Step 2

Rheumatology 5

A 32-year-old man with a past medical history of gout presents to the rheumatology clinic complaining about multiple gout flares in the recent 6 months. He was initially diagnosed with crystal-proven gout 2 years ago after an arthrocentesis and was eventually started on allopurinol 100 mg orally daily. However, he did not tolerate allopurinol, and the medication was stopped. Currently, he takes ibuprofen 400 mg three times daily every time he gets a gout flare. His serum urate levels are 8.0 mg /dl and there is slight worsening of his renal function on recent labs.

Which of the following medication regimens should be considered for long-term gout management in this patient?

  • A) Continue using ibuprofen 400 mg three times daily as needed
  • B) Reinitiate allopurinol 100 mg daily
  • C) Start allopurinol 50 mg daily as the patient was unable to tolerate a higher dose before
  • D) Start febuxostat 80 mg daily
  • E) Start probenecid 500 mg daily


Serena Tharani


Dr. Raj Dasgupta