Which medication should a gout patient avoid due to potential uric acid elevation?

• A. Acetaminophen
• B. ASA
• C. Steroids
• D. NSAIDs

Answer: (B)

Uric acid levels rise when the kidneys don’t excrete it effectively. Aspirin, especially at typical low doses, reduces renal clearance of uric acid by competing for the same tubular transport, which raises serum urate and can provoke or worsen a gout attack. That’s why this medication should be avoided in gout for its uric acid–raising effect. Acetaminophen can treat pain without affecting urate excretion, and NSAIDs or steroids are used to control the inflammatory symptoms of gout without the same urate-raising issue. So the best choice to avoid for uric acid elevation is aspirin.