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In order to start either Allopurinol or Uloric you need to be symptom free.. i have some sort of pain in my feet all the time.. i haven't found a window in the last few months to start.. what can i do?
john
Just start it now.
There are no medical reasons for the delay. Many doctors delay the uric acid lowering treatment because they believe that the patient is less likely to continue with it if they associate it with continuing, or temporarily worsening, pain. I believe a proper explanation would be more effective.
john,
You gotta make do. If you cannot find a pain free window, then just start tomorrow.
Which drug are you going to use?
I'm reminded of the wonderful old lyric, God knows why:
“If you can't be with the one you love, love the one you're with!”
just trying to decide ..my rheumy says Uloric is much better…but she also didnt seem to know that you can get attacks while the UA is emptying out.. she's not prescribing anything like colchisine or anything but i will ask her to..i kind of depend on diclofinac.. she actually still is wanting me to do this MRI of my foot so she can see what kind of arthritis it is, before i go on uloric… as i have said before i have had a bunch of attacks before that were worse ..these a slighter , but non stop, just about constant.. it somehow seems different than before.. i have such an aversion to taking one of these drugs as i have heard they both can cause kidney or liver problems…
rucyrius said:
i have such an aversion to taking one of these drugs as i have heard they both can cause kidney or liver problems…
I thought the medical view these days was that the lowering uric acid was massively beneficial to kidney health.
The liver situation is more complex. I have seen concerns about the effects of febuxostat (Uloric/Adenuric) on the liver, but there does not seem to be a conclusion yet.
There have been reports of liver problems with allopurinol, however these vary greatly between individuals. Some people have reactions agains allopurinol and others do not. Where the reactions do happen, they appear to be reversible once allopurinol is stopped, except in those cases that prove fatal. On the other side of the coin, a recent report (Allopurinol, an inhibitor of uric acid synthesis–can it be used for the treatment of metabolic syndrome and related disorders?) states:
This article presents a review of reports, mainly of recent studies, on the efficacy of allopurinol in various diseases and explores novel potential uses of the drug. Important novel and potential uses of great interest include metabolic syndrome (MetS) and related disorders, chronic kidney disease (CKD), nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Ischemia-reperfusion injury and mucositis, encountered as adverse effects of cancer treatment, have also been under investigation as potential targets for allopurinol
Like many things in life, there are risks on both sides – risks if you take action, and risks if you leave the problem untreated.
Much will depend on what your uric acid levels are, and if you have other alternatives for reducing uric acid.
DO make sure of your diagnosis before starting on any of these lifelong regimens.
Absent completely incontrovertible symptoms Your rheumy should aspirate a joint and look for crystals under polarized light.
Risk of allopurinol is VERY slight…uloric long term risk is unknown.
If you’re interested in the effects of Uloric on your liver, please join the discussion:Improving Uloric Liver Warnings Guidelines for Gout Patients.
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