Reply To: Gout Recce Archive

Keith Taylor

My immediate thought is: “what dose of colchicine were you prescribed?”

There have been some very bad dosing practices. They should have died out by now. Also, colchicine by itself is rarely enough, especially once a gout attack has started.

It is perfectly wise to start allopurinol immediately, but you must do it right. Back in 2012, I published Start Allopurinol Quickly, But Carefully. Scientists had just proved that allopurinol could start during a gout flare. It makes no difference to immediate gout flares. But, the sooner you start allopurinol, the faster you get rid of gout. Unfortunately, there are also bad dosing practices with allopurinol. I mention them in that article.

With gout, it is never good enough to “have tried colchicine.” It is never right to simply “start taking allopurinol.”

Dose is vital.

Get dose right, and gout is easy to manage, and quickly controlled. Get dose wrong, and it might be useless, or even make gout worse.

Joy, I urge you to post more information about your doses of colchicine and allopurinol. Also, colchicine alone is not sufficient once an attack has started. What other pain relief has been prescribed?