Reply To: Gout Assistance Required

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I don’t actually know what dose and schedule would work best for you. Your situation is a bit unusual since you recently discontinued a strong dose. No study is going to ask participants to discontinue their therapy like you did so I doubt there is actual evidence to guide you anywhere.
I therefore think you have to go for a balanced compromise between the various concerns without knowing if being careful actually makes any difference: don’t go back to the full 80mg suddenly but don’t wait several weeks to get to an effective dose either. You could take 20mg for a few days or go straight to 40mg. Taking 40mg for a week or two sounds reasonable. After that, I think taking no more than 60mg until your next blood test would also be a decent compromise between likely efficacy and side effects (again, there are 120mg Adenuric pills out there which would make taking 60mg easier) but we know you can survive 80mg so you could justify taking the whole pill for a month or two after taking 60mg for a little while.
For all I know, none of this will help. If you already triggered your immune system into a chronic gouty state, possibly the only thing that’d help is hitting your immune system with a nasty course of corticosteroids or colchicine.
Even without any help from anti-inflammatory drugs, the worst bout of chronic gout will stop when there is no more solid uric acid for the immune system to get upset about anyway. And taking at least 60mg Uloric ought to get you clean sooner or later. Your next blood test will confirm that (if at all possible, get it done it in 4 to 6 weeks rather than in 10 to 12 weeks).

I would also not pick codeine even though it wouldn’t be the worst thing to take in your situation. I don’t want to recommend a particular analgesic considering the issues some people across the pond have with such drugs. This isn’t like Uloric which is a pretty uncommon drug. Most professionals do know their analgesics. If you explain the whole situation (which is why I laid out the three-part rationale for you above), you should get a decent recommendation from any compassionate professional.
And while I’m nobody, you have a name and so it may be wise (depending on your acquaintances) not to advertise on a public forum that you have a supply of the good stuff or even that you are planning to ask doctors for it.