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Hi Guys,?
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In a previous question I had stated I ?was going to change GPs and see someone today, have some news and questions so started a new topic.?
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I saw my old (from 8 years ago who initially diagnosed me with gout) GP today and she laughed when I said no other Dr would prescribe me allopurinol and was puzzled as to why since I have already been diagnosed with gout, anyway she took my blood for a starting level before starting the meds and sent me for xrays to check for any joint damage.?
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Questions?
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1) Dr gave me script for 100mg tabs, I already have a supply of 300mg tabs, shall I just go ahead and take the 300mgs. I have read everywhere (specially with Zips posts) that 100mgs is not so worth it, and I already have the 300mg tabs right here. my last urate reading for 0.37 (normal range 0.18-.044) that reading was taken in September whilst an attack was kicking off.?
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2) how soon on my 300mg tabs can I start introducing a semi normal diet, not talking going crazy but meat once a week type thing.?
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3) any thoughts on naproxen vs colchcine for prophylaxis while I start allopurinol ? GP is saying Naproxen, but I am thinking Colchine might be better, but just your thoughts would be nice on what you have used.?
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A massive thank you to the guys here, and to all of you in advance for comments and suggestions.?
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imi
1) Use the 300mg immediately. Save the 100mg, in case you need to increment to 400, or drop to 200 in future – I used mine 3 at a time when I was late picking up a repeat 300mg prescription. The normal range is without meaning (and potentially dangerous) to anyone who has experienced one acute gout attack. You must get uric acid to 0.30mmol/L (5mg/dL). This should be easier in England, as it is a clear and precise recommendation by the British Rheumatologist Society. You may need to remind your doctor of this, and explain that the normal range is a statistical average that might help diagnosis ? it is completely irrelevant once gout is confirmed ? like telling an alcoholic that 2 drinks a day is normal. (I'll be using that comparison again ? thank you for the inspiration)
2) Sensibly, you should wait until you break the 0.30mmol/L barrier. However, allopurinol is very effective at reducing uric acid from diet, about 50% effective on uric acid from our natural cell turnover, and completely ineffective on uric acid from dissolving crystals. Personally, I'd celebrate moving forward with a nice rack of lamb, but I do not necessarily recommend that to anyone without my cavalier attitude.
3) Both. Colchicine stops or slows inflammation getting worse, but you have to wait for existing inflammation to subside naturally. That is why it is so important to take it at the first signs of a twinge. Prophylactically, it worked fine for me during the two weeks recommended by my doctor after each dose increase. My personal preference is for pain relief as required after that period. As I reported in the new lowering uric acid forum earlier, I can combine colchicine with NSAID for very quick relief when encouraged by a party. I use ibuprofen, but I believe naproxen is even better
I just spotted your profile picture. 2) should now read:
Personally, I'd celebrate moving forward with a nice squirrel curry.
Hi Keith,
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thank you very much for your reply and your advice, all makes perfect sense, I was umming and arrrring about 300 or 100, but tonight will take my first dose tonight will some naproxen.? Also totally agree re the holding back on food till my levels are under control, I will wait a week before I commence on meat eating, though I am a chicken eater so I think a nice Sunday roast at the end of this week is in order…. oh and a squirel eater too lol….
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I agree re Drs and levels in the UK when my Dr saw my level of .37 she didnt bat an eyelid at me starting Allopurinol, so I think I will have it easy when it comes to agreeing a level of .30 and my level a few weeks ago of .37 gives me hope that achieving .30 is very very doable.
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I know I thank you all the time Keith and I have read a few messages recently commenting on the layout of this website, I am a new user, well I have navigated this site for a few months now, and I can say, the first time I got here I had no problems locating information, the forum or unlocking all the info I needed to assist me and help me get through nasty stages of gout attacks. Infact if I am honest it was actually so much information I spent hours reading and finding stuff, I actually didnt find anything which I thought hmmm thats useless, or hmmm wish it was layed out differently.?
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I just wanted to add that as this morning I was thinking if this site ever shut down or closed, I would feel like my major source of support for me is leaving, as selfish as that sounds it is testiment to how amazing this site is.? Anyway rant over and thank you again for the advice.
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imi
Wow thank you imi
That isn't a rant, it is very good thoughts.
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By the way, I forgot to mention that allopurinol takes up to 2 weeks to reach maximum benefit, so if you are arranging progress tests, you need to wait 2 weeks after a dosage change to get reliable results. My doctor always uses a 4 week gap between retests, and it sounds like you will have similar good service.
Watch out squirrels – we're celebrating.
Hey Keith?
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thank you again, have just popped my first allopurinol 300mg pill and breathed a sigh of relief, will keep a diary and document my progress, side effects, levels and such.?
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if you are ever in London let me know would love to meet you for a coffee or something I live very central (regents park) and yesss Squirrels watch out, so many in London cant wait to break of the steak knife and fork lol
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imi
ctrlkeys said:
Hey Keith?
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thank you again, have just popped my first allopurinol 300mg pill and breathed a sigh of relief, will keep a diary and document my progress, side effects, levels and such.?
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if you are ever in London let me know would love to meet you for a coffee or something I live very central (regents park) and yesss Squirrels watch out, so many in London cant wait to break of the steak knife and fork lol
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imi
The diary sounds like a good idea, and caused a click in my brain. I have had ideas for some time about encouraging other gout sufferers to start their own website. When I started GoutPal.com, it was as much about documenting my own findings and progress as anything else. I found that by doing this publicly, it pushed me into researching and reporting in more detail than I might have done privately. I doubt I would have had the optimism about fixing my gout that I have now, and I certainly would have fewer high-quality friends.
If it is something that might interest you, it would be nice to discuss it near Regents Park. If yes, we can arrange something when you have some free time, otherwise I'll email you whenever I'm likely to be in London.
hey Keith,?
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sounds good to me, and funny enough I do work in IT for the NHS and have access to web design tools and drs and nurses and all kinds of NHS type material, so in theory I am sure we could work something out, am happy to discuss that when we both have time, I generally do have free time during the weeks and would be happy whenever you have time to meet up and have a chat.?
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a last quick question, took my first dose of allopurinol last night and no side effects but a damn itchy left eye, i noticed the serious side effects said irritated eye – contact hospital/gp, though I am not sure to what degree they mean irritated, its irritated like its annoying but its not swollen or red or painful, just annoying, could be nothing to do with the allopurinol just coincidence it decided to happen, years ago when I had a 100mg dose for a month I dont recall having an itchy eye lol… am I just being paranoid ?
I can be strolling through Regents Park about 1pm Tuesday 22nd November, but almost any date is good for me. I'll email you so watching squirrels don't hear of our arrangements.
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Beware of BAFE syndrome. Blame Allopurinol For Everything is not serious, but quite prevalent. It probably has a medical name but happens because we automatically try to link important or unusual events in our lives. Side effects should not be ignored, but if it isn't serious, do not put too much emphasis on it yet. My advice – keep your eye on it (geddit)
Hi Keith,
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got your email and replied. I called the GP and got a prompt within 10 mins call back, she checked her BNF and said she cant find itchy eye, lol, I checked my OWN BNF and yeah its not specific, plus the actual side effect says, irritiated eyes, yeah not specific at all… but no its the same today on day two, but I am guessing that its not a hyper sensitvity reaction as no swelling, no pain,? no discharge, no discolouring, just being a bastard and itching now and then…
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she did give my initial blood results on the day I started allopurinol and they were .39 so 6.6 or 393, I have learnt to convert on the fly now lol…. the xrays she had taken show no joint damage so thats a plus sign too..
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will continue the allopurinol unless I get a serious reaction while causes me to have to stop, I think once my body ajusts and stop being paraniod ill be just fine!
Beware of BAFE syndrome. Blame Allopurinol For Everything
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Oh I just LOVE that acronym. It should go right up there with the even more common SCAMP syndrome?Statins Cause All Muscle Pain .
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Those who suffer these syndromes spend their short drug-free lives with incessant joint?pain?relieved only by ?a massive and fatal heart attack.
@zip2play:Nicely put.
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ctrlkeys said:
initial blood results on the day I started allopurinol and they were .39 so 6.6 or 393, I have learnt to convert on the fly now?
For those with less mathematical prowess, type calc (short for calculator) in the search box above where you will find a link to uric acid calculator
quick update guys, 5 day on 300mg allopurinol and yes last night at 5am i was awoken with the usual pain of gout, left foot 2nd joint, it wasnt extreme with meds managed to fall back asleep, still today its tingling on and off, like it wants to break out into a full on attack but taming it with 1000mg of naproxen and praying thats enough to keep it at bay, colchcine at hand if it really goes mental on me.?
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just thought id give you all an update, took me to day 5 of being totally clear to get what i would call a minor flare right now, will see how it goes by the morning…?
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🙁 *sigh*
ctrlkeys said:
…break out into a full on attack but taming it with 1000mg of naproxen and praying thats enough to keep it at bay, colchcine at hand if it really goes mental on me.
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You got things backwards. Naproxen isn't going to deal with your attack. COLCHICINE is THE attack blocker. Naproxen deals only with your pain, the result of your attack!
When the attack strike, take 1 or 2 Colchicine. If the pain gets unbearable add 1 or 2 500mg Naproxen or Aleve. (They are the same, except Aleve is the non-prescription drug.)
hey Hans
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when the attack actually started yeasterday I took x2 0.5mg colchchines and another an hour later, it held of the throbbing for about 2 hours and then it started again, so I switched to naproxen, my attacks arent all in one hit I tend to get waves of attacks, it comes and goes, I dont want to take colchine at a high dose only to have an attack come back a day later and not be able to take it, so I generally dose with x3 colchine tabs a day and then naproxen to tie me over, but that is because the attacks I get do not hit all at once, generally because they are mild, however I do know what a major flare feels like and if I feel that coming on I do change from naproxen to colchine 1 per hour till ive reached around 4-5mgs
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but I agree with you regarding colchine stopping attacks, problem is when you are getting 3-4 mild waves of attack in a day you cant keep taking 2 tabs each time, would quickly reach the limit, hence why I use naproxen and save colchine for larger flares.?
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hope that makes sense.?
Just to kill a little time until I go to the pub, I looked into colchicine a little further. The important factors are how long it takes to become effective after you take t, and how long it lasts. There are several studies, and they all seem to suggest that effects vary between individuals.
It might take half to one & half hours to reach maximum effectiveness, and it might last 5 to 12 hours. This means to me, that it is going to take a while to find out what works best for you. Logically, Hans' approach is right, and it follows what I do, more or less. Low dose colchicine backed up by NSAID (in my case ibuprofen). Colchicine always at first twinge. NSAID depends on what I'm doing. If going out, I usually take it immediately. If staying in, I often wait.
When I first started allopurinol, and when I increased dose, I took colchicine for about a week as a preventative, and it was very effective.
Mostly, I'm looking forward to the time when the uric acid deposits have melted and I can forget all about this pain relieving stuff.
ctrlkeys said:
quick update guys, 5 day on 300mg allopurinol and yes last night at 5am i was awoken with the usual pain of gout, left foot 2nd joint, it wasnt extreme with meds managed to fall back asleep, still today its tingling on and off, like it wants to break out into a full on attack but taming it with 1000mg of naproxen and praying thats enough to keep it at bay, colchcine at hand if it really goes mental on me.?
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just thought id give you all an update, took me to day 5 of being totally clear to get what i would call a minor flare right now, will see how it goes by the morning??
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🙁 *sigh*
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It sounds like you have matters well in hand. Soon you will be singing the praises of allopurinol and be free of gout attacks.
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Personally, I think gout has a built in clock that can TELL that it's exactly 5 AM. I wonder if it's smart enough to adjust for daylight savings time?
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I cannot weigh in on the effectiveness of naproxyn becasue when I had attacks, it was still a VERY pricey patented super-dooper arthritis medication. Colchicine in high doses for me will stop even the worst attacks.
Hi Keith,?
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yep I use low dose as well and then top up with NSAID, sometimes it works, sometimes it doesn't, today it seems to not have, have taken 1.5mgs of colchine through the day and 1000mg of naproxen and right now looking at the clock thinking I might not be going to work tomorrow as my foot has started to throb again, unless I go back to colchine and just resorted to one an hour ill be up playing MW3 all night I guess….?
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Hey Zip?
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I totally agree about the 5am time clock, I have to be honest I actually dread going to sleep now, and this is really starting to depress me, trying to keep positive now im on day 6 of allopurinol but arguments with GF and family are starting to get worse, and I am starting to hate my life, but I will put my head down and just try and get through it, though my GF who is soon to be my wife in 6 months I am debating if I want her to live a life with someone who has to deal with this so frequently, but again *crosses fingers* allopurinol will come through for me, worst thing is I have to be at work tomorrow, in fact I cant really take the time off, at all, and I cant see how it can happen right now.?
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Anyway, sorry guys just deflated and a bit defeated right now, 9.30pm and I doubt ill sleep properly if at all tonight, ?hope you all have a good night and the support here is fantastic, just being able to read posts helps :)?
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Imi?
hey Hans,?
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any response in my opinion is a supportive and positive response, so thank you for your advice and also yes I agree im sure it is the crystals just falling away and not a new fresh attack, I didnt do the 16 pills route but took the day off work and just rested my foot, I can walk but not very comfortable to get a shoe on so stayed in and cleaned the flat and cooked for the wife to be…..?
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hey again Zip?
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as you will see already skipped work, i figured if i do 16 tabs, normally my threshold is about 4.5mgs before bum from hell develops I wouldnt be able to get into the office anyway so stayed home and just riding it out, I think it is the lowering of my urate through the allopurinol, my level before allopurinol riding around .39 – .42 so i am guessing with 300mg I will get a decent reduction, soon as I can walk and get into work ill get the vampire (phlebotomist) to bleed me and ill report the levels after a week of allopurinol. oOoOoOo got the Rhumie appointment today, 3 weeks, not sure why its worth seeing him anyway since ive already started allopurinol but might as well since ive waited about 3 weeks to get the appointment in the first place!!!!!!!!!!!
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thanks for the post guys….?
okay another update, I hope someone can respond to this as I am seeking a bit of advice here, I got my blood test results back, 9 days on Allopurinol and the reading is 0.22 which is bloody low I think, I know that 300mg would lower my urate quite a bit as I was only at about 0.40 so it has indeed halved it. My questions are listed below.
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1) has my urate level dropped to low ? and does this now mean I can finally eat normally again
2) will there be problems if my urate drops below the level of 0.18 the minimum level listed
3) should I keep this low is it safer ? I am guessing the answer to that is yes, but I am going to ask anyway.
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As always thank you for replies in advanced
God, I HATE that conversion. So .22/59.5 x 1000 =?3.7 right?
If so, then:
1. No, that's a terrific level. Yes, you can eat ANYTHING you want except maybe daily sweetbreads washed down with porter.
2. That would be down to 3.0 mg/dL and would be fine but unnecessary unless you have a lot of tophi to try to dissolve.
3. You could try 200 mg allopurinol and see if you can remain pain free with urates of under 5.0 mg./dL (your molar .30?value) but since you are so recent with pain, probably holding these very low values for at least 6 months before fiddling your dosing is a good idea.
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I hope I did those conversions right. (I hated molar units in high school, I hated them in college and I hate them today.)
hey Zip
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as always thank you for your prompt and informative response, I think the actual conversion is right, its definitely?3.7 ( i normally?do x18, so 0.22×18=3.96) , I knew allopurinol would cut my levels low as I wasnt riding too high in the first place, I will keep on 300mg because you are right in saying I have only recently had pain and even the transition to allopurinol has caused a few flare ups in the last 8 days, so yes a 6 month minimum sounds like a good idea to me.
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I actually have no visible Tophi, my reasoning for getting on allopurinol is that when I am older and wiser I dont want to look back and say, “damn wish i listened to everyone's advice and controlled my urate when I was younger” I would rather bear the flare ups on adjustment now, rather than when my body wont tolerate it.
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I didnt actually expect to see the level drop that low and funny enough I went to my GP yesterday and he looked at my previous test which were 0.39 and said, well I dont think 300mg will do much to lower it but if you get it to 0.33 thats good enough, shows you how much experience he has with allopurinol, but I am one of the lucky ones because I work for the health sector and have 3 separate GPs who I see, so if I generally tend to see them and tell them what I want, in yesterdays case?a blood test and 200 colchine tabs.
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will get more bloods done in 2 weeks and see what my level stablises at.
zip2play said:
?(I hated molar units in high school, I hated them in college and I hate them today.)
I am with you, Zip, all the way. Molar units don't make any sense, even to me, as a chemist in one of my past lives. ?Now 1 mg, one thousands of a gram, that makes sense. A molar unit, what the hell is that? I bet you, 99 out of a hundred doctors don't have the foggiest idea. Only nitwits can imagine a molar unit in their brains which they ain't gotten.
a blood test and 200 colchine tabs.
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Oh you lucky dog, In the States 200 colchicine would set you back $1100 thanks to the criminal patent system.
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I bet you, 99 out of a hundred doctors don't have the foggiest idea.
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Yep,
A mole of Lithium is 7 grams and a mole of Uranium is a half pound. That's nuts.
Ask?an average?chemist for a mole of molybdenum and I guarantee he cannot weigh it out without consulting a chart. Ask for a mole of HAFNIUM and? NONE of them could get it for you.
AND, for us gouties, a mole of xanthine oxidase weighs in at over a quarter ton.
Making weight of a substance depend on what it is is straight out of Alice in Wonderland.
totally agree about the mole measurements, that’s just how some labs do it in the uk for some reason, as long as I can convert it I don’t care, the colchcine script cost me 15 pounds to cash in so a total of 30 dollars, love the uk for its script system, no script is ever over ?7.40 the government picks up the rest 🙂
zip if you want some colchine let me know I’ll mail you a hundred tabs
ctrlkeys,
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What an incredibly generous offer but I am a bit of a sharpy so there was no way I was going to get caught with my pants down and I have at least 200 colchicine in the larder: last Rx filled JUST BEFORE the well went dry in the U.S. but thanks anyway.
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limpy,
I bought my nitro spray bottles from India: $14 instead of $250…I kid you not.
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My goal is to outlive my drugs.
This allopurinol 300 mg topic is now closed.
It covers several variations on a theme, including:
- allopurinol 300 mg making gout worse
- allopurinol 300 mg tab for gout
- allopurinol gout treatment 300mg
- does allopurinol tab (300 mg) relieve pain?
Allopurinol 300 mg sounds OK, but so does a car at 30 mph. Dangerous and useless in a shopping mall or on a motorway. Allopurinol exists to get you uric acid to a safe level. Allopurinol dose does not matter, Uric acid level is vital.
I will move the relevant parts of the discussion to a new common questions section, as time allows. In the meantime, you can easily search for current discussions, or start a new discussion.
You can find the search box at the top of every page, or at the foot of the right-hand sidebar. Even easier, please use the gout search page.
Please browse the allopurinol guidelines for best information.
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