Medical expert of the article
New publications
Aspirin for gout
Last reviewed: 06.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
A derivative of acetic and salicylic acid, 2-(acetyloxy)benzoic acid, acetylsalicylic acid, or Aspirin, is used to treat mild to moderate pain. Doctors used to prescribe this phenolic ester for literally everything and explained to patients how to take aspirin for gout and other joint diseases. Now they don’t. Here’s why.
Can you take aspirin if you have gout?
Today, most doctors believe that people with kidney disease, high uric acid levels in the urine (hyperuricosuria) or blood (hyperuricemia), and those who suffer from gout should not take Aspirin. It turns out that despite all its therapeutic properties, it suppresses the kidneys' ability to remove uric acid from the body. Thus, Aspirin for gout can worsen the symptoms of the pathology. [ 1 ]
Let us briefly dwell on the main pharmacological characteristics of this popular drug - its pharmacodynamics and pharmacokinetics, so that those suffering from the deposition of urate crystals in the joints and other tissues are convinced of the correctness of the modern point of view on the inadmissibility of treating gout with Aspirin.
Aspirin acts as an anti-inflammatory agent by blocking cyclooxygenase, which inhibits the biosynthesis and release of inflammation mediators (prostaglandins). That is why Aspirin can relieve minor pain. And the effect of acetylsalicylic acid on the thermoregulatory center of the hypothalamus determines its antipyretic properties: reducing fever, dilating peripheral vessels and increasing sweating.
Acetylsalicylic acid also inhibits the synthesis of the enzyme prostacyclin, which inhibits platelet aggregation (sticking together). Due to this property, Aspirin is used to prevent the formation of blood clots in blood vessels, coronary heart disease and myocardial infarction.
However, Aspirin is known for its side effects in the form of ulceration of the gastric mucosa and gastric bleeding (with prolonged use). Also, all salicylates can cause bronchospasm, Quincke's edema and anaphylactic shock.
But in gout, the main thing is not even the side effects of Aspirin, but the fact that this drug, acting on the hypothalamus, reduces the functional activity of the antidiuretic hormone (vasopressin). And this is fraught with a decrease in water reabsorption by the kidneys, a decrease in the volume of urine and an increase in concentration.
Aspirin is also no longer used for gout due to the characteristics of its metabolites - free salicylic acid (10%), salicyluric acid (75%), phenol salicylate, etc. - and the specifics of their excretion from the body. Adequate renal excretion of these metabolites occurs only with a slightly alkaline urine reaction, and when the urine is acidic (at low pH), the breakdown products of acetylsalicylic acid are retained in the kidneys.
With gout, urine is most often acidic, and can you take aspirin for gout if
The remaining salicylates that are not excreted reduce renal function, worsen the initial renal failure and, according to experts from the Japanese Society of Gout and Nucleic Acid Metabolism, slow down the rate of uric acid excretion by at least 15%. As a result, the level of uric acid in the blood increases and gout worsens.
So, using Aspirin for gout is contraindicated.
[ 2 ]