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Allopurinol and gout attackes

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Guest

Hi. Any help or advise would be really appreciated please. After having regular gout attacks my doctor has put me on allopurinol. I had to take colchicine for 2 weeks before I started taking one tablet (100mg) of allopurinol per day. I had to continue on the colchince along side the allopurinol for a further 2 weeks in case the allopurinol caused a gout attack (which it did) I had numerous attacks in two months but had no pain relief from the doctor except paracetomal. I had a blood test after 2 months on allopurinol then the doc raised the allopurinal to 200mg per day, still didn't prescribe additional pain relief. I am due another blood test in early december but i'm not sure i am going to continue on the allopurinol as the attacks have been constants since i have been taking 200mg. I have had severe attacks in my toe, then ankle, most recently in my keft elbow and index finger, which were both inflamed and painfully unbearable. my finger was so swollen i went to nhs direct who prescribed diclofenac. when this attack was finally subsiding the gout decided to attack my right shoulder , after speaking with nurse at my doctors surgery i was prescribed dihydrocodeine, along side paracetamol and ibrobrufon. I know i have come a long way on the allopurinol but the thought of the doctor raising the allopurinol again after my next blood test brings me out in a sweat. I don't know how much longer i can bear the pain. I am getting anxious, short tempered and basically quite depressed now. any advise would be really, really appreciated. Thanks.

SYFY

6 likes, 116 replies

116 Replies

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  • alan1951
    alan1951 Guest

    Posted

    I, too, have gout.  I'm a 5' 9" male, and I used to weigh 180 lbs, which put me over the threshold of normal weight by 20 lbs.  Doesn't take much excess weight to trigger a gout attack.  I confess.  It took me TWO  YEARS to lose those 20 lbs., but after I did, my uric acid level dropped to five.  My doctored monitored me, and subsequently gave me the okay to lower the dosage of allopurinol from 300 mg to 150 mg.  I had severe tophaceous gout.  I'm now fortunate enough to take a maintenance dose.  NOW PAY ATTENTION:  If you decide you might want to try losing a few lbs. (not saying you need to lose a few), talk to your healthcare practitioner first.  [u]AND[/u] ... LOSE THE WEIGHT [u]SLOWLY.[/u]  Best of luck to you.

    • rustygecko
      rustygecko alan1951

      Posted

      Have all the tophi gone?

      Congrats on the 20 llb. It ain't easy. I have lost 23 lbs and in an ideal world I'd lose 30 more to bring me down under BMI 25. It's taken 3 years!

  • david49690
    david49690 Guest

    Posted

    S7rprised to hear that you're only on 100mgs daly. The psuggersted dose is 300 to 900 mgs daily. Yes, if you've followed rusty gecko's chat with me. it appears that the allopurinol will disturb uric acid crystals from around your system for a long time unitl  a balance is reached. This last few days I've had pain around my knee joint; in my kneecap, in ll my toes amd my left elbow joint. This, apparently is to be expected as crystals become detached and drop into joint hollows around your system. My doctor only prescribes 12 colchicin tablets each time as they are very toxic and with high usage will give symptoms similar ot what our daughter had with aggressive leukaemia. So watch the colchicin and speak to your doctor about your allopurinol dosage. I'm sure rusty gecko will tag onto this and give you further advice. Hang on in there; as after more than 20 years, in spite of what I've said, my gout seems under some control. It also helps if your GP is a fellow sufferer!!!

    David

    • rustygecko
      rustygecko david49690

      Posted

      100 mg a day is a good dose to begin allopurinol - just to check that you aren't genetically allergic to it. I would even think for the super cautious cut them in half for the first few days. Be aware though that among Caucasians few have the dangerous skin allergy. Once you've been on it a few weeks - get a blood test and see if it's working. You want to see the uric acid well down, not just sneaking under 6.

      As for colchicine - my doc gives me 100 tabs at a time. As long as the patient is sensible and aware of the risks they're ok. Use a couple a day to take the edge off an attack. Don't use more and don't use them for an extended period.

      And drink plenty of water!

  • arne60008
    arne60008 Guest

    Posted

    Take colchicine 2 first hour 1 every hour no more then 9 you well get flu type syptom then you well start flushing it out youll get diaherria believe me it works fast or suffer.
    • rustygecko
      rustygecko arne60008

      Posted

      That number of 1 per hour may well work. However I read some research showing that that gives lots of people stomach upsets and that a lower rate had less stomach problems. I have a feeling it's a bit of a gamble.

  • Bigfrank
    Bigfrank Guest

    Posted

    I have had gout for over

    20 years now .I take allipurnol and moloxicam also I take 2 devils claw and this helps a lot .had my first gout problem last week forgot to take my pills.....hope this helps anyone cherry juice and devils claw helps bigfrank

  • mary33461
    mary33461 Guest

    Posted

    I’ve been diagnosed with gout but can’t take any anti inflammatory or most pain killers and was put colchicine for a 3 days with a anti inflammatory rub but never helped .. foot was so swollen at the top and base and hot to touch  .  Ended up in a&e and was put on steroid prednisone  for a 5 days course of 80mg .. which helped but within a few days a severe gout attack again .. this time doctor put me on 18 day course of steroids with a gradually lowering the dose .only had one slight attack but rested threw out the 18 days so  Felt great apart from wanting to eat everything! But tbh I could of done with putting weight on, started allopurinol 100ml but another attack of gout just after a week so been put back in 18 day course of steroids predisolone .. with lowering the dose gradually again .. I’m normally such a strong person who is made of granite so I’ve been told but this pain is so unbearable.  I’ve bought cherry juice also . & I’ve never been a big drinker .  I’m not saying I’m tea total .. I have a drink on holiday , birthdays and Christmas but in moderation ..  I so hope your gout is at bay and enjoying life again .  Take care xx

    • rustygecko
      rustygecko mary33461

      Posted

      You should have been warned that in the short-term allopurinol will increase the number of gout attacks as it flushed stored of crystals out of your tissues. Regardless of these attacks you should continue with allopurinol as this is the solution.  Also it is unlikely that 100 mg is enough and they should be testing your blood regular with the idea that you’ll probably need 300mg a day at least for the first year or so.

      You should also be told to drink lots of water - this helps your kidneys to flush out the urate. 

      You should avoid sugars but especially fructose (sugar is 50% fructose), and high fructose corn syrup. Avoiding foods like bread and things with yeast in helps some people. Once you’ve been on allopurinol for six months you can probably eat most things as they allopurinol will have flushed you out of high blood urate by then.

      If you have an attack people of find relief from cold water / ice packs or hot water on the joint or a combo of both.

      Colchesine is not an anti inflammatory in the same way that say ibuprofen is, but it will reduce the attack by the immune system on the joint. It upsets people’s intestines though if they pass a certain dose. If you could take a little that could help you.

      Being at a good weight (not obese), is good for your gout.

      Good health. 

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