Reply To: Allopurinol Dose Change, Pain Location Change

Stopping Gout Together Forums Help My Gout! The Gout Forum Allopurinol Dose Change, Pain Location Change Reply To: Allopurinol Dose Change, Pain Location Change

Keith Taylor

The foot pain might have nothing to do with gout. So, if it persists, you should get it examined.

But, let’s assume it’s gout related. If it is, when you’re reducing uric acid, it’s all about the level that you’ve reached. I can’t recall us ever discussing your uric acid targets. But, you should have a target for the debulking period. Also, a maintenance target for when you’ve gone 6 months without any symptoms.

Now, those targets are not strictly related to your foot pain question. But, they put it into a meaningful context. Otherwise, we just end up talking ifs, buts, and maybes. So, can you post your targets if you have them, and the last 2 or 3 uric acid test results?

Moving on to my allopurinol management plan. The truth is, I never really had one. The nearest thing I got was to aim for uric acid as low as possible during my debulking period (which is probably the best plan).

You really do not want to follow my example, d_q. I was spurred into action by a near-fatal accident. 3 and a half years later, I prematurely quit allopurinol because I was too depressed to leave home. Then, I kept making stupid excuses to myself for not restarting. The only good news is, thanks to you, I’m going to make an appointment today, and get back on the allopurinol.

So, I’m not really qualified to give any advice about gout management. Except that, like most teachers, I can explain the theory, even if I have no clue about practical reality. Therefore, my recommendation is to wait until you are fully recovered before you even think about pausing allopurinol treatment. But, I guess it’s good to think forward. So, any break needs monitoring by uric acid tests. Unfortunately, these ideas about allopurinol ‘vacations’ are very new. That means, we have no ideas about how long it is safe to take a break. It would be stupid (like me) to wait until gout symptoms return. So, a year off is probably OK. But, we need DECT for gout before this can ever be a reliable way to manage allopurinol treatment. My feeling at the moment is, once I get back on allopurinol, I’m unlikely to consider stopping it again. But, I can’t guarantee that some foolish action on my part won’t change that!

Reading this back, I suspect I haven’t been particularly helpful. Sorry, I’ll try harder next time.