Reply To: Should I start allopurinol now, or wait until all pain is gone?

Stopping Gout Together Forums Help My Gout! The Gout Forum Should I start allopurinol now, or wait until all pain is gone? Reply To: Should I start allopurinol now, or wait until all pain is gone?

Gout Patient

Patrick, Glad to see you were finally given meds after your suffering was needlessly extended. Anyone who thinks up to 3 gout attacks per year is acceptable has never had a severe gout attack. There are a lot of theories about starting allopurinol. Some say you should start out with 100mg/day and slowly increase, with the theory being that gradual increases may prevent gout attacks that sometimes occur when starting allopurinol. Some say you should start out considerably stronger to start having the crystals dissolve sooner. Read up on the prescribing info. From the document I have, the min effective dose is listed as 100-200mg/day; average dose for mild gout is 200-300mg/day and average dose for moderate to severe tophaceous gout is 400-600 mg/day. Max recommended is 800mg/day, and it is suggested that requirements for over 300mg be divided into multiple doses. Sounds like your doc is starting you out slow, and will want to monitor not just your uric acid level after this, but also check for any liver or kidney problems to make sure your body is handling the allopurinol ok. I assume he will then increase the dosage if all is ok. The dose that is actually correct for you is the one that gets and keeps your uric acid level at a point where your gout is reversed, and then the maintenance dose should be one that keeps the UA level to where the gout cannot form crystals again. While all gout cases are different, in my case I had it for several years and it became almost constant, striking at least every month for 9 months straight and lasting at least 50% of the time. So I was virtually out of commission. When I started taking the allopurinol 4 months ago, I actually got some pretty bad attacks that didn’t go completely away for 3 months, so I have only been without gout now for about a month. Finally they stopped and I think I am out of the woods now. From what I understand, for some people, as the uric acid leaves your body it causes your immune system to respond similarly to when it built up in your body. So it actually causes what feels the same as a gout attack. It takes time to clear all the stored up uric acid out of the tissues and joints. Once that (hopefully) happens then you are finally free. It is at first depressing, thinking the meds are not working, but if you know what is really happening, then it gives you strength to carry on knowing that you are really getting better and that it will eventually stop; it just doesn’t feel like it yet. Best of luck to you!