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Uloric vs. Allopurinol (Page 2)

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December 18th, 2010
Got
I am 65 in age and have had chronic gout for 20+ years and it now to a point that my lifestyle is very poor and walking is sometimes very difficult. The gout goes from ankles to elbows to fingers and last 10 plus days. My Dr. has just now prescribed allopurinol, but I am afraid to take it as I have heard that it damages the kidneys and it has other bad side effects. Do I need to be afraid of this drug?
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replied December 29th, 2010
Allopurinol is a tried and true treatment that has been around for years. So is cochlicine, it is one of the grandfathered remedies under the FDA. It was around before the FDA was formed. The main reason it is not under the FDA is the its interaction with newer drugs, ie NASDs, and some Drs not understanding how to prescribe is effectively.

First start out with a low dose say 100 mg of allopurinal for several weeks and then work up to the 300 mg if you need to. Remember it took years of build up to get the topies and the uric acid level to where they are causing the attacks so take time to get it down.

Second take something like cochlicine with the allopurinol to manage the pain. In fact the recommendation is not to take allopurinol without cochlicine because of the pain that can be caused by the allopurinol pulling the Uric acid out of the body.

If you will check the latest recommendation from the FDA, many of the NSAD's are no longer recommended particularly in combination with uric lowering drugs. Taking some of the NASD's with either colchlicine or uric lowering drugs accounts for some of the reported side effects of kidney and liver damage. I actually had a doctor proscribe cochlicine and napoproxin togather, thankfully I didn't take the napoproxin and found a new doctor.

The newest recommendation is not more than two cochlicine in any given day, even for an acute attack. The old recommendation of one every two hours until "gastrointestinal distress" is no longer recommended. (Many doctors never read beyond the comma where it said "or until pain is re-leaved") Many of the reported side effects are from the older recommendations. Besides the side effects of NASDs are just as bad or worse. Check the history of cochlicine, the only three conditions is has any effect on is gout, Mediterranean familial anemia, and a very specific cancer chemotherapy treatment. (Take it for a headache or hitting your thumb with a hammer and you'll get not relief unlike any NASD). There is no such history on Uloric or any of the newer drugs.

I have been on a regime of one cochlicine of .6mg and 100mg allopurinol for 3 years and all the tests are fine. Without it for a day and the next day I hurt. I can handle the cochlicine with only soft stools and can take an extra one once in a while when I hurt more. Won't take any more than the 100mg allopurinol because I can't handle more cochlicine on a regular daily basis. It took several months before I could handle the cochlicine daily.

Yes there are apparently some people who do not tolerate allopurinol. However, I would check the dosages and how it is being taken before changing or trying a newer drug. I believe gout is one of the most misunderstood conditions out there. Many doctors really don't understand the causes and treatment or for that matter who can get it.

Diet is a significant part of the treatment and avoidance of attacks. I went off of all meat, chicken, fish, pork and the bad vegs (oats, asparagus, brockly, spinach, mushrooms)and no alcohol for 2 1/2 yrs. This summer I was able to start adding some chicken and non-shell fish back into my diet. Some mushrooms seem Ok. The others still cause problems. Surprisingly pork doesn't seem to cause problems in moderation, but look at beef and I start to hurt. Many doctors discount diet.
But if it is purines that start the avalanche and they come from food, then why wouldn't diet be important.

I view gout management as no different than managing diabetes. There are those who cheat on their diets, play with the meds, etc. until they loose their sight, a limb, and all of the other things that will happen when not managed. Then they wonder why its happening to them and try to play catch up and spend the rest of their life in with all kinds of problems that could have been avoided.

One last note. It is possible to have high uric acid levels and not have one symptom of gout. It is also possible to have low uric acid levels and have severe gout symptoms. Uric acid levels are a gauge not the end all either diagnoses or treatment.
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replied January 19th, 2011
I was taking Allopurinol for my gout for about 3 weeks and it was working great except for one thing...I developed terrible itching on my arms and legs with a little rash. My Dr. is switching me to Uloric to see if it helps without causing the itching. I haven't started it yet because I want the itching to totally stop before starting Uloric.

Anybody else experiencing itching/rash with Allopurinol?
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replied January 19th, 2011
Allopurinol causing itching
I was taking Allopurinol for my gout for about 3 weeks and it was working great except for one thing...I developed terrible itching on my arms and legs with a little rash. My Dr. is switching me to Uloric to see if it helps without causing the itching. I haven't started it yet because I want the itching to totally stop before starting Uloric.

Anybody else experiencing itching/rash with Allopurinol?
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replied January 20th, 2011
I suffered from gout for years, i am 41 years old and have had high uric acid since my 20's. Allopurinol didn't work at first because my doctor gave me 300mg from the start,and this made it worse. I saw a rheumatologist and he started me taking allopurinol (100mg) and colchicine daily and every two weeks increased allopurinol by 50mg until i reached 300mg once daily. After six months i was able to stop the colchicine. I have been gout free for over a year and my uric acid is <6. It is a slow process but you have to be paient and do not stop taking the allopurinol.
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replied February 11th, 2011
Another Uloric question.
My husband developed alergic reacion to Allp after a few years and so the Dr. prescribed Uloric today. The instructions say, in part, "USE OF THIS MEDICINE IS NOT RECOMMENDED IF YOU HAVE MALIGNANT DISEASE.." Know anything about that? I assume Lymphoma is a malignant disease.
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replied February 11th, 2011
This a partial answer to my own question. We contacted the druggist who printed the instructions. He said there hasn't been enough time to know the effects of Uloric on "malignant disease." Advised us to further discuss this with the doctor, who won't be in until Monday. Thanx anyhow.
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replied February 16th, 2011
So sorry to join in so late. I am not a doctor. I'm sure with the help of the internet I could play one on T.V.! But this is all hypothetical. I probably have more time to think than most of you. Uric Acid, I believe, is caused by overworking the kidneys(and maybe the liver, pancreas, lymph nodes.) The one thing that causes the aches and pains, and swelling in extreme conditions, is the radiant cold. For instance, I just woke up with a throbbing foot because I took my first dose of allopurinol yesterday. The web says it can take up to 3 mths to stop the attacks. My floor is not insulated, so my foot is throbbing more as I share this. So I'll get to the point so I can stop torturing myself. Cut your weight(if overweight), saturated fats, certain medications(check with your doctor first), red meat, nicotine, caffeine, alcohol, and anything else you are "abusing." Drink more water to flush the "toxins" and uric acid from your system. And last but not least; stay out of the cold and keep the affected area elevated and warm. I'm going to trust my instincts and keep taking allopurinol. Good luck!
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replied February 28th, 2011
Gout,Uloric vs. Allopurinol
Listen when your Dr. starts you on Uloric or Allopurinol and does not give you colchicine along with either one of these drugs..run from him/her as fast as you can and never go back. I have had the gout since I am 23 years old...I know the pain...What worked fro me? I tried allupurinol and didnt like the way it made me feel, finally my rhumatolagist put me on 2 tablets,06 tablets of colchcine daily...that has been working for over 30 years without and side effects.
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replied March 5th, 2011
success with allopurinol
I have been taking 300 mg of allopurinol once a day for 25 years and have never had another attack since I started taking it. No side effects. Uric acid stays normal.
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replied March 7th, 2011
I'd been taking allop (300 mg) for about a mth and a half and got my uric acid from 750 down to 493 (doctor wants me below 350), when i developed a rash and he made me go off it asap. he's not prescribed me uloric and i'm hoping this will work out better. i've been staying away from red meat and anything else high in purines and i hope i can get my uric acid under control some day. i'm turning 30 this yr and thinking about starting a family next year, but my doctor has been unable to tell me if taking uloric while pregnant, is even an option. anybody have any ideas?
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replied March 10th, 2011
Try allopurinol first, for me it didn't work. Had bad side effects. Uloric has so far been great for me.
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replied March 21st, 2011
try krystexxa. It is administered through iv bags. Just approved by fda 6-8 months ago and should me on market right now.
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replied March 27th, 2011
Gout remedies
I am 58 years old and have had gout for over 30 years. I have been taking allopurinol for over 20 of those years. The only side effect I have noticed is the tendency to make me sleepy. Other than that, my gout is very well controlled and attacks very rare and mild when they do occur. I am on 100 mg once a day. My advice is, if you are trying something as a gout remedy for the first time, try allopurinol first. If it works for you as well as it has for me, you will be in good shape. Tried and true, generic (therefore cheap) and effective for many, if not most, gout sufferers.
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replied April 19th, 2011
Is the rash worth the use of Allopurinol?
I take Allopurinol 300mg. It works, but I have developed a skin rash that may be caused by Allopurinol. Yet Allopurinol costs very little. The Uloric costs me $198 for 30 tabs. The insurance does not cover it, and I have Medicare and BlueCross/BlueSheild.

I have no problem with the rash. I seldom have flare ups with Allopurinol. I don't think I should go broke taking the Uloric. Yet, I do have some kidney problems. My creaatinine is 1.98. Uric acid is 5.1.
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replied July 11th, 2011
more questions than answers on gout - docs seem useless
I am 65 Years oldand have had gout on and off for 13 years. SOmetimes not bad and others leave me unable to walk. Knees like grapefruits. Ankles like softballs. It appears to go all over my feet - toes, ankles and sometimes the front of my foot is all red and swollen. I use chochicine irregurally and inmethcin for the inflamation. I have tried to start Alop 300 mg several times but each time the gout flares up. Maybe I'll try a 100 ng dose. Does anyonethink stress is a contributor. also it seem I always get a bad attack in the spring every year.
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replied October 1st, 2011
Uloric?
Wow, great post. Lot of good data here. Have had gout for about 8 years now. Currently 37YO. Started first with diet, then colchicine and Anti-inflammatory, then started with Allapuranol a year ago. Started it by slowly coming off of the colchicine and went from 100 to 200 to 300 mg of allapuranol. Stayed on 300 for 4 6 months and it worked like a charm. Then clipped it down to 200 for 6 months and though I am not as good as with the 300 I have not had anything near of an attack that I have had in the past.

Yes, I believe that stress does play a factor as I always am so much better after vacation.

Am really thinking about considering uloric though. Had no idea allapuranol makes you tired and that is exactly how I feel. No energy and burn out easily. I am getting old but not in bad shape so hoping to improve my health.
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replied October 17th, 2011
just stanted alp 3 weeks ago - gout for 15 years. Iam 65 y o. about how long shoud I expect it to kick in?
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replied October 18th, 2011
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It may take a while. When they put me on it started with 100 mg a day for several weeks, then 200mg for several weeks, and up to 300mg. Now, they have been reducing it and measuring my blood to monitor it.

I would say it depends on the person but it is a drug that is more long term in it's effects. You may even have a gout attack while taking it if you are coming off of colchicine or other drugs.

I hate drugs. Wish I did not need them.
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replied December 22nd, 2011
alpuronal vs aloric
was taking allop for 3 months (first 150MG's then moved it to 300) after another month got a severe reaction skin rash arms, legs next and scalp.
Immediately got off it. Anyone else experience the rash and moved successfully to Uloric?
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replied January 8th, 2012
rash with allipurinol
Hi...Yes! I started taking allopurinol in early December (300mg) and within three weeks I had a very very severe and extremely itchy rash on my back, front, upper arms and thighs...even places without an actual rash have been incredibly itchy..my head, feet..everything. My doctor had me completely stop the medication, have been using a 2.5% hydrocortisone cream, and now it is finally getting better.
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replied April 25th, 2012
Gout
I have had gout in my foot/toe for about 3 weeks and my doctor prescribed Indicin which I have been taking and it does relieve the symptoms although the gout has not completely gone yet and if I stop taking the Indocin the gout seems to come back. He also gave me a script for Allopurinol to take every day once the gout has gone. Can anyone tell me when to start the Allopu. an I start taking it before the gout has completely subsided or do I just stop the indocin when the pain has almost gone and start the Allopu then. Driving me nuts! JOHN>
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replied May 11th, 2012
Uloric and Gout
Uloric WORKS, expensive but worth it. Im 39 and have had Gout for 8 years Allopurinol made me feel flush so i just started drinking alot of water and it worked for a few years with only maybe 1 attack a year. started Uloric 2/29 uric acid level was 10.8.. 3 months later with an attack a week it is 5.3 and my feet are starting to look normal. I think the gout attacks are gone. I will take colchicine when needed however it is VERY hard on my stomach..
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replied September 26th, 2012
The truth about gout!!!!!!
First of all, this disease has been around for since the beginning of time. While "home remedies" can help, they are NOT the answer. For centuries we have viewed gout as a gluttoness disease that is brought on by people who can't control what they eat. This type of thinking is still prevelant. For example, when you see your doctor is the first question they ask "what did you eat last night?" Diet is no bigger than a trigger. It's triggering a chronic metabolic disease where you are either producing too much Uric Acic or you have trouble excreting it. Both of this issues will cause the level in your blood to be high. What happens when you add to much sugare to your coffee? The coffee can't dissolve all the sugar crystals and they settle to the bottom of the cup. The SAME thng happens in your body. The only problems is we don't know where those crystals go once they form in your body. Most of the time they will form in the cooler extremities. This is why gout initally presents in the big toe. Gout is not your fault. Your body has a problem with Uric Acid.

I have good and bad news for gout sufferers. The bad news is that this disease is chronic and you need to take a medicine the rest of your life. The good news is,if caught early enough, it's reversible. If bone damage has occured, of course, that is not reversible. It doen't matter which drug you take or what remedy you try, you have got to get to a serum UA level of <6 mg/dL (even lower if you have tophii). If you have a sUA of 8.5 and 300 mg of Allopurinol gets you below 6, you one of the lucky ones who pay a $4 copay. If you need something more potent to reach 6, you're going to have to pay more for a branded drug.

One last note, when sUA levels fluctuate either up or down you are at risk of a flare. This triggers your immune system to attack. This is why you flare when you start urate lowering drugs b/c UA is dropping and the crystal in your joints are changing and you immune system is attacking them. This is why you flare when you eat meals high in purines (steak, beans, beer, shellfish) b/c the UA is increasing rapiding causing the crystals to change in size and trigger the immune system again. Theoretically, one could be seen as a "good" flare and the other bad. The bottom line is no crystals = no flares. But, it will take a while after you lower your sUA for the crystals to dissovle so you can pee them out. After all, you've been laying down crystals for years and you can expect some pain when they're coming out.

I hope this helps. Don't let your doctor or your friends blame you for your gout. It's an inflammatory arthirits like RA, fibromyalgia, and lupus and it's time we start treating it the right way.
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