{"id":3920,"count":8,"description":"Gout is caused by deposition of monosodium urate crystals in joints (most often the first metatarsophalangeal joint \u2014 \"podagra\") and soft tissues, secondary to chronic hyperuricaemia. Modern management has two parallel goals: (1) abort the acute flare with anti-inflammatory treatment, and (2) reduce serum uric acid to below 360 \u00b5mol\/L (300 \u00b5mol\/L in tophaceous gout) with long-term urate-lowering therapy. The MedsBase Gout Treatment catalogue carries both arms, supplied by <strong>WHO-GMP certificerede producenter<\/strong>.\n\n<strong>Akut anfald \u2014 antiinflammatorisk behandling.<\/strong> Three options work, choice based on contraindications. NSAIDs (high-dose for 5\u20137 days) are first-line in patients without renal impairment, peptic ulcer, heart failure, or anticoagulant therapy. Naproxen 500 mg BID, indomethacin 50 mg TID (the historical \"gold standard\" for acute gout), and ibuprofen 800 mg TID are common choices. We stock <a href=\"https:\/\/medsbase.com\/da\/brufen\/\">Brufen<\/a> (ibuprofen), <a href=\"https:\/\/medsbase.com\/da\/inmecin-r\/\">Inmecin-R<\/a> (indometacin SR), <a href=\"https:\/\/medsbase.com\/da\/indicid-75-sr\/\">Indicid-75 SR<\/a>, og <a href=\"https:\/\/medsbase.com\/da\/indoga\/\">Indoga<\/a> (indometacin). Colchicin 1,2 mg peroralt efterfulgt af 0,6 mg en time senere (derefter 0,6 mg BID i 2\u20133 dage) er alternativet \u2014 s\u00e6rligt nyttigt n\u00e5r NSAID'er er kontraindiceret. F\u00f8res som <a href=\"https:\/\/medsbase.com\/da\/goutnil\/\">Goutnil<\/a> (colchicine 0,5 mg). V\u00e6r opm\u00e6rksom p\u00e5 diarr\u00e9 (dosisrelateret) og undg\u00e5 ved betydelig nyre- eller leversvigt. Oral kortikosteroider (prednisolon 30\u201340 mg dagligt i 5 dage) er det tredje valg, n\u00e5r b\u00e5de NSAID'er og colchicin er kontraindiceret \u2014 se kategorien Smertelindrende medicin.\n\n<strong>Urinsyres\u00e6nkende behandling \u2014 til kronisk styring.<\/strong> Indikationer: \u2265 2 anfald om \u00e5ret, toph\u00f8s gigt, uratnefrolitiasis eller kronisk nyresygdom stadium \u2265 3 med hyperurik\u00e6mi. Allopurinol (xanthinoxidaseh\u00e6mmer) er f\u00f8rstevalg \u2014 start med 100 mg dagligt (50 mg ved CKD), titrer op med 100 mg hver 2.\u20134. uge med m\u00e5l om serumurat &lt; 360 \u00b5mol\/L. De fleste patienter har brug for 300\u2013600 mg dagligt. Lagres som <a href=\"https:\/\/medsbase.com\/da\/zyrik\/\">Zyrik<\/a> (allopurinol). HLA-B*5801-testning anbefales hos han-kinesere, koreanere og thail\u00e6ndere f\u00f8r start (risiko for alvorlige hudreaktioner). Febuxostat (alternativ xanthinoxidaseh\u00e6mmer \u2014 nyttig ved allopurinol-intoleranse eller utilstr\u00e6kkelig effekt) lagres som <a href=\"https:\/\/medsbase.com\/da\/hyloric\/\">Hyloric<\/a>. CARES-studiet viste en signal om kardiovaskul\u00e6r d\u00f8delighed \u2014 vurder kardiovaskul\u00e6r risiko f\u00f8r skift fra allopurinol. Probenecid (urikosurikum \u2014 \u00f8ger renal uratudskillelse) som <a href=\"https:\/\/medsbase.com\/da\/bencid\/\">Bencid<\/a>. Nyttig ved underekskreterer med eGFR &gt; 50; kontraindiceret ved historie med urinvejssten.\n\n<strong>Profylakse mod anfald under igangs\u00e6tning af urinsyres\u00e6nkende behandling.<\/strong> Igangs\u00e6tning af urinsyres\u00e6nkende behandling kan mobilisere tophi og udl\u00f8se anfald i op til 6 m\u00e5neder. Profylaktisk colchicin 0,5 mg en eller to gange dagligt i de f\u00f8rste 6 m\u00e5neder (eller NSAID-profylakse) reducerer incidensen af anfald \u2014 stop n\u00e5r urat er p\u00e5 m\u00e5l og ingen anfald i 3\u20136 m\u00e5neder.\n\n<strong>S\u00e5dan v\u00e6lger du.<\/strong> F\u00f8rste anfald uden risikofaktorer \u2192 NSAID i 5\u20137 dage, ingen urinsyres\u00e6nkning endnu. Tilbagevendende anfald (\u2265 2\/\u00e5r) \u2192 start allopurinol 100 mg dagligt med titrering + colchicinprofylakse. Allopurinol-fiasko eller intolerans \u2192 febuxostat (vurder kardiovaskul\u00e6r risiko). Underekskreterer (24-timers urinurat &lt; 600 mg) uden urinvejssten \u2192 overvej probenecid som alternativ eller till\u00e6g. Toph\u00f8s gigt, refrakt\u00e6r sygdom eller pegloticase-indikation \u2192 henvisning til reumatologi.\n\n<strong>Vigtigt.<\/strong> Lifestyle measures matter: reduce alcohol (especially beer), reduce fructose-sweetened drinks, weight loss, hydration, low-purine diet, vitamin C 500 mg daily, dairy intake. Continue urate-lowering therapy through acute flares \u2014 stopping precipitates further flares. Avoid loop and thiazide diuretics where possible (raise urate). Aspirin 75\u2013100 mg has minor effect; cardiovascular indication usually outweighs urate concern. Acute monoarthritis with fever needs joint aspiration to exclude septic arthritis \u2014 gout can mimic but cannot be assumed.\n\nAll MedsBase Gout Treatment products ship from <strong>WHO-GMP certificerede producenter<\/strong> med diskret emballage og er d\u00e6kket af vores <a href=\"https:\/\/medsbase.com\/da\/medsbase-re-shipment-assurance-policy\/\">Reshipment Assurance Policy<\/a>.","link":"https:\/\/medsbase.com\/da\/gout-treatment\/","name":"Behandling af gigt","slug":"gout-treatment","taxonomy":"product_cat","parent":3223,"meta":[],"menu_order":0,"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/da\/wp-json\/wp\/v2\/product_cat\/3920","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/da\/wp-json\/wp\/v2\/product_cat"}],"about":[{"href":"https:\/\/medsbase.com\/da\/wp-json\/wp\/v2\/taxonomies\/product_cat"}],"up":[{"embeddable":true,"href":"https:\/\/medsbase.com\/da\/wp-json\/wp\/v2\/product_cat\/3223"}],"wp:post_type":[{"href":"https:\/\/medsbase.com\/da\/wp-json\/wp\/v2\/product?product_cat=3920"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}