Allopurinol for Gout
Discussion
My GP has prescribed me 100mg Allopurinol. This came after a blood test which showed that the uric acid was 530mcmol/L (needed to be between 210 and 420). His advice was to take the Allopurinol alongside Colchicine for three weeks.
After following his advice and being moderately careful with food (the occasional pint of beer and maybe a prawn or two) I'm suffering with another gout attack. It's not as bad as previous attacks in terms of pain, but the joint is stiff and very sore from the flare up.
I understand that taking Allopurinol can bring on an attack and I'm wondering if this is it, or is it just the price I'm paying for not being careful...
After following his advice and being moderately careful with food (the occasional pint of beer and maybe a prawn or two) I'm suffering with another gout attack. It's not as bad as previous attacks in terms of pain, but the joint is stiff and very sore from the flare up.
I understand that taking Allopurinol can bring on an attack and I'm wondering if this is it, or is it just the price I'm paying for not being careful...
k me, I'm crawling around the house to get around - can't put any weight on it whatsoever. 
Paul Dishman said:
Glassman said:
Can't say anything has changed much recently (other than an on edge, preggers wifey!). I'm not even sure this is gout but it's pain with an industrial 'P'
Ask your doc if you could increase your allopurinol dose to 300 mg per dayGP said that 100mg was starting high (with a view to reducing the dose after a review)
garyhun said:
Are you on the allopurinol?
I've been on it for 6 months now and have had zero attacks of gout.
I started on 100mg but blood tests showed it was too weak a dose for me so went to 200 and then blood tests showed by uric levels as normal.
If you have not already I really recommend it. Hope your attack is over quickly
Yes - been on the drug since July 2010. Have been attack free since; one or two twinges along the way but nothing even close to pain. I've been on it for 6 months now and have had zero attacks of gout.
I started on 100mg but blood tests showed it was too weak a dose for me so went to 200 and then blood tests showed by uric levels as normal.
If you have not already I really recommend it. Hope your attack is over quickly
Until last night.
garyhun said:
It's rather crazy that there is no standardisation for this. My Dr was great and said each prescription would cover 2 months worth to save me money 
Interesting point; I get 48 tabs per prescription. It's a bit annoying that I also have a repeat prescription scenario for Omeprazole. Payment is per meds, so 'sticking them on one prescription' carries no benefit. 
GP has thrown a bit of a curve ball at me this arvo.
Went in to collect some painkillers and antibiotics (not gout related) and as she was writing out the prescription she asked the usual questions, at which point I reminded her that I'm on Allopurinol and Omeprazole. She then said that while I'm on this course of anti inflams/painkillers/antibiotics, I whouldn't take Allopurinol BUT, I shouldn't really be on them unless I'm prone to frequent attacks??
I think I need a review with a specialist.
Has there been a development/new news about Allopurinol?
Went in to collect some painkillers and antibiotics (not gout related) and as she was writing out the prescription she asked the usual questions, at which point I reminded her that I'm on Allopurinol and Omeprazole. She then said that while I'm on this course of anti inflams/painkillers/antibiotics, I whouldn't take Allopurinol BUT, I shouldn't really be on them unless I'm prone to frequent attacks??
I think I need a review with a specialist.
Has there been a development/new news about Allopurinol?
I would get between one and three SEVERE attacks a year. If I count the mild ones (which felt like bruising, but definitely were gout attacks) I'd say I was averaging maybe four or five a year.
The severe attacks were unbearable. You feel like you're about to drown from having so much water in you (trying to 'flush' it out) and the pain killers just don't seem to work at times. A full-on attack almost comes with its own obligatory time which must be endured before the pain/inflammation begins to subside.
Since being on Allopurinol, I have not had an attack. But there have been one or two half attacks (and they're usually preceded by a heavy session of drinking a particularly hoppy new beer, or some industrial scale debauchery).
To be told that I shouldn't really be on Allopurinol is like asking me to play Russian Roulette!
The severe attacks were unbearable. You feel like you're about to drown from having so much water in you (trying to 'flush' it out) and the pain killers just don't seem to work at times. A full-on attack almost comes with its own obligatory time which must be endured before the pain/inflammation begins to subside.
Since being on Allopurinol, I have not had an attack. But there have been one or two half attacks (and they're usually preceded by a heavy session of drinking a particularly hoppy new beer, or some industrial scale debauchery).
To be told that I shouldn't really be on Allopurinol is like asking me to play Russian Roulette!
jonah35 said:
Sorry to hear of your issues glassman. However, squid, praws, pork, lager and red wine??!!
Started the evening with a couple of beers. We got through our starters and then I switched to wine to have with the main. Classy, me.
TwigtheWonderkid said:
A work colleague's father died of the side effects of allopurinol. Without going into horrific and alarming detail, basically his skin went to hell in a handcart. Once the process had started they were powerless to stop it.
Oh, ok. 
garyhun said:
You can get a whole load of other stuff direct from Cherry Active - http://www.cherryactive.co.uk/
Gary, which form(s) are you taking?
Allopurinal didn't work for me. The next step would have been to increase the dose which made me step back from it. I suffered a few flare-ups meanwhile and the intensity seemed to increase.
Five months ago (for several other reasons) I decided to switch to a predominantly plant-based diet and I can say with a degree of confidence that it has made a difference. I still get a flare-up but it's more of a manageable twinge rather that acute pain and swelling.
If I knocked alcohol on the head...
Five months ago (for several other reasons) I decided to switch to a predominantly plant-based diet and I can say with a degree of confidence that it has made a difference. I still get a flare-up but it's more of a manageable twinge rather that acute pain and swelling.
If I knocked alcohol on the head...
Update:
Over a year on and it's still going well. Still mostly plant based with occasional fish/eggs and the odd bite of a piece of chicken when the kids are tucking in.
Acute flare-ups: none.
Slight hint of gouty pain: occasional.
I'm not stocked up on Colchicine as much as I once used to be and wouldn't dare to be without. I have Ibuprofen to hand just in case, but I've only ever reached for it after a particularly physical footy match. Overall, my joints do not ache like they used to when I was chowing down on meat two or three times a day. My diet is now 90-95% meat free and it seems to be the difference.
Fingers firmly crossed and touching wood etc.
Over a year on and it's still going well. Still mostly plant based with occasional fish/eggs and the odd bite of a piece of chicken when the kids are tucking in.
Acute flare-ups: none.
Slight hint of gouty pain: occasional.
I'm not stocked up on Colchicine as much as I once used to be and wouldn't dare to be without. I have Ibuprofen to hand just in case, but I've only ever reached for it after a particularly physical footy match. Overall, my joints do not ache like they used to when I was chowing down on meat two or three times a day. My diet is now 90-95% meat free and it seems to be the difference.
Fingers firmly crossed and touching wood etc.
The Ferret said:
Have you had your uric acid levels checked in the last year though?
I've said it many times, maybe not on this thread but certainly on others, unless your uric acid levels are brought under control then the silent damage is still a risk, and the risk is far more serious than the pain in a big toe once or twice a year.
The fact you occasionally still get a hint of gouty pain would suggests your uric acid is still high.
By all means go plant based, but at the same time get those levels checked for peace of mind.
I'm trying as much as I can to not depend on meds. I've said it many times, maybe not on this thread but certainly on others, unless your uric acid levels are brought under control then the silent damage is still a risk, and the risk is far more serious than the pain in a big toe once or twice a year.
The fact you occasionally still get a hint of gouty pain would suggests your uric acid is still high.
By all means go plant based, but at the same time get those levels checked for peace of mind.
HotJambalaya said:
I'm on allo, 200mg daily, havent had a flare since I started until one looked like it was about to happen 2 days ago. Have an emergency prednisone prescription for when it happens (had to get it renewed since I'd thrown the last lot out since I'd never needed it!), 5 day course, stopped after 2 days all fine. Levels checked last month, right where they want it to be.
I'm not a huge beer drinker anyway, but I limit myself in no way whatsoever with what foods I eat and enjoy, apart from currently trying to get a bit fitter. I'd rather take the meds then eat mushy peas on toast the rest of my life. Working back what I ate the last few days when my flare up occurred it seems that in particular for me dehydration is my biggest cause. I remember thinking a few days ago while taking a wizz that I needed to drink more water that day.
Having said that I'm actually going to oktoberfest this year, and there will be a fair bit of beer consumed. Lets see....
I've been on Allopurinol. I got the big flare up they warn about when you start. Six months later, I got another. GP then suggested upping the dose which made me think hard about the way forward. I'm not a huge beer drinker anyway, but I limit myself in no way whatsoever with what foods I eat and enjoy, apart from currently trying to get a bit fitter. I'd rather take the meds then eat mushy peas on toast the rest of my life. Working back what I ate the last few days when my flare up occurred it seems that in particular for me dehydration is my biggest cause. I remember thinking a few days ago while taking a wizz that I needed to drink more water that day.
Having said that I'm actually going to oktoberfest this year, and there will be a fair bit of beer consumed. Lets see....
As you say, they biggest factor here is hydration. You can do yourself a big favour by drinking water and plenty of it. It's not always practical, especially during the colder months (speaking for myself).
My diet/staple isn't boring. I have quite a wide range of food that I enjoy. Yes, the meat and meat products element has all but gone, but sometimes eggs and fish maybe once a week. I'm enjoying my cooking and I'm planning meals more than I ever did (it's also very cost effective and less wasteful).
Age becomes a factor too; at 52 (or 43 + VAT) the inevitability of change is becoming more and more apparent. That said, diet isn't the only lifestyle change. I'm still playing sport and still in a physical job. Not being ruled by gout (and the attacks used to be quite frequent) means I am enjoying life a lot better without that affliction. The mild flare-ups usually come after a heavy sesh over the weekend.
HotJambalaya said:
I just dont really get that, unless you were having proper side effects from the allo, (and im not talking about the initial flare that some people get going onto it) why would you panic about the dose being adjusted according to your needs?
Decided that I would rather not rely on meds if I could. Gassing Station | Health Matters | Top of Page | What's New | My Stuff