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AKT1-149

Nigel is a 40 year old plumber who presents with severe acute pain in his left toe. He has previously been diagnosed with Gout and usually takes Ibuprofen 200mg three times a day during a flare as he could not tolerate Colchicine in the past. Unfortunately, on this occasion his pain is persisting despite regular Ibuprofen. He is also prescribed Allopurinol but admits he doesn’t always take it. His eGFR is 55. On examination you note a highly inflamed and tender left hallux.

What would be the most appropriate treatment option?

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