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Allopurinol during acute gout — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsAllopurinol during acute goutGPhC CRA

A 55-year-old man with gout presents to the pharmacy. He has been on allopurinol 300 mg once daily for six months. He is experiencing an acute flare of gout in his left big toe. He asks if he should stop his allopurinol. What is the most appropriate advice?

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Correct answer: E — Continue allopurinol at the current dose and treat the acute flare with an appropriate anti-inflammatory

Allopurinol should not be started or stopped during an acute gout flare as changes in urate levels can prolong or worsen the attack. If allopurinol has already been established (as in this case), it should be continued, and the acute flare should be treated with appropriate anti-inflammatory therapy such as an NSAID, colchicine, or a short course of corticosteroid. This is consistent with NICE and BSR/BHPR guidance.

Reference: BNF; NICE CKS Gout