Reply To: Why colchicine with Allopurinol and Indomethacin?

Stopping Gout Together Forums Help My Gout! The Gout Forum Why colchicine with Allopurinol and Indomethacin? Reply To: Why colchicine with Allopurinol and Indomethacin?

Keith Taylor

Hey, thanks Maurice. It’s nice to get some positive feedback.

My dose of choice might shock you, but there is logic behind it.

First, I started allopurinol properly with a low dose, and increased gradually. Also, I’m not in one of the racial groups that are advised to take a genetic screening test before allopurinol. I say this, not in answer to you. But, other gout sufferers will read this, who are concerned about allopurinol side-effects. I’m not susceptible to any such side effects. So, I see no limits to allopurinol dose.

In the UK, maximum advised dose is 900mg per day. In the USA, it is 800mg per day. Gout PAtients should note that this is not a medical maximum. Under medical supervision, with appropriate liver and kidney monitoring, a specialist might prescribe higher doses.

In short, my dose of choice is 900mg per day. Then, once visible tophi have disappeared, and pain symptoms have gone for six months, the dose can be lowered. At that stage, you can be almost certain that the uric acid burden has dissolved. So, all you need is an annual check for uric acid, liver function, and kidney function.

Of course, a doctor might feel that there is no reason to go for the maximum dose. In that case, I would ask for evidence that a lower dose is better.

Essentially Maurice, it boils down to what you are most comfortable with. You are clearly on the road to recovery. So, it’s up to you if you want to proceed with caution, or race ahead. Either way, it’s a good place to be, compared to most gout sufferers.