NSAIDs for Gout: Best Options, Risks, and What Actually Works

When a gout flare hits, NSAIDs, nonsteroidal anti-inflammatory drugs used to reduce pain and swelling during acute gout attacks. Also known as anti-inflammatory painkillers, they’re often the first thing doctors reach for because they work fast—sometimes in hours. But not all NSAIDs are created equal, and using the wrong one can do more harm than good, especially if you have kidney issues, high blood pressure, or a history of stomach ulcers.

For gout, indomethacin and naproxen are the most commonly prescribed NSAIDs. Indomethacin works quickly but can cause dizziness, stomach upset, or even confusion in older adults. Naproxen is gentler on the stomach and lasts longer, so you don’t need to take it as often. Ibuprofen is available over the counter, but you’d need to take 800 mg three to four times a day to match prescription strength—and even then, it’s less reliable for severe flares. Ketorolac, another NSAID, is strong but risky for the kidneys, and it’s not recommended for long-term use, especially if you’re already dealing with gout-related kidney strain.

NSAIDs aren’t safe for everyone. If you’re over 65, have chronic kidney disease, or take blood pressure meds like ACE inhibitors, NSAIDs can spike your creatinine levels and worsen kidney function. That’s why doctors often check your kidney labs before prescribing them. People with heart failure or a history of GI bleeding should avoid NSAIDs altogether. And if you’ve had a bad reaction to one NSAID, you might react to others too—they’re all in the same family.

That’s where alternatives come in. Colchicine, a drug specifically designed to stop gout flares by reducing uric acid crystal inflammation. Also known as gout-specific anti-inflammatory, it’s not a painkiller like NSAIDs, but it stops the flare from getting worse. It’s slower—takes a day or two—but much safer for kidneys. Then there’s corticosteroids, oral or injected steroids used when NSAIDs and colchicine aren’t options. Also known as steroid treatment for gout, they work just as well as NSAIDs for many people, with fewer kidney risks. A single steroid shot in the joint or a short 5-day oral course can calm a flare without stressing your system.

What you won’t find in most guides is how often people use NSAIDs for gout without realizing they’re masking the real problem. Gout isn’t just about pain—it’s about high uric acid levels. NSAIDs don’t lower uric acid. They just hide the symptoms. That’s why long-term management needs allopurinol or febuxostat, not just pills for flare-ups. But when you’re stuck in bed from a swollen toe, NSAIDs are the bridge to relief.

The posts below cover real-world experiences with these drugs—what works, what doesn’t, and what side effects actually matter. You’ll find comparisons between NSAIDs, tips on avoiding kidney damage, and why some patients switch to steroids or colchicine after one bad reaction. Whether you’re newly diagnosed or tired of the same old advice, you’ll find practical, no-fluff answers here.