Which treatment should be avoided in gout attacks?

Allopurinol should be avoided during acute gout attacks because its primary function is to reduce uric acid levels and prevent future gout flares, rather than to relieve the symptoms of an ongoing attack. Initiating allopurinol during an acute flare can actually lead to increased inflammation and worsen the symptoms, as it can mobilize uric acid and possibly exacerbate the attack.

In contrast, naproxen and indomethacin are nonsteroidal anti-inflammatory drugs (NSAIDs) that can provide symptomatic relief during acute gout episodes by reducing pain and inflammation. Colchicine is another medication that, when taken in the early stages of a gout attack, can help reduce pain and inflammation effectively.

Thus, while allopurinol is an important medication for long-term management of hyperuricemia and prevention of gout attacks, its use should be reserved for when the patient is stable and not experiencing an acute episode.