allopurinol everyday even during attack
Hi i'm new to the group and I am 56 yrs old.I have suffered with gout
on and off for 30 yrs.I live in the uk and was first told to take allo
300mg every day but to stop if I had an attack and take indomethacin
until it settled then take allo + indo then just allo.Most GP's and
consultants have said this.Six months ago I saw a rheumatologist
because I had not worked for 5 mths because of gout/arthritis.He
explained the "sponge" theory (which I had never heard before) and
told me to take allo 300mg every day even if I had an attack.This I
did but I am no better and in fact get worse and longer attacks.Has
anybody else had the same advice?
Allopurinol resistance and sensitivity can come to those that have been on it for a while. When Allopurinol cannot be taken any longer or has no positive effect it can be said that it has stopped working for the individual.
When I first posted I was really asking if taking allopurinol during
an attack was what other sufferers had been advised as in the past I
have always been told to cease until the attack had settled down.
This is not true. Some ppl get relief from an attack by taking allopurinol.
I did not say "pain relief". I said relief.
When I take allopurinol my gout is controlled. Same for a family member
of mine who has gout. Same for some ppl on this listserve.
You "seriously doubt" a lot of statements on here. You just started
posting again and it's already sounding like a broken record.
My name is Tom and I have been prescribed 450mg. of allopurinoll. I am allergic to indocin and cochicine. figure that one out! Is cranberry juice and orange juice good for gout people like us? tom
This is not true. Some ppl get relief from an attack by taking allopurinol.
Cranberry juice no!!! Orange juice is good!!
Tom Lynch
My regular family doctor prescribed Allopurinol during an attack and I
got worse! (I quit taking right away) Then I went a Rheumatologist and
she was angry that my family doctor had did that! I take nothing until
I first start to have the slightest pain and then take Indocin for a
week. The Rheumatologist said that Allopurinol should be taken until an
attack has been gone for 3 to 4 weeks and to start it slowly over 6
months with monthly blood work.
Gypsy
Okay...I've read all of the posts regarding Allopurinol. I am allergic to it, so I had supposed that I really had no take on it. However, what sense does it make to take a medicine that you still have to watch everything you eat anyway? What sense does a medicine make that can cause more of a problem for you in the end, as well as liver damage?
So far I've had five years worth of attacks. I had one that lasted a really long time, and I looked at the food list and realized that I'd been eating peanut butter alot, and so I cut it out and the attack went away.
When it gets really bad, I go to the podiatrist who gives me a shot into the joint. Inside of two or three days, the pain is gone. And I've listened to each of you and taken advice regarding drinking spring water and eating more alkaline foods when I feel a twinge coming on. <knock on wood
Stress is a real problem for me with the gout, so I try and stay as calm as possible. Normal stresses don't seem to bother it too much.
I don't know alot about the chemicals. But I do know that diet and watching my stress level and drinking alot of water seems to be doing the trick for me. I'd far rather have a shot than to risk my organs. I don't want to live in pain either...neither do I want to die from having taken medications that eventually don't work at all.
Nancy
In a message dated 17/11/2006 21:12:37 GMT Standard Time, nkorb1@... writes:
neither do I want to die from having taken medications that eventually don't work at all.
That is the most irresponible thing to post. You have NO evidence to support that and someone reading that would think that allopurinol will not benefit them.
If you HAD read ALL the posts you would have realised that even though you THINK you are allergic to allopurinol because of your first experience there are ways that some people who were allergic have overcome this problem by different methods of dosing.
Am I not responsible for my own health? What do you mean "irresponsible"? Because it's something you don't wish to hear or want to be in denial about? I'm not here to defend an particular medication. I'm here to glean what information I can from everyone here to control my gout. I don't need to be attacked by someone because I have a valid opinion. You have NO evidence that Allopurinol will benefit EVERYONE either. So how "responsible" is your advice?
It is a FACT that EVERY single medication related to gout and arthritis, carries with it a warning regarding damage to the liver. Again, I don't wish to take a medication that will not work always, that carries with it increased gout attacks long before it begins to work, if it works at all, that can damage my liver and that I still have to watch my diet anyway. I accomplish the same thing by having a shot of cortisone into the join of my toe or my knee to help with the attack, and then watch my diet and drink tons of water. AND I don't run the risk of harming my liver.
LOL...I think an anaphallactic reaction was proof enough for me. However, from what I've been reading here lately, your cure all doesn't remain a cure all, and you still have to do all the same things that I do by watching the diet. So what good is the medicine?
I am sorry but i cannot agree with you.
What good is the medicine?
It has saved me from suffering from gout the last two and a half years and lead a normal life i do not have to watch my diet (Where did you get that from?).
I take 300mg of allopurinol and lead a normal life, I do not have to watch my diet. I have no side effects. i have never been so happy or healthy and the reason is because of the advice given in this group by people with years of experience and vast medical knowledge.
I was and am concerned that your opinion could be misunderstood by others to have been a matter of fact.
I do not advocate the taking of allopurinol, but having tried to live with gout by diet alone for the previous ten years, I made a decision to change, and have not looked back since.
If the future proves that I suffer with damage then i will report back and advise others of the risks but having read many many medical reports the chances are very very slim.
In a message dated 20/11/2006 22:52:37 GMT Standard Time, nkorb1@... writes:
LOL...I think an anaphallactic reaction was proof enough for me. However, from what I've been reading here lately, your cure all doesn't remain a cure all, and you still have to do all the same things that I do by watching the diet. So what good is the medicine?
Sounds like allo is good for you.
But why do you ppl insist on EVERYBODY else following your program?
Why does it threaten you when someone else wants to try or is
doing it differently than you are?
Please can you identify where I have insisted that ppl should go on allopurinol. I am not threatened by others, what threatens is when a poster says " i dont take allo because i will probably die " thats what threatens me because that statement to someone indicates that allo is not safe and does not have medical information to support it.
It is the non users of allo who seem to be the most threatened on this site, and anyone who doesnt agree is either villified or moderated, and that is a pity because like the other posters on this site, i feel as though my time is done and it worries me that new people looking to seek help will only be directed down a non medical route, as the only posters left will be anti allo users.
In a message dated 21/11/2006 22:14:55 GMT Standard Time, opc73@... writes:
Sounds like allo is good for you.
But why do you ppl insist on EVERYBODY else following your program?
Why does it threaten you when someone else wants to try or is
doing it differently than you are?
In a message dated 21/11/2006 22:21:49 GMT Standard Time, loitnent@... writes:
Slow weight loss is the best. Losing my weight rapidly is what got
me into this Gout mess in the first place. I do not wish a gout
attack on anyone. I absolutely loathe them. And I listen to adhere
to all instructions the doctor gives, as I DO NOT want another gout
attack anytime every if at all possible! I avoid it like the plague.
I manage my gout with allopurinol. That is all I take to keep my
gout in order.
Hi folks. Cor quite a debate raging here. Here's my two pence/cents/euros.
I have been on the dreaded Allo for about 9 months. It caused all sorts of pains to begin with but soon settled down. I have had the odd twinge here or there (mainly caused by my overindulgence on seafood or beer) but nothing bad at all.
I feel it has done good for me. Whether or not I would want to stay on it permanently is a different topic. Like all of you I have my worries about long term use but my doc says that we can lower the dose, currently 300mg in the future or even wean off completely.
BUT!!! at the moment I have NO sleeplless nights crying in pain. I can have to odd blow out beerwise and I can go to the gym 3 times a week and not suffer. So for the moment me and Allo are pals.
Regards to all
Sean
All prescription meds come with warnings as well as over the counters
ones.
it doesnt threaten me, but it worries me - for other people's sake
I think its natural when someone holds a strong conviction (ie my conviction
is: "allopurinol works very well, is safe long term, and is so for the vast
majority of people") for them to try and convince others to try to
persuade/convince/explain why it works for them - and why it will 'probably'
work for you..
and of course the specific issue that raises the temperature of the posts
round here is the idea that new people to this group might read claims of
various 'snake oil' (sorry if thats inflamatory - but you know what I mean)
techniques - cherries, bromelain etc.. (or other approaches - like eels
alkalysing tecnique which I am very interested in) and think they might work
for them
and (IMHO) they probably wont
but allopurinol probably will
Tim
Please can you identify where I have insisted that ppl should go on allopurinol. I am not threatened by others, what threatens is when a poster says " i dont take allo because i will probably die " thats what threatens me because that statement to someone indicates that allo is not safe and does not have medical information to support it.
It is the non users of allo who seem to be the most threatened on this site, and anyone who doesnt agree is either villified or moderated, and that is a pity because like the other posters on this site, i feel as though my time is done and it worries me that new people looking to seek help will only be directed down a non medical route, as the only posters left will be anti allo users.
I do not see it as that at all. Some of the issues with Allopurinol come from the doctor themselves. First many doctors do not seem to know gout very well and then they use a drug they themselves don't fully understand and do not follow the drug makers directions on monitoring or followup. The drug was made for Cancer patients, these are people who are considered to be cured by their problem if they live 5 years longer only to have it show its ugly head somewhere else. The drug maker put a warning on Allopurinol that this drug may be used for other purposes than along with the cancer treatment and makes recommendations on a followup procedure that most doctors do not tell you or accomplish it with their gout patience. Would anyone here argue that many older patience end up with a pharmacy in their house by starting one drug that fixes one thing and then causes another problem that a new drug is needed for and son on. Often drugs are prescribed as an easy answer instead of
guiding a patience to diet or life stile changes. Here is the drug Allopurinol guidance page.
Generic Name: Allopurinol (al-oh-PYOOR-in-ol)
Trade Name: Aloprim®, Zyloprim®
For which conditions is this drug approved?
Allopurinol is FDA approved for management of patients with cancer who are receiving cancer therapy that causes elevations of uric acid levels in association with tumor lysis syndrome.
It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action?
Allopurinol works by reducing the formation of uric acid.
Tumor lysis syndrome (TLS) is the development of electrolyte and metabolic disturbances that may occur following the treatment of cancer and can result in life-threatening complications if not managed appropriately. TLS is caused by the sudden, rapid death of cells, particularly cancer cells in patients with leukemia or lymphoma, in response to cancer therapies. TLS may occur spontaneously, although this is uncommon. When cancer cells are killed by therapy, they spill their inner (intracellular) contents, which accumulate in the body faster than can be eliminated. These intracellular contents cause the metabolic and electrolyte disturbances that result in TLS. Hyperuricemia is a component of TLS and refers to excess uric acid in the blood. Uric acid is the end product of the digestion of certain proteins and is normally eliminated through the urine. When excess uric acid is present, it is converted to crystals formed of sodium urate. These crystals may deposit in the tiny
tubes that are part of the kidney and cause acute kidney damage, which can ultimately lead to kidney failure.
How is allopurinol typically given (administered)?
Allopurinol is usually given orally as a tablet, but also may be given intravenously (into a vein). Patients taking the oral tablet will take the tablet after a meal and with plenty of fluid. Patients may have an allergic-type reaction to treatment with allopurinol, although this is uncommon. Patients should tell their healthcare provider immediately at the first signs of a rash or other skin abnormalities, as more severe side effects may follow.
How are patients typically monitored?
Patients will usually have scheduled meetings with their healthcare provider while they are being treated with allopurinol. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy. In addition, levels of electrolytes and products of metabolism will be measured frequently to monitor the possibility of developing TLS. Patients will also be monitored for allergic-type reactions that may occur with treatment with allopurinol, including skin abnormalities and liver dysfunction.
What are the most common side effects associated with treatment with allopurinol?
⢠Skin rash
⢠Nausea and vomiting
⢠Abnormalities of the kidneys
⢠Diarrhea
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
⢠Pay careful attention to the physicianâs instructions and inform the physician of any side effects.
⢠Wear sunscreen and protective clothing and try to minimize sun exposure.
⢠Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
⢠Maintain adequate rest and nutrition.
⢠Eat small meals frequently to help alleviate nausea.
Are there any special precautions patients should be aware of before starting treatment?
⢠Patients should tell their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
⢠It is important that patients inform their physician of any pre-existing conditions (chicken pox, infection, heart disease, kidney disease, liver disease, lung disease, thyroid disease, etc.) as they may worsen with this drug.
⢠Patients should inform their physician if they have ever had convulsions or seizures.
⢠Patients should inform their physician about any other medication they are taking (whether prescription or over the counter, including vitamins, herbs, etc.) as they may interfere with treatment.
⢠Patients should check with their physician before starting any new drug or nutritional supplement.
⢠Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
⢠Patients should use caution when driving or operating heavy machinery, as allopurinol may cause drowsiness.
⢠Patients should avoid the use of alcohol, as it may decrease the effectiveness of allopurinol.
When should patients notify their physician?
⢠Skin rash or skin abnormalities (discontinue allopurinol at first sign of a rash)
⢠Yellowing of skin or eyes
⢠Irritation of the eyes
⢠Swelling of the lips or mouth
⢠Swelling of ankles or feet
⢠Swelling of abdomen
⢠Severe abdominal pain
⢠Sudden weight gain
⢠Persistent or severe nausea, vomiting or diarrhea
⢠Painful urination or blood in the urine
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. Click here to view the package insert
Copyright © 2005 Cancer Consultants Last updated 01/05.
Important Limitations of Use
The information provided below on the chemotherapy drug you have selected is provided for your information only and is not a substitute for consultation with an appropriate medical doctor. We are providing this information solely as a courtesy and, as such, it is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule for any particular cancer, condition or patient nor is it in any way to be considered medical advice. Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician.
As with any printed reference, the use of particular drugs, regimes and drug dosages may become out-of-date over time, since new information may have been published and become generally accepted after the latest update to this printed information. Please keep in mind that health care professionals are fully responsible for practicing within current standards, avoiding use of outdated regimens, employing good clinical judgment in selecting drugs and/or regimens, in calculating doses for individual patients, and verifying all dosage calculations.
The prescribing physician is solely responsible for making all decisions relating to appropriate patient care including, but not limited to, drugs, regimens, dose, schedule, and any supportive care.
I take cherry pills and so does my doctor, who also suffers from gout. Both
of us have found a great deal of relief from them. My doctor has very bad
problems with his kidneys and he doesn't want to risk his liver too, so we
both subscribe to as natural methods as we can get, to include loads of
spring water.
However, that takes nothing away from those of you for whom allopurinol
works. I would not take it because I don't want to risk my liver, and
because I don't see any guarantees that risking my liver will result in my
never having another gout attack. Good luck to you all, I wish you good
fortune. But I certainly don't deserve to be attacked because of my beliefs
or because they differ from yours.
nkorb, Good post and makes a lot of sense.
This explains things more clearly and I understand that you dont want to risk your liver being damaged.
How bad were your gout attacks?
Mine were excruiating and I could not control gout so I had to choose allo as there was nothing else. I researched it and became aware of side effects, there are about 15 people i know in the uk that take allo and have had no problems (not including posters on here).
My attacks were excruciating as well. And there are no guarantees that I won' t get other attacks. However, by watching my diet, eliminating the triggers, drinking lost of water and taking 2 Cherry Pills, three times a day, I haven't seen another gout attack for several months.
When I get an attack, I go to my Podiatrist and get a shot of cortisone into the joint and it eliminates the pain and swelling within a day or two. I don't take aspirin for pain, but I do take darvocette on occasion, and I drink tons of Spring Water. I've paid alot of attention on these boards and believe it or not, the information has been invaluable to me. However, there is just too much in the way of debate regarding a drug that may or may not help and may or may not be damaging in other ways..
Statistically there is a 99.9% guarantee that you will get further
attacks and the attacks will get worse.
What is your serum urate level? What was it when you first got your
first attack ahd what have you done to lower it? If you allow your
serum urate level to remain where it is,and where it has been, you
are setting yourself up for continuous attacks that will get worse
and worse as you get older. In the beginning you will be able to get
through the day but eventually your gout will cripple you. You will
have periods of time where you cannot move under your own volition
and it is one of the most unpleasant states that a human being can be
in.
Cherry juice and cherry juice pills do nothing to lower your overall
bodily uric acid. It will serve to push the equillibrium pH of your
system back into the acidic region which will tend to reduce the
ionization of uric acid in your body. The reduced urate in your
blood will indeed supress the formation of monosodium urate crystals
which is what gets us in the form of gout. By keeping your body full
of "Cherry Juice" you will keep overall urate formation down from
ioonization but you will also be keeping more and more of the uric
acid within your body. You will have done nothing to either reduce
overall uric acid formation or increase urate elimination. Diet can
account for a maximum of 15% of your uric acid load and that is a
conservative estimate with other estimates ranging to as low as 5%.
As a person who suffers from gout, you have been storing uric acid in
your body for more than 10 years at a minimum and that storehouse of
uric acid must be removed if you are going to have any chance of
beating the gout monster.
It is not vodo and it is not magic. It is clinically measurable and
it is directly related to your overall serum urate level. If you do
not reduce that urate level, you will continue to get gout attacks.
lost of water and taking 2 Cherry Pills, three times a day, I haven't
seen another gout attack for several months.
The fact is that if you get gout attacks, the normal course of action
of gout is that you will pass through months and sometimes years of
no attacks and, during that time, you will be completely symptom
free. Triggers or no triggers though, the gout will come back and the
longer you go between attacks, as a general rule, the worse the
attacks will be.
Get your urate level measured and then get it measured again in 6
months. It if has not gone down then you are guaranteed of having
more attacks and as you get older those attacks will get worse and
worse.
cortisone into the joint and it eliminates the pain and swelling
within a day or two.
That absolutely works and you are taking cortizone. You are so afraid
of the side effects of the primary treatment for gout and yet you
take cortizone. Look up what the side effects of continuous
cortizone treatment are. It just does not make sense.
It cannot be argued that allopurinol will help every person who has
gout. There are people with severe coronnary diseases for whom
allopurinol might be contraindicated. There are also people who have
an allergy to allopurinol and who get a severe and even life
threaztening alergic reaction. However, among those who do get the
severe allergic reaction, moderation of the dosage and spreading it
over a longer period of time in the day will allow more than 90% of
those with the allergic reaction to get themselves on a permanent and
therapurtically effective dosage of allopurinol. There are rare
cases, and I say rare based on my reading of the literature, where a
person can tolerate allopurinol but for whom it is not effective. A
person posting on here has identified himself as a person in that
category. However, the fact is, and the literature on this is both
extensive and easy to get at, that allopurinol, when used to tgreat
gout, is effective in almost all cases, significantly more than 95%
of the time and it completely stops gout attacks for as long as the
patient keeps taking allopurinol. It is not, as you have stated
"a
Although it may not help some people and it may be dammaging to some
people, the overwhelming number of people who take allopurinol for
gout and who have no other complicating condition such as immune
defficiency or cancer, report complete remission of gout symptoms for
many any years, usually till the end of life, and they do not develop
any problems from taking the drug. It is a drug that will help almost
all people who suffer from gout and it will not do any harm to the
overwhelming majority of those people for whom it is helping to fight
gout.
Our reaction to your statement that ir is a drug that may or may not
work is because you are incorrect, statistically, is saying that it
may not work. With the weight of statistics behind the statement,
allopurinol will work in almost all cases where it is used. There is
no drug that works as it is intended in all people. the varriation
among people is so great that there are always exceptions to the
general way a drug works.
However, the exceptions are usually rare.
The side effects of too much cortizone are horrible and when you take
cortizone you are treating only the symptoms and not the fundamental
problem. Get your urate measured and then take steps to get that
level, whatvever it is, down. If you can reduce that level through
diet, then good for you. If you cannot reduce it with diet and you
stay off of allopurinol, then you will continue to suffer form gout
attacks and, as I said, they will get worse and worse.
That is such a well written piece Im not sure how anyone could sensibly
argue against it.
A good friend of mine had his first gout attack about a year ago - a few
minor re-occurances - so he is 'not yet' on allopurinal - I will keep this
and show it to him when he is considering taking the plunge - my guess is in
about 2 or 3 years.
There are some ppl on this list who use a non-allo approach and it is
working for them. Why does that threaten you?
Stop worrying so much. Both sides are presented on this board and
if someone does not have the wherewithall to see what will work
for them, no amount of worrying and hand wringing by you will
change that fact.
Or maybe you just prefer the childish bickering and drama?
In a message dated 25/11/2006 23:48:05 GMT Standard Time, opc73@... writes:
neither do I want to die from having taken medications that eventually
OPC, If my recent posts came across as childish bickering and drama then i cannot do anything about that, I have always listened and respected all views but when someone quotes statements like the above then the balanced argument becomes unbalanced and based on my own experience and for the benefit of new posters i thought my reply had to be strong to counter balance that statement which in many many people is not true.
I don't particularly think you needed to make a comment at all. Each of us makes our own decisions based upon the information that we research or hear from other people. Simply because you have reached one conclusion in your life, does not give you the right to dictate to anyone else how they should feel, act, etc.
I stated my opinion, explained it, and attacked no one. Your "strong parental statement" simply sounded foolish and childish to me. You have reached one conclusion. You have found a medication that you believe has solved all your problems and you don't feel that you need to worry about the future. I get that.
I'm 57 years old, fairly close to 60. I'm already on medications that claim to possible affect my liver. I have chosen to take other routes to overcome my pain and this disease. It takes a good deal of self discipline and you have no guaratees that you won't get another attack even on your medication. I made a statement for me...obviously there are people who want to know how to treat this disease without medication besides me. Please try to be tolerant of other's rights here as well.
Nancy Korb
OMG -- I should not even be taking this med --

cccheryl38, if they put warnings in your normal food about the side effects you could get from eating it you'd probably be saying the same thing.
Live for 60 more years with gout, or 40 without it? I know which I'd choose right now.