Replacing Febuxostat Due To Adverse Effects.

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This topic contains 2 replies, has 3 voices, and was last updated by  Keith Taylor 3 years, 2 months ago.

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  • #14601

    Frank McAuley
    Participant

    After 17 years of self-treating attacks of GOUT coupled with poor G P care I consulted a new GP  and then a rheumatologist when the attacks were getting more frequent.

    On 18 Feb 2012 I started 80 mg Febuxostat and on 22 Aug ’12 this was reduced to 40mg. I have had blood tests every 3 mths with L F and K F tests normal;on 26 Jan’13 the uric acid reading was 2.2 mg/dL .

    During the time which I have been taking the medication I have experienced :-

    ringing in ears – at various times;

    muscle tightness and cramps which have got worse;

    joint pain;

    generally “not feeling right”.

    On 7Feb ’13,in consultation with my GP,it was decided that I should stop the Febuxostat to ascertain if it was responsible for the symptoms as stated- so early days!

    I have my own Gout Meter so I shall be “keeping a tight eye” until the 26 Feb ’13 when my G P wants to review the situation.

    In light of this possible prob with the Febuxostat may I please have your advice as to the finer pts of starting Alluprinol (excuse spelling), viz, doseage , method of taking- time etc ? Perhaps I should have taken it from the start?

    The recent info re Febuxostat makes me uneasy but it has changed my life: decrease of anxiety re possible flare-ups , no pain in toes, so I know I need to control it the uric acid!

    It’s now about 12 mths since I’ve been taking Febuxostat but I still have small deposits of Tophi on the surface of the skin on both my ankles!

    May I please add my thanks for your your “service” throughout this testing time.

     

    #14602

    KeithTaylor
    Participant

    Thank you, @frank-mcauley – an interesting start to my week.

    Before I think about allopurinol, I’d like to express a few thoughts about uric acid lowering in general.

    I find it helps to realize that our bodies are experiencing massive change. When we reduce uric acid concentration in the blood, crystals that have grown slowly over many years start to dissolve rapidly. Most of these simply melt away, and the dissolved uric acid is flushed through our kidneys. But White Blood Cells are vigilant, and they react aggressively to any sign of a uric acid crystal. We may well experience a gout attack, and there have been many discussions here about gout attacks during uric acid lowering treatment. Keep calm and take the pain relief is the best response to this. However, also be aware of the changes taking place in your body, and do not be alarmed by the associated stress, feverishness, and generally “not feeling right.” This will pass. You can minimize it with plenty of fluids, and as much gentle exercise as you can find time for. Also maxing out on the fruit and veg will give you a better quality of general nutrition that leaves you better placed to meet the challenges of reducing your “urate load” (the total of all the uric acid deposits that have built up during the years plus the dissolved uric acid circulating in your body). Steak with salad rather than steak with fries is an acceptable compromise you will grow to love.

    But ringing in the ears and cramps should not be part of that, so let’s try allopurinol.

    First off, you need to choose your target. I like your 2.2 mg/dL, and as you have visible tophi, that is the best target to maintain for six months, then review. However, any number between that and 5 is viable.

    Start with 100mg allopurinol per day. After two weeks, if you have not experienced rash, and your liver and kidney function tests are satisfactory, start a two-weekly increase until you reach your target uric acid level. 2 weeks is optimum, 4 weeks is acceptable, any longer is time-wasting. The increment should be something you and your doctor are happy with. Personally I went 100, 200, 300, 600, 900. The important thing is to monitor kidney and liver function. Ensure you drink enough fluids to pee around 2.5 liters per day.

    Good luck with this Frank. I know you have not had the easiest of times when reducing uric acid. I hope allopurinol reduces your side effects and resulting stress.

    #22433

    Keith Taylor
    Participant

    As I mentioned in his other thread, Frank has now moved to my new gout forum, where he is discussing Allopurinol And Colchine Dosage.

    As he has knowledge and experience about febuxostat also, you might want to ask Frank how allopurinol compares with febuxostat.

    Please join Frank, and post in the new gout forum now.

    As Frank has moved to the new forum, I’m going to close this febuxostat discussion.

    I will continue to respond to other posts in this forum, but I will focus most attention on the new forum.

    Please make sure you switch your gout updates to the new forum at https://feedburner.google.com/fb/a/mailverify?uri=GoutpalNetwork

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