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


It sounds like you took way too much febuxostat. Besides the side effects, the main effect of a large initial dose (in a study, people who started with 10mg per days had fewer problems) would indeed be to give you weird joint pain/tenderness/redness as UA deposits are dislodged and move around.
Both allopurinol and febuxostat and xanthine oxidase inhibitors (XOI). Considering the side effects I can understand if you don’t want ever to take a XOI again. But it would be a mistake never to take a UA-lowering drug again. There are compounds which lower UA in common foods such as milk (the amount varies depending on the season, how the animals are fed and so forth) and you never got such reactions from foods, right?
Gout typically gets (much) worse over the years and 0.51 is high enough that there’s little chance to fix it without drugs so it would be reckless to avoid all UA-lowering drugs altogether. So the most obvious next step for you would be to get a UA excretion test in order to guess whether your kidneys could get rid of more UA without forming stones.
The 0.01 change in UA is just noise (you’ll need to get tested many more times) and your diet should obviously be improved further if you’re going to make do with a drug which only moderately reduces UA. This will take time.

Yes, colchicine will not give you attacks like UA-lowering drugs.
But in my opinion there is a risk of nursing a low-level attack for a long time if you don’t take enough to kill it off. I don’t know if there is a reason you should avoid large doses but most people can take a good bit more than 0.5mg per day for 1-3 days if need be.
The one week on colchicine, one week off plan doesn’t sound like a great idea. But it would be better than never taking it or taking it all the time.
How about choosing whether to take it or not depending on your symptoms rather than a predetermined schedule? Unfortunately symptoms react pretty slowly to colchicine so this ain’t easy. But you’d learn what usually works and what usually doesn’t with practice.
If you tolerate indomethacin well and as long as your attacks are infrequent, you could just use that and not bother with colchicine.