "side effects" - one reason why they are are not long term gout treatment. Maximum is probably 30 days.
PUBLIC COMMENTS ABOUT CORTICOSTERIODS. Read these public comments and you'll see they can be beneficial, but it is not always plain sailing with them.
Corticotrophin (ACTH) Corticotrophin may be used as an immediate treatment instead of prednisone or the others. Corticotrophin stimulates your body to produce corticosteroids. It may be beneficial for elderly patients, who can't take steroids.
Possible side effects include vomiting; appetite loss or increase; diarrhoea (diarrhea); constipation; sleep disorders and others.
CAUTION If you’re taking prednisone or any other corticosteroid, any noticed side effect should be immediately reported to your doctor.
NOTE CAREFULLY Corticosteroids have many other drug and dietary supplement/herbal interactions. Take a list of everything you take to your Doctor before they are prescribed.