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  • #3703
    ctrlkeys
    Participant

    Hi Guys,?

    ?

    I have a question but as usual some update history, I have been on allopurinol for 2 months now, actually officially 2 months since Jan 9th, I have had my blood recorded 3 times now, I normally can ask for blood tests as oftern as I want and due to the fact that I work in a health centre its easy for me to pretty much write the test form myself, so basically. ?I jumped straight into 300mg of allopurinol and below are my results since doing that.?

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    Nov 2011 – 0.22?

    Dec 2011 – 0.24

    Jan 2012 – 0.23

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    Great results right, before the allopurinol I was about 0.44ish so I am in the urate dissolving territory, however, I have pretty much been in a constant pain situation since my numbers lowered, first all over xmas my left toe was sore, not a full on attack just an annoying (cant train) soreness, now my right toe is having an attack, it is probably not as full blown as previous but its on a scale of 1-10 a good 5, which is enough to keep me up with worry, have taken x3 0.5mg colchcine and will probably take another one before I go sleep, on a daily basis I dont actually take any preventative measures, am attempting to deal with the soreness and knock attacks out as they come. So my question is…… the million dollar question, have others had this experience of pain in the first few months when lowering their urate to such a level, and if so, how long did it last ???????????? I can understand now why people give up on Allopurinol, however, I wont be one of those people I can understand why people think this is such a struggle, because for me, its not easy.?

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    any and all comments are very welcome. feel a bit better now, thanks for listening.?

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    Imi?

    #12528
    limpy
    Participant

    I was in pain for months on and off prednisone.?I wish my dumb ass rhummy would have put me colchcine right off instead of the roids. He told me I'd be on colchine for 8 to 10 months but it was?one?.60mgs pill twice a day for 18 months. Finally?I talked a new doctor into upping my dose of allo from 200mgs to 300mgs a day after a month of that?I stopped the colchine all together.?I still have some pain but nothing like before. I hope this helps. Good luck Limpy

    #12529
    ctrlkeys
    Participant

    hey Limpy?

    ?

    thanks for your comments, yeah I jumped straight to 300mg because I know ultimately its where ill end up, and last nights mid level attack blew up into a full on attack dispite 2mgs of colchcine and 50mg of indomethacin, its subsided now and just swollen but didnt sleep much last night, I think im going to go back to colchicine twice a day again, and just ride out a good 4-5 months on allopurinol and see if that helps settle me down.?

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    the thought of having to do all this again when im older is whats keeping me firmly on allopurinol to be honest.?

    #12530
    hansinnm
    Participant

    ctrlkeys said:

    … attack dispite 2mgs of colchcine and 50mg of indomethacin, …


    I don't know if this is of any help: 2-0.6mg Colchicines (1 in AM,1 in PM) and 2-500mg Naproxen (or Aleve) did the trick for me during a real bad attack. Mind you:That's ME. I never took Indomethacin, so I can't comment on that.

    #12531
    ctrlkeys
    Participant

    Hey Hans?

    ?

    I might give that a try I got Naproxen here, I just found that Indomethacin was more potent but I think my main problem was I let the attack settle in, I refused to believe I was having a serious attack because I was on allopurinol and since starting ive not had a major attack, I thought it was going to pass through the night, and started the colchcine/indomethacin when the attack was fully instigated, the result was just having to ride the pain out.?

    ?

    I may try Naproxen next time along with a small dosage of colchcine, that might be the way to go as with Naproxen you can keep using it for weeks in a row, the problem with Indomethacin is you are suppose to cut it down as soon as possible.?

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    thank you for your comment by the way :)?

    #12532
    hansinnm
    Participant

    ctrlkeys said:

    Hey Hans

    ?

    I might give that a try I got Naproxen here, I just found that Indomethacin was more potent but I think my main problem was I let the attack settle in, I refused to believe I was having a serious attack because I was on allopurinol and since starting ive not had a major attack, I thought it was going to pass through the night, and started the colchcine/indomethacin when the attack was fully instigated, the result was just having to ride the pain out.

    ?

    I may try Naproxen next time along with a small dosage of colchcine, that might be the way to go as with Naproxen you can keep using it for weeks in a row, the problem with Indomethacin is you are suppose to cut it down as soon as possible.

    ?

    thank you for your comment by the way 🙂


    Hello Imran,

    You are welcome.

    You are still very young and you don't want to get where I was: Ignoring (not knowing) about the build-up of SMU (the salt of the Uric acid) as tophi which eventually destroy your joints if you don't take car of it in time.

    So make sure that your dosis of Allo will reduce/keep your SUA at 5mg or less.

    Second only take your Colchicine for as long as your inflammation lasts. That time and amount depends on the severity of your inflammation.

    Third, take the Naproxen only when your pain level gets past unbearable and quit when you can endure the pain. It has worked for me for 25+ years. The thing I didn't do was taking or being prescribed Allo when my gout attacks started.

    Fourth, keep an eye on your liver and kidney functions to assure that the meds are not harming them.

    #12533
    zip2play
    Participant

    My first dose of allopurinol was 400 mg, After that first dose, I never had another frank gout attack, and I'm talking years and years.

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    After a year or two I lowerd my dose to? 300 mg. for a decade. Doofy doctor kept harping about the dangers of allopurinol? so I relented and went down to 200 mg. for almost a year ?and started getting mild, non crippling attacks ?back

    Went back up to 300 mg. where I am today?and fired the doctor.

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    After agout 20 years my hands are getting suspect with some small tophi , a trigger finger or two and mid hand pain…so I am strongly considereing either going back to 400 allopurinol or adding 500 mg. probenecid (potent uricosuric) to my 300 mg. allopurinol.

    ?

    My feet remain fine unless I go on a beer binge…then a dulll ache with overwalking.

    #12534
    zip2play
    Participant

    Of course, not to beat a dead horse with my colchicine treatment since many of you have heard it timeless times in the past:

    For a severe attack you take colcicine, one an hour, until your pain stops, severe diahrrea begins or you reach 16 tablets (8 mg.)

    Any dose of colchicine that DOESN'T stoop pain seems quite pointless to me, more like “drug abuse.” Like wanting to get to San Francisco from NYC?on a train?but buying a ticket instead to Kansas City.

    ?

    For NSAID analgesics I would recommend indomethacin. It? made me dizzy (so that ended my career as a tighrope walker :D) but it eased the pain by a good deal.

    #12535
    drmarclevine
    Participant

    Stay on the Allopurinol.? Yes, it stinks that the medicine that will help you in the long-term can start out by hurting you.? Perhaps consider that without the Allopurinol you'd be having flares anyway and you'd be no closer to solving the problem long-term.? With the Allopurinil the pain is still the pain but it's also a sign that your body is healing.?

    My experience after about three months on Allopurinol is that the food and drinks that trigger my gout (shellfish and beer) still do but with Colchicine and other anti-inflammatories the attacks never get a chance to go into full flower.? My rheumatologist told me that I'd still be susceptible to flares for 12-18 months after initiating Allopurinol so I keep the Colchicine handy and do not hesitate when I feel an attack starting.? My rheumy also pointed to recent studies that suggest relatively low doses of Colchicine are as effecitve as the 'pill every hour' formula without the stomach issues.? Every case is different but low doses (1.2mg a day or .6mg a day) have worked for me and I've had weeks where I've needed no Colchicine if I watch what I eat.?

    #12536
    ctrlkeys
    Participant

    Hey Hans,?thanks for your advice there re the naproxen, I have my liver and kidneys tested regularly, in fact normally when I get urate test I also the the Liver Function test and get it done myself, my numbers are way under 6 0.23 equals 4.14 so for 2 months since starting allopurinol i havent gone higher than 4.14, the drug is definitely working, and im sure shifting crystals around is causing the flare ups, I do have alot of tattoo work and did have a 7 hour session a week ago which MAY have promoted my gout to rear its head anyway, so I am not really doing myself any favours.?

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    ZIPPY my favourite gout forum poster 🙂 im like a zip groupie with the amount of your stuff i read lol, totally agree re the colchcine regime and to be honest was umming and arring about going above 2mg as i was doing indomethacin, however, for future reference I will keep doing a pill an hour till the bowels open, as in the past when I got gout 8 years ago, 4mg of Colchicne would knock my attack clean out, so now taking only 2mg and hoping for the best isnt exactly smart on my part, and I dont mind running to the toilet, its preferred to hobbling to the toilet in pain.?

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    Hey DrMarc, thank you for your advice too, i will definitely be staying on allopurinol and fingers crossed in 6 months to a year ill be clear of the majority of flares, I do totally agree that minus the allopurinol I would be on the same flares, and whilst having a flare I am keeping an eye on my blood levels and they remain at 4.14ish so I know the urate must be clearing and not reforming. Again my advantage being I work on a health centre and can request lab tests on myself at the drop of a hat, so monitoring for me is easy. Also I have tried colchine in low doses and it does tend to work for me, the last flare happened after I took 7 days of my usual 1mg of colchcine a day routine, that was because I had a tattoo done and wanted it to give it max healing time off any meds.?

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    Guys, thank you for the advice, I have to say it makes me feel a lot better to hear peoples opinions and advice, sometimes the pain of an oncoming attack is actually worse for me than the attack if that makes sense, because from the oncoming pain i know whats about to happen and most times fail in killing the attack fast, though I am going to try the colchcine in high doses next time.?

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