Gout: Drug Causes

Key points

• Gout is a form of microcrystal synovitis caused by deposition of monosodium urate monohydrate in the synovium, due to chronic hyperuricaemia (uric acid > 0.45 mmol/L) · note NICE NG219 confirms the clinical diagnosis at a serum urate of 360 micromol/L (0.36 mmol/L) or more — a different, lower figure from the classic hyperuricaemia cut-off.
• Diuretics: thiazides, furosemide
• Cytotoxic agents (via increased cell turnover and uric acid production)
• Aspirin: low-dose aspirin (e.g. 75mg) has also been shown to increase the risk of gout attacks, not just high-dose
• Other drug causes: ciclosporin, pyrazinamide, alcohol