Reply To: Just Started Allopurinol, Unclear on Follow-Ups

Stopping Gout Together Forums Help My Gout! The Gout Forum Just Started Allopurinol, Unclear on Follow-Ups Reply To: Just Started Allopurinol, Unclear on Follow-Ups

#8965
nobody
Participant


The mechanism for crystal dissolution is the same regardless of the drug you take (or even if you don’t take any drug). It’s primarily a function of temperature and of the amount of uric acid in your blood. If you have too much but not a huge amount, crystals are going to dissolve on a regular basis but you are never going to be rid of all of them.

0.40 is still too high. Granted, you had only started allopurinol and taken it inconsistently to boot. Test results also vary randomly so you need to do more. But my preliminary guess would be that 100mg is not enough allopurinol in your case. It looks like a small dose such as 150mg or 200mg might be sufficient however, at least if you are careful about your diet and alcohol consumption.
If the specialist would rather give you febuxostat/Uloric than have you try a desensitization protocol (see my earlier post), you shouldn’t start with more than 20mg (many doctors are clueless about this). Really, you should start with 10mg and increase to 20mg later but this may not be practical depending on the pills sold in your country. I think Uloric does come in round 40mg pills that look like they can be cut in halves or even quarters easily. So don’t let the doctor give you the troublesome 80mg pills if you can avoid it.
Allopurinol and febuxostat would the most straighforward way to cure your gout but, again, there are alternatives if they both prove unworkable. Best start by giving them a good try though!

About your plan for attacks, I would strongly recommend you inquire about taking more than two 25mg indocid tablets at the same time. If you get a nasty attack, you will need it (that or the prednisone)! I don’t think it would be a great idea to take a lot more than you’ve already been taking over the course of a day. I’m only talking about when the attack starts.
Doctors may want to give you a PPI (stomach protector) to go along with the indocid if you were to take a heavy dose.
Maybe also ask for a painkiller than doesn’t stress the liver like the acetamiophen/paracetamol you’ve been taking if you are going to try febuxostat/Uloric (that drug can be nasty on some people’s liver).