Keith’s GoutPal Story 2020 Forums Please Help My Gout! Gout Treatment Allopurinol side effects go away?

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  • #2968
    cjeezy
    Participant

    Now that I?ve started 200mg of the drug, I?m very fatigue and things seem a bit hazy/foggy. I also have shortness of breath (for example, when I was walking and talking on the phone it felt like I was out of breath a bit). Has anyone else experienced this and do allopurinol side effects go away? Does your body gets use to the drug?

    #5571
    cjeezy
    Participant

    Just realized that I already had a similar post to this. Oh well, l feel so crappy now I just forgot. Maybe someone will come along and say their symptoms went away. Anyways, I’m still hoping this has something to do with me quitting smoking and not the drug because I want to take it! Last 3 home readings on 200mg were 5.1-5.7.

    #5572

    Yes, I felt side effects when my doctor put me on 300 mg on day 1. I was fatigued with very less energy. I reduced it to 150 mg from day 2 and continued for appox 4 weeks. Then I increased it to 200 mg for last 2 weeks. I have been taking it for appox 6 weeks now. Last reading of Uric acid was 6.3 in the afternoon test after 1 week of 200 mg. I am getting it tested again tomorrow to see if the value is above 6.0 and if the dose should be increased to 300 mg.

    On some days, I feel very lethargic and drowsiness, which continues for few hours at times. I am unable to link it to anything, it just happens occasionally. In the begining, there were many days when I have symptoms of flu, malaise etc. but then the nody probably got adjusted to it.

    I did feel mild breathlessness couple of times and more exertion while climbing stairs as compared to before. I also felt stomach aches on couple of days. But I think the body is getting adjusted to it and now I feel less lethargic.

    #5573

    Good to see, from UTubelite, that the fatigue side-effect seems to reduce in time.

    I cannot find any serious research in this area – presumably because the state of mild fatigue is not debilitating enough to justify investigation.

    One possible explanation is that, as uric acid crystals are dissolving, your immune system is hard at work fighting a widespread outbreak of old urate deposits. Though this may not be concentrated in a small enough area to trigger a gout flare, but might be enough to cause fatigue – or am I the only one to have occasionally felt totally knackered during a mild gout attack?

    The sensible approach is to have a word with your doctor. He may be able to run tests to look for obvious causes – anemia? (clearly, I'm clutching at straws here)

    #5574
    pagey57
    Participant

    yes I had side effects when I first started on alopurinol.

    I ached really badly just abourt every where.

    I started of on 50 then built up to 300 which is what I am on now.

    Everytime I upped it I felt really bad. I had palpitationss as well when I was trying to get to sleep.

    You do get used to it and I am much better now but I do have little bouts of that achey feeling.

    You just have to hang in there.

    All the best

    Chris

    #5575
    cjeezy
    Participant

    Thanks for all of the responses everyone.   Pagey, how long before the majority of your side effects went away?  I had the palpitations at first, but they went away. I expected the aches, however the fatigue is just plain awful…Can't even go to the gym right now.  Even standing up gets me a little light headed at times.  Also, I'm starting to think its possible that my shortness of breath is caused by quitting smoking after 16+ years. I quit at the exact same time I started this Rx.  Anyways I just wanted to see if anyone else had these symptoms because when I looked online the feelings I have all say “rare side effects” and to “contact your doctor…yadda yadda”  I'll try and wait it out another week and see how I feel.

    #5576

    When I was getting the side effects, I talked to my doctor and showed him twice in 3 weeks time. He gave me an anti-anxiety medicine and that helped me. I am still taking it. He said a lot of time, the breathlessness and light headedness( which I got one day when I got up from the chair and I have to hold on to the wall to stand straight…as I had also started taking BP medication just weeks back, it was not clear what caused it) is due to anxiety of mind thinking into possible side effects. I would also see my eyes in the mirror to see if they were getting yellow.

    So, seeing my anxious nature and to put the things in better prospective, after 4 weeks of Allopurinol and Colchicine, the doctor ordered labs for Liver and Kidney enzymes . Every thing came out OK. Before the Allopurinol, he tested me for Liver, Kideny and a lot of other tests including iron, other minerals, vitamin levels etc…..all of them were OK.

    I think,  most medications do cause transitionary side effects, which we have to live through unless some of them are disruptive enough. Doctor can best address them and advise.

    UTubelite

    GoutPal said:

    Good to see, from UTubelite, that the fatigue side-effect seems to reduce in time.

    I cannot find any serious research in this area – presumably because the state of mild fatigue is not debilitating enough to justify investigation.

    One possible explanation is that, as uric acid crystals are dissolving, your immune system is hard at work fighting a widespread outbreak of old urate deposits. Though this may not be concentrated in a small enough area to trigger a gout flare, but might be enough to cause fatigue – or am I the only one to have occasionally felt totally knackered during a mild gout attack?

    The sensible approach is to have a word with your doctor. He may be able to run tests to look for obvious causes – anemia? (clearly, I'm clutching at straws here)


    #5577

    Hi cjeezy,

    I did get the light headedness side effect, and I also noted out of balance at times while I was walking. Like you suit smoking, which drives you to think and confuse what could be the cause, I also had started taking Tenormine – BP reducing medicine for the first time in my life. The high doses of Mortin caused high BP, to counter which I was advised to take Tenormine 25 mg twice a day.

    The doctor said Tenormine is more likely a cause. The dose was reduced to 25 mg( That I understand is the minimum dose) in the night only. I am an anxious character and get nerveous too fast by presuming too many things. The interesting thing to note is that with 2 times BP medication, my BP was showing in 140-145 and 90-95. With one dose at night, it now shows 125-130 and 80-85( and I do have white collar BP syndrome). The doctor has already told me to withdraw Tenormine over next 2-3 weeks time.

    The things are better as of now though there are still occasions when drowsiness, lethargy show up but to lesser extent now.

    To summarize, there may be other factors than the Allopurinol only to cause some of these side effects, including nerveousness.

    UTubelite

    #5578
    Utubelite
    Participant

    I am currently on 200 mg of Allopurinol. I am going for the serum Uric Acid test today.

    Here are my readings-

    1. July 23, before medication – 9.2, medication started on July 30, tested on fasting of 14 hrs

    2. Aug 5 ( 150 mg of Allopurinol, I will call it AP) – 7.0, no fasting, tested around 3 pm

    3. Aug 21( 150 mg of AP continued) – 6.6, no fasting, tested around 5 pm

    4. Sept 1( 200 mg started a week before – Aug 25) – 6.3, no fasting, tested around 3 pm

    Now the question –

    If I have to go to 250 mg or 300 mg, what is the best way to do it to minimize the side effects – take it as one dose of say 300 mg in the morning( I am taking AP with breakfast) or split it into 200 mg morning and 100 mg night( doctor has told me to increase dose to 300 mg if the readings are above 6 but left the option of single dose or split to me). I may go for 250 mg for a week and then increase to 300 mg, yet to decide.

    #5580
    pagey57
    Participant

    cjeezy said:

    Thanks for all of the responses everyone.   Pagey, how long before the majority of your side effects went away?  I had the palpitations at first, but they went away. I expected the aches, however the fatigue is just plain awful…Can't even go to the gym right now.  Even standing up gets me a little light headed at times.  Also, I'm starting to think its possible that my shortness of breath is caused by quitting smoking after 16+ years. I quit at the exact same time I started this Rx.  Anyways I just wanted to see if anyone else had these symptoms because when I looked online the feelings I have all say “rare side effects” and to “contact your doctor…yadda yadda”  I'll try and wait it out another week and see how I feel.


    Hi

    My aches lasted for over a year but that was mainly because my dosage of Alopurinol kept being increased.

    I had a very difficult time getting used to it.

    It is ok but I still feel achey now and then.

    I go to the gym 4 times a week but I take it a lot easier than I used to.

    Just do it to keep your self moving.

    I take glucosamin and omega 3 fish oil and that helps enormously.

    I seem to sleep very heavy and dream a lot now.

    I definately dont sleep as well as I didd before Alopurinol

    All the best

    Chris

    #5582
    cjeezy
    Participant

    pagey57 said:

    I seem to sleep very heavy and dream a lot now.

    I definately dont sleep as well as I didd before Alopurinol


    That's interesting.  I've also noticed that my dreams are just plain WILD lately! and I do sleep pretty heavily ?except for the fact I have to go to the bathroom about 2 times a night due to all the water I drink during the day!

    I had a follow up with my Dr yesterday.  He kept assuring me that the fatigue was not due to the drug because he's never had anyone complain of it (interesting).  I skipped my dose yeserday morning and felt pretty good, I took 200mg before bed and feel a bit better today.  I want to also ask everyone here because I forgot in my original post, but has anyone else noticed that their vision is just a bit off (like it takes a second longer for things to focus at time)? I hate to keep badgering my Dr and sounding like a hypochondriac, but not sure about this symptom.I want to stay on this drug and so does my Dr but how serious should side effects be b4 you stop taking it? I know Uloric will run me about $60/mo or $150 for 3 months but I don’t really want to test a newer drug. Any input?

    #5585
    pagey57
    Participant

    cjeezy said:

    Post edited 10:21 pm – September 9, 2009 by cjeezy


    pagey57 said:

    I seem to sleep very heavy and dream a lot now.

    I definately dont sleep as well as I didd before Alopurinol


    That's interesting.  I've also noticed that my dreams are just plain WILD lately! and I do sleep pretty heavily …except for the fact I have to go to the bathroom about 2 times a night due to all the water I drink during the day!

    I had a follow up with my Dr yesterday.  He kept assuring me that the fatigue was not due to the drug because he's never had anyone complain of it (interesting).  I skipped my dose yeserday morning and felt pretty good, I took 200mg before bed and feel a bit better today.  I want to also ask everyone here because I forgot in my original post, but has anyone else noticed that their vision is just a bit off (like it takes a second longer for things to focus at time)? I hate to keep badgering my Dr and sounding like a hypochondriac, but not sure about this symptom.I want to stay on this drug and so does my Dr but how serious should side effects be b4 you stop taking it? I know Uloric will run me about $60/mo or $150 for 3 months but I don’t really want to test a newer drug. Any input?


    Hi

    you  sound so much like me.

    I thought that every time I felt slightly unwell it was caused by Alopurinol.

    I went to the Drs for check ups and he always showed me that there was another reason for what ever it was was wrong.

    For example I had terrible aches on the top of my foot it turned out that I had torn a ligament.

    So bottom line is not to get paranoid about it .Its doing you more good than harm.

    I dont think you should skip a dose either ,not a good idea.

    Chris

    #5588
    cjeezy
    Participant

    Hi Pagey,

    I didn’t really skip a dose I just took it at 7pm instead of 7am. Have you noticed a hard time focusing on things with your vision?

    #5591
    pagey57
    Participant

    cjeezy said:

    Hi Pagey,

    I didn’t really skip a dose I just took it at 7pm instead of 7am. Have you noticed a hard time focusing on things with your vision?


    Hi

    No my vision has always been ok.

    I know when I started on it I was very tired and that affects your vision .

    I think you should be careful as I said not to blame everything on Alopurinol.

    I am much better than I was a year ago ,thankfully.

    Good luck

    Chris

    #5594
    cjeezy
    Participant

    Yes it very well could be the tiredness effecting my vision.  It's not blurry, it just takes a second or two longer for everything to focus (mainly small detailed things).  Also, Allop is the only Rx I'm taking

    #5603
    pagey57
    Participant

    cjeezy said:

    Yes it very well could be the tiredness effecting my vision.  It's not blurry, it just takes a second or two longer for everything to focus (mainly small detailed things).  Also, Allop is the only Rx I'm taking


    just hang in there it does get better but slowly

    All the best

    Chris

    #5625

    I have never been able to stay on this drug, Allpurinol

    Just never works, I can't move at all wiith it, so even if it hurts worse at first after even 2 weeks and you can't go to work thats not helping you at all. 

    How would you pay for the medication let alone keep a physically active trade job?LOL

    You have to try to eliminate the problem not band aid it with drugs IF possible.

    I have had uric acid blood tests for years and it never shows high counts according to my MD.

    They have checked not running an attack and with running an attack.

    My MD last commented wow is your system ever touchy to small amount of anything.

    I had gout recently for over a month, a couple months ago till I completely cut off  a bunch of stuff like peanut butter,fibre rich bread, eggs, bacon, mushrooms, any red meat period.

    My colchicine or indomethancin wouldn't even touch it.

    Thou on the first yellow pills they have cut me down to 2 per day now.

    That won't dislodge a bad attack.

    Indomethacin killed the pain

    But it isn't good for you either really.

    Now still good going on two weeks no gout ..so far I will see if gout tries to go around my change in eating and tag something else. The body can be like that.

    Its very difficult to say specifically what works or doesn't work…as everybodies body can and does react differently to various foods their associated additives or lack of.

    Just like some people can absorb different vitiamins more or less than another person.

    #5640

    2 extremely serious issues here, John:

    1. Allopurinol is not a painkiller. It helps regulate uric acid, but only if you check your uric acid NUMBERS. High / normal / low uric acid assessments are completely meaningless for the gout patient. You must know your uric acid number and keep it below 6mg/dL. If you only take enough allopurinol to let the number swing in the 6 to 8 range, you are forced into a cycle of perpetual gout attacks. Are you certain that the dose from your MD is enough to lower your uric acid below 6mg/dL?
    2. If gout has failed to respond to proper daily use of allopurinol, there is a strong chance that it is not gout. You should be referred to a rheumatologist to test for pseudo-gout and other conditions that are commonly confused with gout.
    #5642
    zip2play
    Participant

    John,

    To repeat what Gout Pal strongly implied: your physicians assurance that your Uric Acid numbers are NORMAL is meaningless, ask him for the NUMBERS and then YOU judge whether they are normal.

    The AMA considers 8.3 to be NORMAL but once gout is established a uric acid anywhere near that high will keep its sufferer in constant torment…and attack can occur with a uric acid of 6.0, but a NON-gouty person can have a 9.6 without triggereing gout.

    If any doctor looks at the reference range and proclaims normal with anything above 6.0 AFTER the patient has told him he has gout, that doctor has announced to you very cleartly that he doesn't understand gout and should not be attempting to treat it.

    It just happened to me with a new doctor who proclaimed my 6.6 as normal, and I corrected him by saying for people without gout that is a risky level.

    If by the little yellow pills you mean colchicine, you are correct: 2 pills per day will do little to stop and established attack, you need more. John, I strongly recommend you try allopurinol 300 mg. again and DON'T STOP taking it. Take 2 colchicine with it, 4 id needed. Just waiting around til you have another attack is NOT the way to deal with gout because eventually there will be no pain free periods. You just cannot assume that you have the problem taken care of becasue you are in a pain free period. Since early gout comes and goes, it is too easy to misjudge cause and effect. Just because you stopped eating peanut butter on Tuesday and the pain stopped Wednesday means nothing more than if there was a full moon on Tuesday. 

    **************************

    Anyone with vision disturbances remember that after age 40 presbyopia is “normal” condition and the effect is on the ability to focus on small close stuff.

    ***************************

    Utubelite,

    Take you allopuinol any way you wish because it it the first metabolite, oxypurinol, that does most of the work and it has a half life of several days. Ultimately the dosing schedule has little meaning and in fact I think one COULD just as well take 600 mg. every second day. I take my 300 mg. as a single dose after breakfast.

    #5643
    cjeezy
    Participant

    zip2play said:

    Anyone with vision disturbances remember that after age 40 presbyopia is “normal” condition and the effect is on the ability to focus on small close stuff.


     I'm only 31 🙁

    #5649
    Utubelite
    Participant

    I got my Uric Acid tested yesterday at 2pm before I ate my lunch. The numbers came down to 5.1. I am on 250 mg of Allopurinol( 200 am and 50 pm) since last one week.

    My last week reading was 5.5 on Sept 8( with 2 weeks on 200 mg and 4 weeks 150 mg prior to that). All of these tests were done in labs.

    My trend has been consistent with the dose and passage of time with UA levels falling every week.

    I guess, I do not have to go to 300 mg dose as the numbers may go down further with 250 mg as it builds up its concentration in the coming days. I will get tested next week again.

    I am on very strict diet without alcohal, meat or any other high purine product. I plan to start eating now in small quanitities as the numbers are now considerably below 6.0.

    Any advise?

    Thanks!

    #5650
    cjeezy
    Participant

    I too just had another lab test today. Hopefully I will have results by tomorrow. Did you say that your lab tests matched your home test numbers? If you’re at 5.1 on 250mg, while low numbers are good to rapidly dissolve crystals, I wonder if you could eventually cut back to 200mg??? If you did I would of course monitor it closely. Maybe other expercienced gouters will have an opinion. I know my Dr said he would be happy if I was at 5.5. Just my 2 cents.

    #5652
    Utubelite
    Participant

    I never tested at home. All the times, it was lab test only. I was able to reach 5.5 with 2 weeks of 200 mg, so I think, if everything goes fine, I may be able to cut it back to 200 mg. For the time being, it is 250 mg and I will test next week to see where the numbers are….I hope, below or around 5.

    One other thing to note is that I have been now exercising ( light jogging and walking) for an hour a day for a week, which was my routine before I got the toe injured followed by gout. So, the numbers include the exercise impact. I did lose about 3 pounds in a week time.

    Let's see view of others on numbers 5.5 v/s 5.

    I am waiting to see your numbers.

    #5660
    cjeezy
    Participant

    Hi Utubelite,

    I'm in the same boat as you.  I started a new post with my updated numbers

    #5666
    zip2play
    Participant

    I think there is nothing wrong with settling on 5.5, BUT if it has to be achieved with meat and alcohol restriction then one must ask oneself if that is sustainable forever.

    I have recently gone back to the 300 mg.dose and I find it conventient and cheaper that the pill is available as a 300 mg. dose. (Many of my discount chain pharmacies have a 30 pills/$4  price so 30 x 300mg. cost the same as 30 x 100.) And it makes it SOOOO easy to pop ONE allopurinol with my morning raft of pills and vitamins and minerals and lecithin and cod liver oil, OY! (It took me 20 years to realize the 300's make more sense than a bunch of 100's…I suppose becasue I started with a 400 mg dose.)

    Remember too, that as uric acid spikes and troughs during the course of the month it might be wiser to have slightly too much allopurinol than too little, because a SINGLE gout attack can be so disruptive. Our goal is ZERO attacks and a uric acid that is ALWAYS below 6.0. After all who can be certain what our serum uric acid is at 4:30 AM preceding an attack, no matter WHAT number we got at the doctor's office last month?

    #5668
    cjeezy
    Participant

    That makes sense Zip. Any thoughts on my current numbers which I listed in another post yesterday?

    #14097
    KeithTaylor
    Participant

    This allopurinol side effects topic is now closed.

    It covers several variations on a theme, including:

    • Allopurinol side effects forum
    • Allopurinol dreams
    • Is tiredness a side effect of allopurinol?
    • Allopurinol side effects fatigue

    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 Side Effects guidelines for best information.

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