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Allopurinol initiation — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsAllopurinol initiationGPhC CRA

A 58-year-old man has had three gout flares in one year and has urate 520 micromol/L. He is now pain-free after a flare treated two weeks ago. His GP asks about urate-lowering therapy. What is the most appropriate alternative?

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Correct answer: A — Start allopurinol at a low dose with flare prophylaxis if appropriate

Recurrent gout flares are an indication to discuss urate-lowering therapy. Allopurinol is commonly first-line and should be started at a low dose with titration to target urate. Flare prophylaxis with colchicine or an NSAID may be used if suitable because starting urate-lowering therapy can trigger flares.

Reference: NICE CKS; BNF