Short answer: They can cause a temporary rise in uric acid during the fastest weight-loss phase — usually the first few months — which can trigger a gout flare in people prone to it. Over the longer term, GLP-1 medicines (and the weight loss they produce) tend to lower uric acid. The kidney angle: uric acid is handled by the kidneys and can form kidney stones, so hydration and not stopping your gout medicine matter.
Why uric acid rises early. When fat breaks down quickly, it releases purines, which the body converts to uric acid. Add the mild ketosis and dehydration that can come with rapid weight loss, and serum uric acid can climb transiently — typically peaking in the first 3–5 months. A small number of people have gout flares during this window.
Why it improves later. After the early phase, uric acid usually falls. In the STEP (semaglutide) and SURMOUNT (tirzepatide) weight-loss programs, uric acid decreased overall as weight came down (on the order of ~0.5–1 mg/dL). So the long-run direction is favorable — it’s the early phase that needs attention.
The kidney connection. Uric acid is filtered and excreted by the kidneys and can crystallize into uric-acid kidney stones, especially when urine is concentrated. Two simple protections help: stay well hydrated, and keep urine from getting too acidic if your clinician has flagged stone risk.
If you have gout or take gout medicine.
- Do not stop allopurinol (or febuxostat) on the assumption that weight loss will replace it — stopping urate-lowering therapy is a common cause of early flares.
- If you have established gout, frequent flares, or a high baseline urate, tell your clinician before starting a GLP-1 so they can plan (and sometimes cover the early phase).
- Treat a flare as usual (with your clinician’s guidance); the transient rise is expected to settle.
Practical steps.
- Hydrate — especially in the first months and during any nausea, vomiting, or diarrhea.
- Keep taking urate-lowering medicine if you’re on it.
- Lose weight gradually rather than as fast as possible.
- Flag a gout history to your clinician before starting.
Bottom line. GLP-1 drugs don’t cause gout directly, but the rapid early weight loss can nudge uric acid up and trigger flares in susceptible people — before the longer-term drop. Hydrate, keep your gout medicine, and let your clinician know your history.
Full guides: Semaglutide (Ozempic/Wegovy) and Your Kidneys and Tirzepatide (Mounjaro/Zepbound) and Your Kidneys.
Related questions
Does Ozempic or Mounjaro lower uric acid long-term? Yes — with sustained weight loss, uric acid generally falls. The concern is a temporary rise during the fastest early weight-loss months.
Can a GLP-1 trigger a gout attack? It can in people prone to gout, usually within the first few months, driven by the rapid fat breakdown and dehydration. Staying hydrated and continuing urate-lowering medicine reduces the risk.
Do GLP-1 drugs cause uric-acid kidney stones? There’s no strong evidence they cause stones; some data even suggest lower stone rates overall. Still, a transient uric-acid rise plus dehydration can favor stones, so hydration matters.
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Written and medically reviewed by Dr. Amir S. Naderi, MD, FASN. Last updated: July 8, 2026. Educational information only — not medical advice. Never change or stop a prescribed medication without talking to your doctor.