January 14, 2021 at 3:34 pm #10274
I’ve suffered with gout for about four years, but recent bouts have driven me to the doctors who prescribed Allo, but i developed the rash.. currently waiting to be 4 weeks gout free to start febuxostat and see if that works..
I’ve been reading this forum for three days solidly and just wanted to express my feeling of joy at finally finding somewhere with decent info.. I’m not sure who runs this site and forum.. but thank you for your hard work.
January 14, 2021 at 7:55 pm #10275nobodyParticipant
We’re Keith’s guests. But whether Keith actually is some dude, a kind of collective or an alien from outerspace I do not know.
You don’t need to wait to be gout free to start febuxostat. If you frequently have long periods with no gout symptoms, OK. But don’t keep waiting and waiting if your gout comes back several times.
It makes sense not to start it immediately after having developped a reaction to allo anyway but 4 weeks seems excessive. Then again, if your symptoms are infrequent, there’s no rush.
If you also get a reaction to febuxostat, there are other options still but they are a lot less straightforward than allo and febuxostat. So I would recommend giving febuxostat the best chance you can… which means starting with a much smaller dose than doctors typically recommend and increasing it progressively. Since you know you are prone to reactions, best give your body a chance to get used to the stuff instead of shocking it with 40mg or some other brutal dose.
January 14, 2021 at 10:49 pm #10276
Thanks for the reply.. so if I said my doc started me on 300mg of allo daily would that sound weird? I haven’t checked the mg on the febux yet to see what it is, but it says one tab a day..
I was told that I had to be 4 weeks gout free before I could start taking the febux.. I’m currently on colchicine trying to calm this flare up, so that I can start counting the four weeks down.. tbh my doc has been asking me what I’ve read so far on the forums so it’s not a great confidence booster.. 😂. He told me the four weeks was for my UA levels to reduce after an attack, as the allo or febux could cause another attack if my count was still high..
Another doc I met told me to keep taking 1000mg of colchicine while I started the allo.. this is the first forum I’ve seen with any good advice so I’m all ears..
January 14, 2021 at 11:42 pm #10277nobodyParticipant
Starting allo with 300mg is… not what guidelines say you should do. It’s like driving without a seatbelt or something… probably fine in most cases but the guidelines aren’t making the procedure more complicated for nothing.
That explanation about waiting for your UA level to reduce makes little sense to me. No matter. Waiting some does make sense anyway, for different reasons. And it’s probably not worth picking a fight with your doctor over the number of weeks.
The drug will require a long time to do its work anyway.
The pitfall would be to wait, wait, and wait again as the clock is reset by one attack after another. Don’t wait forever is all I’m saying. While that’s not ideal, you can start in the middle of an attack if you need to.
Hoping you don’t suffer another attack is not a strategy so instead of trying to lower the odds, I think you should focus on how to deal with a serious attack, just in case.
1mg colchicine (you must have meant 1000 micrograms) was never enough to deal with my attacks. And sure, most people can take that every day when they start allo or febuxostat. It works to prevent attacks, or at least to make them milder.
But once an attack has settled in, anti-inflammatory drugs such as ibuprofen is what people typically take. Even if you can get such drugs without seeing a doctor first, I wouldn’t recommend it because this drug class is actually quite dangerous. Instead, I would dicuss with a doctor the following:
-can I take an NSAID on top of colchicine and febuxostat, and if so for how long without a break?
-should I be taking a coxib instead of a traditional NSAID and should I be taking a PPI as well in case I need to take that NSAID for longer than X days?
and most importantly you should ask: if the attack turns out to be really bad, what’s the absolute maximum I can take during a single day? When you ask that last question, swear you won’t take that dose two days in a row!
I don’t know your medical history and so forth and I’m not even a doctor so I’m not going to answer these questions. That’s just what I’d discuss with my doctor if I wanted to be prepared.
January 15, 2021 at 12:41 pm #10278
Thanks for the reply, off the back of your comment i have found several papers and trials which do state that its safe to take febux during a flare, I’ll check with the doc that hes delaying me for a different reason, otherwise i’ll get started. I don’t want to wait until i’m clear as this has been ongoing continuously in one form or another since November.
You are also correct about dosage, I’m taking 2000 micrograms a day of colchicine, and am allowed to take up to 4 x 400mg of ibuprofen during a flare up which i’m doing now.
I’m going on the 27th jan to have full bloods done, and until then have ordered a home UA test kit to see if any of the readings i get at home correlate to my results.
I’ll check with the doc re the cobix vs nsaid.
many thanks for your input again my friend.
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