GoutPal Interactive

I've tried the allopurinol and haven’t had much success, the attacks just keep coming… and I’ve been told to get off of the indeosin, because it will have a bad effect on my kidneys if that’s my only source of treatment… and basically it is.  I live near the Wheaton Md area and could use some advice and direction.

Thanks

Post edited 2:09 pm – June 3, 2009 by GoutPal

Lawrence said:

I've tried the allopurinol and haven’t had much success, the attacks just keep coming… and I’ve been told to get off of the indeosin, because it will have a bad effect on my kidneys if that’s my only source of treatment… and basically it is.  I live near the Wheaton Md area and could use some advice and direction.

Thanks

You need to be aware that allopurinol is for long term treatment of gout, and it has one function – to lower uric acid levels.

Control of uric acid is vital to gout sufferers – it is the only way to prevent more uric acid crystals forming, which will cause crippling joint damage if you do not do anything about it. Allopurinol is the best way to control uric acid, but there are two important considerations:

• As with all uric acid lowering treatment, you will have a period of time where gout flares continue as old uric acid crystals dissolve.
• Dosing is vital – you must take enough to lower uric acid below 6mg/dL, therefore frequent blood checks, and professional monitoring are vital. (The maximum dose per day for allopurinol is 900mg, not 600mg. Doses above 300mg are normally split, to be taken 2 or 3 times a day))

Pain relief, such as Indocin (indomethacin / indometacin) is OK for short term pain relief, but not suitable for prolonged use. Ask your doctor about colchicine, as you will probably need some pain relief during the first few months of uric acid lowering treatment.

After a few months of allopurinol, you should be more or less free from gout pain, and able to live a normal life. However, do not get complacent – daily allopurinol and regular uric acid level checks are vital to ensure that this happy state of affairs continues.

I recently visited a rheumatologist who claim specialized in gout, just like GP said, during the initial phase UA lowering treatment, flare up will be likely, but he is confident that allopurino(or probenecid) + 1 tablet of colchicine twice a day and if there is twitching or remaining joint pain, add 1 or 2 200mg celebrex for a week will clear up most of the pain. He highly recommend allopurino whether its overprodution or under excretion, he said as long as you keep bumping up allupurino it will lower your UA level to below 6 regardless.