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This is a familiar story. I was the same re allopurinol. I stopped but a few years later I developed sub-acute gout. Almost constant low level pain with some acute episodes. Fact is you’ll need to be in some for of UA lowering therapy at some point.
Regarding dosage, your originally quite high UA level would suggest 300mg is a decent dose and UA level of 300 is better than 350. Also from a practical aspect a single 300mg allopurinol tablet a day is easier to manage with a busy lifestyle.
There is evid nice if breakthrough attacks with initial dosage increases but this indicates UA lowering therapy is working. Crystals breaking up shed their protein ciast and reexpose themselves to your immune system, hence the flares. My advice is to see a rheumatologist. They are experts in this field and their experience is invaluable.
Btw I’m a clinical biochemist and I thought I’d handle my gout alone, I still do my own bloods but clinical input is very helpful.
Wrongly prescribed allopurinol and now stuck on it
I was diagnosed with gout at age 26, female and was vegan at the time, pretty healthy diet. I was told that it’s genetic, and I do have a family history of gout amongst other kidney problems. After diagnosis, I was given anti-inflammatories which helped reduce the pain and inflammation and going to my follow-up appt my regular doc was on holiday. The fill-in doc told me I needed to take allopurinol to reduce the uric acid in my body and silly naive me didn’t think to get a second opinion. I was given a 100mg dose and that didn’t work.
While I tried that for about three months I also went to a naturopath and tried copious amounts of supplements, herbs, cherry juice, you name it, to no avail. Finally, my regular doc sent me to see a kidney specialist, and he told me that I should never have been put on it in the first place but now I’m on it and there’s nothing else I can do. He upped me to 300mg/day and that’s worked to keep my uric acid down just fine. However, I’m now 33 and just sick of being reliant on a drug that I shouldn’t need to take. I don’t have any gout symptoms, except for when I try to wean myself off the meds and then I get a small flare-up. Is it worth the risk of increasing my uric acid levels to get off the meds? Also, I would like to try to eliminate the foods that are triggers for me, but how can I do that while I’m taking the allopurinol and have no symptoms? Rock. Hard place… Any advice greatly appreciated!
What do you do if allopurinol is prescribed wrongly? Change your doctor, your prescription, or your treatment plan? Get recovery from bad allopurinol dosing
Gout Necessities: Mitigare cheaper than Colcrys
I was misdiagnosed several times with gout. Many trips to the ER that were either a sprained ankle or sprained toe. I will keep this short and sweet. If you have gout the necessities are Mitigare, (brand name of colchicine) as my insurance will not cover colchicine or Colcrys. Methylprednisolone Steroid pack. This will stop gout in in tracks. For me, it was within 8 hours. I have started on Allopurinol 300mg per day and have not experienced any gout symptoms at all or any side effects, regardless of diet or alcohol intake.
I would recommend you keep these drugs on hand so that you are not immobilized or wheeling yourself around in your office chair or crawling on the floor because you cannot walk. Which I have done many times.
Don’t needlessly suffer, my final gout attack put me down for 3 weeks and I thank the folks at the ER and my doctor for treating me with the correct drugs, and having prescriptions on hand so that I don’t needlessly suffer! It has been a God Send.
Pain relief is a necessity for gout sufferers. Colchicine is best but Colcrys is expensive. Get Mitigare – the same gout drug. Now pay less for colchicine.
Colchicine Proper Dosage
My doctor gave me a prescription for colchicine.
It was take 2 capsules wait one hour and take another one.
Wait two days and repeat dosage.
Your website says to take no more than one capsule a day. So, my dosage would be considered a high prescription.
I just want to be sure that I have the right information.
What is the proper dose of colchicine? The doctor says take colchicine every other day. But you say take it every day. What is the proper Colcrys dose?
Thanks, Keith! Appreciate your response. I did have bloodwork done when I went for initial diagnosis a couple of weeks ago. At that time, the Dr. said uric acid level was 6.9, kidney function slightly elevated and to drink more water(I already drink 8-10 glasses a day). Anyway, I called her last Tuesday about the rash, and she advised me to stop taking the Allopurinol for a week, but to continue the Colchicine. I am into the 5th day without the Allopurinol, still have the rash, but, it is not quite as itchy and is not spreading any further. Will contact her again in coming week, and go from there. I do wish there was a good natural way to get rid of uric acid. O well, maybe one day. 🙂
I am a 65 yr old “gouty” woman(6.9 uric acid level). For the past 2 weeks, I have been on allopurinol(100 mg twice a day) and colchicine(once a day for next 3 months). The past 4 days I have experienced tiny, slightly itchy bumps breaking out on my back(I never have skin breakouts), which began on my lower back, and now have moved to include upper back. It isn’t severe, but annoying, and somewhat uncomfortable. Could it be a reaction to allopurinol, and should I stop taking it and call my doctor?
Thanks for this site, Keith!😁
I have had gout for over 30 years and consider myself to be an expert on the subject. I was doing research on the long term effects of taking allopurinol when I came upon your discussion. I am simply offering up advice to someone that is suffering.
When I speak of relief, I thought I was clear that relief came in the form of lowering my uric acid level to that recommended to people with gout. (5mg/dl) Sorry if I implied it was analgesic, which it clearly is not. Allopurinol is in a class of medications called xanthine oxidase inhibitors. It works by reducing the production of uric acid in the body. High levels of uric acid may cause gout attacks or kidney stones. Allopurinol is used to prevent gout attacks, not to treat them once they occur.
Keith, I dont mean to say you’re naive, but to say that generic drugs are the same as brand is just not right. Please see this article: http://www.theatlantic.com/health/archive/2015/03/generic-drugs-the-same-but-not/388592/ as well as many others that can be found, that explain exactly why generic drugs are NOT the same.
All I know is that when I started taking the brand (and I am not endorsing or being paid by Walgreens or Sabela), my serum level dropped to 5mg/dl, as recommended by doctors, and gout attacks stopped. Whereas with the generics, it was always borderline high, and I continued to have attacks.
I would just like to add that I have been taking Allopurinol for years and only gave me minimal relief with attacks every month or 2. It only started working when I switched to the brand, (non generic) Zyloprim. When I took the generic, I still had uric acid levels that were borderline high and I was taking 200mg. Currently, I take 200mg of Zyloprim and haven’t had an attack in over a year. The only problem is my insurance doesn’t cover it and its expensive. From my point of view, worth it. I hope you can afford it.
I think that Milk being mostly water, drinking it regularly probably flushed out uric acid from your system, or prevented dehydration. Stopping drinking milk probably increased your uric acid concentrations and therefore your gout. With regard to the recent attacks, these could be due to you uric acid levels dropping as a result of restarting your milk consumption.
uric acid blood: 4,6 mg/dL (normal:2,6 a 6,0 mg/dL)
urine uric acid:1.124,6 mg/24 hr (normal: 250 a 750 mg/24hr)
I have been using allopurinol 300mg for 1 week, I have had no Side effects
I just got 30 Colchicine 0.6 mg for $9.11 CDN. I live in Canada. I hope that Trump can sort out your medical systems in the USA.
28 yrs. old and has had gout 2 yrs. His last test levels were at 6.0 but has been as high as 9.. He takes alipurinol daily 400mg. and when he has acute spells takes colcrys. The affected sites are mostly in his knees. It is because of his diet as he has always been a huge meat eater. Mostly chicken, lean pork and occassionaly beef. Eats a few different veggies, but it is impossible to make him eat less proteins and more veggies. He has reduced caffeine and high fructose corn syrup. Any helpful advice would be appreciated.
Original posted by Carol:
Only uric acid in urine is high and knee swelling intermittently
Hello, I’m Brazilian and since I was 14 years old (I’m 30) I had 3 episodes of intermittent knee swelling, which lasted 1 year.
The bumps are painless, most of the time, but I feel pain in some movements. The only thing I feel different is an increase in body temperature while sleeping, before the knee swells. They swell the most at night.
They become swollen 3-5 days and after 7-10 days, itch again, non-stop.
All the tests gave negative for rheumatological factors, negative reactive protein, this year I did arthroscopy in the 2 knees for the removal of synovial plica, but nonetheless they continue to swell.
No doctor knows until today that I have.
I already took anti-inflammatory and colchicine for 1 month but did not improve.
My blood uric acid always gives 4.3, but I always found my urine cloudy and with the strong odor, so I requested the urine uric acid test and gave very high: 1,200. I’ve already done 3 exams and they always go high.
I am healthy and I follow a diet that has low purine. I do physical exercises 6 times a week, but the swelling limits my movements.
I began to use colchicine and I will start today with alopurinol 300mg.
I wonder if it can be a type of gout, with little pain, be intermittent and only with high urinary uric acid.
I hope you help me.
Original post by Johan
Midfoot Gout Problems
Had to visit a top foot specialist in South Africa this week.
Reason was the severe pain inside the top of my right midfoot.
Now, this has been ongoing for most of my adult life – am turning 62 soon.
Even this extremely experienced gentleman did not have an explanation of why the cartilage in this area has disappeared or why there are holes in my cartilage.
All I can say is that I had suffered from gout in this foot in all its forms for years.
Fourteen years ago(cannot believe it was that long) I was infected with an Aureus virus from a doctor’s injection for the start of a gout attack. Fortunately, I survived that incident. But it destroyed a lot of the tissue in the area and caused damage to the cartilages.
So now I am destined for foot surgery with a painful recovery period of at least 6 months. It is also a very expensive procedure. Don’t even mention the word uncomfortable. Just Google midfoot surgery on Youtube. You’ll probably faint.
The reason why I mention all of this is to warn you against the probable long-term consequences of gout attacks which our doctors conveniently forget to inform us off.
ANY infection of ANY sort between two joints must be considered the same as you would view a heart attack.
Please don’t play around with uric acid levels and such. Later in your life, you just might regret the decisions you made when you were young.
I’m not 100% sure on the exact date, but it’s definitely between the last two tests, when I went to see my GP about the serum urate level. So, I reckon towards the end of August.
I’ve maintained a good diet: no alcohol and a reduction in meat consumption. I should probably drink more water, however..!
I’m going to remain on the 400mg Allopurinol, take Naproxen as necessary and have another blood test in January unless something goes wrong. I’m surprised there is still some swelling, but it’s not much and just a little bit sore from time to time.
Ok, an update on some tests:
05 Jul 16 Serum urate level 526 umol/L
28 Jul 16 Serum urate level 309 umol/L
19 Aug 16 Serum urate level 337 umol/L
17 Oct 16 Serum urate level 267 umol/L
So, looking good currently, but my foot’s still been a little painful and slightly swllen too. Currently taking 400mg of Allopurinol per day.
Any thoughts/advice please?
Thank you, Keith. That was immensely reassuring. I just didn’t understand what was happening to me. I did believe that the Uloric was going to make me better, but couldn’t understand how the dissolving crystals were making me have the pain. Now I understand, thanks to you.