Finally prescribed Allopurinal – What is Allopurinal?

Stopping Gout Together Forums Help My Gout! The Gout Forum Finally prescribed Allopurinal – What is Allopurinal?

This topic contains 2 replies, has 2 voices, and was last updated by  Patrick 2 years, 6 months ago.

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  • #1019

    Patrick
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    Ŧallars: Ŧ 106.86
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    I’ve been diagnosed with gout for about 4 years now and my doctor FINALLY put me on Allopurinal. A little backstory as I’ve told it before, but my Rheumotologist was reluctant to put me on Allopurinal because his thinking was I wasn’t getting more than 3 “severe” Gout attacks a year. We went back and forth every time I went to him to be treated, saying I was tired of this.

    Well I had 2 severe attacks that were within 2 months of each other (Dec and Feb) and after the last one in Feb, I went back to my regular MD and asked for all the previous annual physical blood work results he had and I brought those with me 2 weeks ago to my Rheumotologist.

    Since 2012 my Uric Acid results were as follows:

    2012- 8.2
    2013- 8.6
    2014- 8.8
    2015- 9.6

    See the trend? Well since the end of last year, I’ve made sweeping changes to my lifestyle and changed diet, alcohol, hydration, and really bumped up the exercise. The results were 8 lbs of weight loss (I weigh 165 lbs by the way) and my Uric Acid was 7.6. Not good enough for me or my Rheumotologist. He put me on 100mg of Allopurinol and 0.6 of Colchcine. He wants me to update my blood work in 5 weeks and wants a face to face in 6 weeks. I feel like “finally I can start to get this Uric Acid under control” after 4 years of begging.

    I read a lot on this site, as well as a few others so I kind of know what to expect in the upcoming weeks. Anything you all can think of would be appreciated.
    I learn a lot from the experiences of everybody here, and thank you for that.


    3 Weeks Wasted from Late Starting Allopurinol media

    How much time will you waste by delaying start of allopurinol therapy?

  • #1025

    Gout Patient
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    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!

  • #1026

    Patrick
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    Ŧallars: Ŧ 106.86
    GoutPal Scholar Badge Rank: Scholar

    Robert thanks for the kind words and the advice. I’m finally glad my Rheumotologist prescribed Allopurinol for me also. You are correct in your assumption that he is starting me off slow (100mg) and wants to see me again in 6 weeks with new blood screening results and discuss further treatment options. He discussed with me that if he didn’t see a significant drop in my Uric Acid, he would bump up my dosage to 200mg or 300mg, depending on where the UA was.

    He also put me 0.6 of Colchicine to help curb potential gout attacks. I’m hoping that will help so that I won’t go through what happened to you with gout attacks happening as the crystals dissolve.

    I’m hoping that my medications will help control my UA and I can go on leading my life the way I used to (with more knowledge of course). Thanks and good luck to you also

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