Gout guide

Gout flare treatment and prevention online in Virginia and West Virginia

This guide is for a typical gout flare in someone previously diagnosed with gout, or for starting/continuing daily allopurinol prevention with a recent creatinine — never for a first-ever hot, swollen joint or any hot joint with fever, which always need emergency or urgent in-person evaluation.

Start online

Start a $59 online review for Gout (flare or prevention).

Gout causes sudden, severe joint pain and swelling, most classically in the big toe. If you've had gout before and this flare feels typical, or if you want to start or continue daily allopurinol to prevent future flares, online treatment can often help quickly. But a hot, swollen joint for the first time ever, or any hot joint together with a fever, can be a joint infection instead of gout — and that always needs same-day in-person evaluation, never online treatment.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response windows

Quick facts

You must be physically in Virginia and West Virginia at the time of request
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response windows: 24/7, every day

Common symptoms

Sudden, severe pain, swelling, redness, and warmth in a joint (classically the big toe)
A flare that feels similar to previous gout flares you've had
Wanting to start or continue daily allopurinol to prevent future flares

May fit online care

Adults 18 and older
A previously diagnosed gout flare that feels typical for you
No fever, and this is NOT the first time you've ever had a hot swollen joint
For allopurinol: a photo of a creatinine result from within the past 6 months
No azathioprine/6-mercaptopurine use, and (if starting allopurinol) ancestry counseling addressed if applicable

Look for another care setting

A hot, swollen joint for the FIRST TIME EVER (needs emergency evaluation for possible joint infection)
Any hot, swollen joint together with a fever (possible septic arthritis — an emergency)
Wanting to START allopurinol during an active flare (allopurinol is only continued, never started, during a flare)
No creatinine result from the past 6 months for an allopurinol decision

What to have ready

Whether this is the first time ever you've had a hot swollen joint (if yes, seek in-person care instead)
Whether you have a fever
A clear photo of your creatinine (kidney function) lab result, if requesting allopurinol
Your current medications, especially azathioprine, 6-mercaptopurine, or a blood thinner

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer the fit questions, and choose the response window you want. If the concern still fits this service, a physician reviews it and sends a secure update after sign-in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD — board-certified, cardiology-fellowship-trained, and Alpha Omega Alpha. Recognized with the Act Fast Award for the fastest physician stroke-treatment times (2019–2022) and as the most efficient, highest-rated physician in the HCA LewisGale Alleghany emergency department (2018). Licensed in Virginia and West Virginia — your care is never handed off.

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Why can't you treat a hot, swollen joint the first time it happens?

A joint infection (septic arthritis) can look almost identical to a gout flare, but it needs urgent drainage and IV antibiotics, and can permanently damage the joint if treatment is delayed. Because online care cannot examine or aspirate the joint, a first-ever hot swollen joint — or any hot joint with fever — always needs same-day in-person or emergency evaluation to rule this out.

Why can't I start allopurinol during a flare?

Starting allopurinol during an active flare can prolong or worsen that flare due to shifting uric acid levels. It's started only once a flare has resolved — though if you're already taking allopurinol, you should keep taking it without interruption, even during a flare.

Why does ancestry matter for allopurinol?

People of Han Chinese, Thai, or Korean descent have a higher rate of a gene variant (HLA-B*5801) linked to a serious, sometimes life-threatening skin reaction to allopurinol. If this applies to you, genetic testing before starting is recommended, and you'll be counseled on what rash symptoms mean you should stop the medication and seek care immediately.