Appropriate treatment for acute gouty arthritis in a man with congestive heart failure and renal insufficiency might include:
Extra info: Renal insufficiency is a relative contraindication for the use of allopurinol and due to its side effects (hypertension) also the corticosteroids. Colchicine is a better option, since it is eliminated via the liver. Indomethacin has interactions with many drugs, including anti-coagulants, ACE-inhibitors, β-blockers and diuretics. The patient utilizes probably one or more of these drugs.