Is my allopurinol dose correct?

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This topic contains 1 reply, has 1 voice, and was last updated by  Keith Taylor 1 year, 10 months ago.

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  • #2278

    UK Gout Patient

    A friend told me that I should check that my allopurinol dose is correct. My doctor prescribes 300mg allopurinol per day. This seems fine for me, as I have had no gout symptoms since I started taking allopurinol.

    I have an appointment with my GP today. What should I say to him to make sure that I’m taking the right allopurinol dose? Also, is my friend correct? Why should I worry about allopurinol, when I have no gout symptoms?

  • #2279

    Keith Taylor
    Ŧallars: Ŧ 1142.19
    GoutPal Scholar Badge Rank: Scholar

    The best thing is to get your uric acid test result history from your doctor. Then, keep notes of your results every time you get it checked. You should get a uric acid test at least once a year, or more frequently during treatment changes. It’s important to maintain annual tests, even if you have no symptoms. I’ll explain why in a moment.

    When you have accurate numbers, you have something to discuss with your doctor. Your target uric acid level should always be below 0.30mmol/L (5mg/dL). Increasingly, UK GPs know about professional rheumatology standards. The standards explain that 0.30mmol/L target. But, please note that some UK labs report μmol values. In that case, your target is below 300μmol/L. (see multicolored table in the sidebar, for more information about uric acid ranges)

    For some gout patients, 300mg allopurinol daily is the right dose. But, only if it achieves your personal uric acid level target. In the world of gout, we have a bad history of doctors prescribing 300mg allopurinol as a standard. This is wrong, as all gout treatment must be planned around each individual patient’s needs. You can read more about that at 300mg Allopurinol: What is Gout Myth #2.

    In that article, there is a link to the British Society of Rheumatology UK Gout Management Recommendations. Most doctors will have that information to hand. But, you can print those official guidelines out, if you wish. It can be awkward telling your doctor about information you find on the Internet. However, this is a professional report aimed at frontline doctors. My own GP thanked me for pointing out the information to him. In my case, I simply mentioned it’s existence, and my doctor accessed it immediately.

    Finally, “Why should I worry about allopurinol, when I have no gout symptoms?”
    Uric acid deposits build up very slowly. And so, you can go for several years without a gout attack. But, if uric acid is higher than your safe level, gout will eventually hit you seriously. Now, it might be that, when you check your actual results, you have nothing to worry about. But, if your uric acid test results are higher than 0.30mmol/L, you might have a problem.

    I attach a lot of importance to this, mainly due to experiences of friends. One friend, in his 80s, never had proper gout treatment, in my opinion. He took allopurinol every day for many years. He thought he was doing everything right. Then gout attacks started again. Unfortunately, this is much harder to deal with in your 80s than it is in your 50s. His tears drove me to anger. Hence, I’m sensitive about this issue.

    It only takes a few moments to make sure your uric acid level is safe. Many doctors understand the issue. And, they manage this for you. But, there are still many doctors who have not yet heard of current rheumatology guidelines. So, we have to take responsibility for managing our own uric acid levels.

    I hope your uric acid is safe. Please report back when you get your test results. And, let us know what your doctor says about safe uric acid levels.

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