Indomethacin continues to be recommended for the treatment of acute gout, but I have seen reports and personally witnessed that this agent is harder on the stomach than most other nonsteroidal anti-inflammatory drugs. Shouldn’t clinicians abandon the use of indomethacin altogether?
—Craig Freyer, MD, Ft. Worth, Tex.

For acute gouty patients with GI problems, indomethacin may cause added peptic distress, but for the asymptomatic individual, this medication remains a reasonable, inexpensive, and effective short-term therapy. Remind patients that headache is a possible side effect as well.
—Jack Waxman, MD (117-9)