If you cannot tolerate NSAIDs or if they do not help, your doctor may suggest a corticosteroid, such as prednisone, to reduce inflammation. Corticosteroids may be taken orally; less frequently, they are injected directly into the affected joint (usually numbed ahead of time with a nerve block).
Another option is an injection of adrenocorticotrophic hormone, a compound that directs your adrenal gland to make more cortisone. Although the medication colchicine may be given in pill form, it tends to cause unpleasant side effects (nausea, vomiting, cramps, and diarrhea). Rarely, people may take drugs to lower uric acid levels in their blood. These include probenecid (Benemid, Probalan) to increase urinary excretion of uric acid, and allopurinol (Zyloprim) and febuxostat (Uloric) to reduce the body's production of uric acid. Allopurinol is a good choice for most people, as it is available as a generic and therefore far less expensive. But for people who are allergic to allopurinol or cannot tolerate it, febuxostat might be a better alternative.