GoutPal Interactive

Hello, i run into web site after helplessly trying to get some info about gout. My dad is visiting me here, and he is having one of his attacks. He is 72.

I guess he was never diagnosed properly, and last 15 years he was given some non-steroid, anti-inflammatory medication. At the end he ended up in a hospital for a bleeding ulcer, and that was first time he was diagnosed with gout. That was last year in September.

His gout was so bad, that he couldn’t walk. He was given injections for pain and inflammation. They put him on allopurinol 100 mg. he got better, but never 100%. When he came here, I looked through his lab tests. Back in September his uric acid was 516 umol/l. Average should be 182-403. In November it was 400umol/l, and in December was 474umol/l. All this time he was taking 100mg allopurinol.

I was trying to contact his doctor and ask, and comment, that 100mg is not working for him, but no luck getting right answer. Right now he is having another attack, his elbow is swollen, hot ,red. His foot ankle has same problem. He is cold all the time, not a happy camper. I increased his allopurinol to 200mg one week ago.

Today we had his blood drawn, and I will know his uric acid measurements tomorrow. His diet is very healthy, no alcohol, lots of water. I am not giving him any ibuprofens because of his stomach ulcers.

Please advise about mg of allopurinol/ uric acid levels, or any other medication that might work. Do you know how long it takes for allopurinol to have an affect on uric acid? Thanks a lot. Nina

Allopurinol Drug Recall For Europharm’s Purinol

The Department of Health in Hong Kong has withdrawn Purinol from sale, and is investigating other drugs manufactured by Europharm. Please note that this only affects Europharm Laboratories in Hong Kong.

The contamination appears to have occurred due to delays in the process of converting the active ingredients mixture into tablet form. It does not affect other manufacturers of allopurinol.

Patients receiving Purinol are urged to seek alternative allopurinol supplies from the clinics where there drugs where dispensed. It is vital that you do this immediately, as suspected medicines should never be used, but allopurinol should not be discontinued without the advice of your doctor.

Please check your allopurinol packaging immediately. You only need to take action if the medicine was manufactured by Europharm Labs of Hong Kong. Note that you should do this even if you live outside Hong Kong, as the drug is exported from there to other countries.

Allopurinol intolerant gout sufferers in the USA moved one step closer to an alternative gout fixer yesterday.

Though this does not bind the FDA to issuing approval for febuxostat, it represents a highly positive outcome and bodes well for a new treatment sometime in the next few months.

In this part of the approval process, evidence is considered by the committee. I’ll present some of the evidence in detail over the next few weeks. To set the scene, here is the summary, from “Briefing Document for Febuxostat” by Takeda Pharmaceuticals North America, Inc.

Summary and Conclusions

Febuxostat is a potent, nonpurine, selective inhibitor of Xanthine Oxidase (XO), which has been shown to be effective in reducing and maintaining serum uric acid (sUA) <6.0 mg/dL at doses of 40 mg and 80 mg. Maintaining these sUA levels is associated with the clinical benefits of tophi resolution and reduction in gout flare.

Febuxostat 40 mg and 80 mg provide an effective treatment option for patients with hyperuricemia and gout. Based on the clinical data, 40 mg and 80 mg are effective doses with 80 mg providing added benefit for patients with more severe disease.

Febuxostat also provides benefit in this patient population with comorbid conditions and has an advantage over allopurinol of not requiring dose adjustment in patients with mild to moderate renal impairment.

Febuxostat doses of 40 mg and 80 mg are well tolerated and have a similar safety profile as the currently marketed allopurinol. The rates of cardio-vascular (CV) events observed in the febuxostat clinical program were low. The potential CV risk was prospectively evaluated in the CONFIRMS Study and no difference in the rate of CV events was observed between febuxostat 80 mg and allopurinol; whereas, with its known risk of AHS, the risk in terms of severe rash is greater with allopurinol.

Febuxostat 40 mg and 80 mg doses are both recommended for approval to allow clinicians individualized dosing options. The 80 mg dose is more effective than 40 mg, especially in subjects with more severe disease as defined by the presence of tophi or higher sUA levels.

Overall, the benefits of febuxostat 40 mg and 80 mg clearly outweigh the risks and support approval of febuxostat for the treatment of hyperuricemia in patients with gout.

Looking for Allopurinol information to help your gout? Have you tried different spellings? Alipurinal, alipurinol, allipurinal, allopurino, alopurenol, or alopurinal are some alternative spellings that you might find. Got any more?

Tophi are a common indication of chronic gout. As gout progresses to the stage often called tophaceous gout you need some serious gout treatments. What are the alternatives to getting rid of a tophus?