Gout Pal Interactive

Post edited 10:07 pm – September 4, 2009 by robert

one last thing that I must again expose your false information and I quote

“Allopurinol has been around for more than half a century so ALL it's side effects are well known and well studied. Febuxostat has been around a YEAR and it's side-effects testing is miniscule.”

 Uloric has been tested in over 4,000 patients and  for over 5 years! …… again why is it that you stated it has been around for 1 year? but than again hey I am distorting the truth?

I am going to sum it up for you……Uloric is superior to allopurinol at lowering uric acid. However Allopurinol is cheaper, so a new patient who has just been newly diagnosed with gout should try Allopurinol first to see if he/she can achieve a serum uric acid level less than 6. If Allopurinol is unsuccessfull at achieving this goal they should be switched to Uloric, because and here is the best part….. Uloric is better at lowering Uric Acid!!! please spare me with any more nonsense. and please if anyone other than this gentleman has any questions I would love to offer any help that I can.

again I ask you when have I peddled Uloiric? was it when I said allopurinol is cheaper and should be tried first? and if it fails than switch over to Uloric? is that peddling Uloric? that sounds like a fantastic sales pitch. lol you sir are insane and Uloric has been tested in over 4,000 people for over 5 years. I don't understand your point. even though it was approved in april 2009 doesn't mean it didnt exist before that does it? I have not said anything that isnt true and i have not pretended to be a doctor. My intentions were to try and share what I have learned in my experience dealing with this disease. go back and read my first post. I did not tell anyone to take uloric. I said it's a new medication that offers patients who haven't been able to get their uric acid down to try it. If a patient is on Allopurinol 300 mg for 15 years and their uric acid isnt below 6 what makes you think a doctor is going to titrate to 400 or 500 mgs? these are the patients who I have seen first line getting the benefit. please go back and look at my posts and tell me when I ever said everyone should be on Uloric or even if I said you should talk to your doctor about it? that would be unprofessional of me and that is why I did not do it. I started my frist post by stating I was a Uloric rep and I was here to offer any advice that I could and also answer any questions I could. I am not a Dr and never claimed to be one. I never tried to pursuade anyone. I was here to offer my experiences( and I do believ I have experience and knowledge that people on here might benefit from) if you do not like what I am saying please feel free not to read what I have posted. My intentions were and are pure and it's a shame that because of your pre-conceived notions of representatives you can't get beyond that.

I have had gout for over 14 years. My worst attack was in 1994 (Will never forget it), it was so bad I couldn't walk for a week!!! It “Hit” me in my right big toe and ankle. It took close to a month to quit hurting. I was perscribed allopurnal (300mg) and it worked quite well for the past 14 years, however at my last physical my levels had gone up to over 6 and a couple of weeks later I had my first attack of gout in years! It has lasted for over a month, it isn't a bad one just very uncomfortable. It is in my right big toe and ankle and also has made an appearence in my right thumb and wrist. My doctor has switched me over to uloric 40mg. Yes, it is quite expensive ($179.89) here in Northern California and I have to go in in three weeks to check my uric acid level and do a liver panel. My insurance picks up 80% of the prescription so the cost to me is quite reasonable. I have been using Uloric for 4 days now and it seems to be working. Had I not had insurance, I think I would have paid the $179.89 myself just to get rid of the pain. If you've had a gout attack you know what I mean, you just want the pain to go away. We can all argue about the benifits of allopurinol vs uloric, and allopurinol worked for me for over 14 years, quite well,too. But it is nice to have an alternative that even though is pricy, appears to be working. SCS

I have been taking Uloric for about 4 or 5 months now.  I started with the 40mg and it did nothing more than Allopurinol 300.  However, I have had significant success with the 80mg in lowering my Uric Acid levels.  It is causing existing gout tophi to go away as well.  The primary side effect I have is similar to Allopurinol (i.e. hair loss).

Great news SCS.

I hope the treatment continues to be so successful. What is your Uloric dose?

I suspect that the 300mg allopurinol wasn't quite enough, and you were hovering around the 7 mark for some time. This can bring very slow build up of crystals until one day the gout flare happens. This is the reason that frequent uric acid testing is so important. You might get away with once a year if you have had a long history of stability, but in your shoes I would insist on once a month until things settle down again.

As a 'potential taker' of AlloP [ I have some ready to go @ 100mg] I was interested in the comment from Robert @    ' Steven's Johnson syndrome which can be deadly' .

Doing a quick check online threw up the incidence as being 1 per million- though if sampled from specific 'contra-indicated' drug users- this incidence would be somewhat higher, sans doubt!

It is , however a low figure to start from and the condition is not submerged, like gout,  SJS being obvious from rashes, blisters and mucous membrane lesions in the early stages.

So , given the context of this discussion where the relative merits of both drugs are being flushed into prominence [ from an interested bystander point of view], over emphasis on this syndrome as a side effect is tending to 'shroud  waving ' – imo.

After all, SJS can be triggered by flu, herpes and many drugs other than AlloP.

If someone really needs Uloric then, like many other drugs on the market, new or old, risks of side effects need to be considered, and lived with, if necessary.

Some get excellent results and others the short straw. Risk benefit analysis!

Richard,

I think the thinking goes that if you start messing with the uric acid stores by liberating more of them into a lowered serum during an attack, the attack will get worse. But I don't think that is writ in stone. Sometimes common wisdon is more common than wise. It's easy to see a situation where somebody is suffering minor toe pain for monthas and months…should duch a person avoid treatment?

It's your call and the worse the attack, the more care should be taken starting Uloric but if the pain is realatively minor, maybe getting a start on treatment earlier might be beneficial. You can start with a low dose for a couuple days and see if you feel better or worse?

A lot of these methodologies are passed down from generation to generation and not all of them are iron clad.

I can see the logic of stoppiing crystal production at all times. But like I said, it's your call.

Richard,

You mentioned a meter is there such a thing that we can use to detemrine the levels ourselves.  I tried to find it on line but only found one in England but could not order it seems that they have a problem with there site.  If you could direct me it would be greatly appreciated…

Thanks Miles

trev said:

As a 'potential taker' of AlloP [ I have some ready to go @ 100mg] I was interested in the comment from Robert @    ' Steven's Johnson syndrome which can be deadly' .

Doing a quick check online threw up the incidence as being 1 per million- though if sampled from specific 'contra-indicated' drug users- this incidence would be somewhat higher, sans doubt!

It is , however a low figure to start from and the condition is not submerged, like gout,  SJS being obvious from rashes, blisters and mucous membrane lesions in the early stages.

So , given the context of this discussion where the relative merits of both drugs are being flushed into prominence [ from an interested bystander point of view], over emphasis on this syndrome as a side effect is tending to 'shroud  waving ' – imo.

After all, SJS can be triggered by flu, herpes and many drugs other than AlloP.

If someone really needs Uloric then, like many other drugs on the market, new or old, risks of side effects need to be considered, and lived with, if necessary.

Some get excellent results and others the short straw. Risk benefit analysis!

trev the relevence of steven's johnson syndrome is small, but the context of the  discussion was talking about going above 300 mg of ALLO. the reason the prevelance is so small is because dr's do not go a bove 300 mg of ALLO (97% of all prescriptions for allo written for 300 or less) because drug accumulation of allopurinol can lead to an increase in the risk of stevens johnson syndrome. being that the medication is excreted primarily in the urine(98% I believe) this is why it is not safe for patients with mild to moderate renal impairment. also the kidney's cannot excrete enough of the drug if you titrate the dose higer therefore makin the drug's bioavailibility go up and hence increase the chances of getting the syndrome. This is why doctor's do not titrate above 300mg and until uloric became available there were no other options fo rpatients who couldn't get uric acid below 6 on that dose. Uloric was proven superior at lowering uric acid. As I stated in many earlier posts I am not slanting the information just presenting all of it.