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Allopurinol initiation during acute gout — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsAllopurinol initiation during acute goutGPhC CRA

A patient with a first acute gout flare asks to buy allopurinol immediately because he wants to prevent another attack. The joint is still swollen and painful. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Advise acute flare treatment first and discuss urate-lowering therapy with the GP after assessment

Allopurinol is not an acute analgesic and initiation during a flare requires careful clinical decision-making and counselling. Acute gout is treated with appropriate anti-inflammatory therapy if suitable. Urate-lowering therapy should be discussed with the prescriber, usually with prophylaxis considerations. Patients already taking allopurinol are generally advised not to stop it during a flare unless told otherwise.

Reference: NICE CKS; BNF