What is the primary medication prescribed for gout prevention?

Allopurinol is the primary medication prescribed for the prevention of gout attacks. It works by reducing levels of uric acid in the blood, which is crucial because high uric acid levels can lead to the formation of monosodium urate crystals in joints, causing the painful inflammation characteristic of gout. By inhibiting xanthine oxidase, an enzyme involved in uric acid production, allopurinol helps to prevent the recurrence of gout flares and also aids in managing chronic gout by lowering urate levels over time.

In contrast, medications such as probenecid can also be used in gout management but mainly promote uric acid excretion rather than lowering production. Colchicine is typically used for acute gout flare management rather than prevention, providing symptomatic relief rather than addressing the underlying cause. Ibuprofen, as a non-steroidal anti-inflammatory drug (NSAID), is effective for pain relief during gout attacks but does not prevent the underlying problem of uric acid overproduction or underexcretion. Thus, allopurinol is not only effective in managing chronic hyperuricemia but is also the cornerstone of preventive therapy in patients with frequent gout attacks.