Allopurinol initial side effects.

[Gout Patient]

Hi all

I’m 45, not overweight, don’t drink, don’t have any identifiable trigger foods. Had gout for 8 years. The pattern has been that I get a 1-2 low level attacks and one severe attack each year lasting 1-4 days. After a prolonged attack lasting 8 weeks this summer that caused a large tophus on my big toe, I decided to start Allopurinol as it seemed clear I was becoming a chronic gout sufferer risking joint and soft tissue damage etc.

I’ve been on 100Mg of Allopurinol for 3 days and it seems to be making me quite dizzy, also yesterday it gave me the sh*ts. I read that the heartburn I also get is probably temporary. I will be getting SUA levels checked monthly to titrate the dose, and I assume that I’ll end up on 300Mg to bring SUA to the desired level. I’m not on any other drugs and I’m not planning on taking regular daily colchicine or indomethacin at the moment to prevent attacks cause by SUA lowering therapy, but this may change if the lower SUA starts some attacks.

My question is has anyone else had these dizziness and gastro side effects, and do these side effects go away after time. I travel a lot for work so side effects like this aren’t going to be manageable if they don’t go away especially if I end up on higher doses.

Also any idea what % of people get attacks when starting allopurinol and how long until they start after starting allopurinol?

Thanks.

[Patrick]

Boomer,

I was lucky and never got the side effects you did. My buddy takes 300MG of Allopurinol and had horrible side effects of GI problems and digestive issues. From what i know, the sh*ts is quite common.

I’m not that sure about the dizziness, but dizziness is a common side effect to many prescription meds. I would presume that as your body gets used to the Allopurinol, the bouts of dizzinesss may subside. If they don’t, consult your doctor as this may be attributed to something else. He may also prescribe you Ativert (a Vertigo/Dizziness med) or he may titrate your dose.

The GI side effect can be controlled with over the counter stuff like Pepto, but the dizziness, if persistent, should be talked over with your PCP or Rhuemotologist. Hope this helps

[Keith Taylor]

“Also any idea what % of people get attacks when starting allopurinol and how long until they start after starting allopurinol?”

That’s not possible to answer, and even if it were, it doesn’t really help in gout management. It’s a bit like a learner driver asking what percentage of new drivers have a crash, and how soon after they pass their test.

In gout, to avoid the “crash”, be prepared with a 100% effective personal gout pain therapy. Then, you’ll never have a “gout crash” during early allopurinol treatment. And, once allopurinol gets your uric acid down to a safe level, you’ll never have another gout attack.

Boomer, don’t “assume that I’ll end up on 300Mg to bring SUA to the desired level”
A) It might be 300mg daily, or it might be a different dose.
B) Effective uric acid control does not depend on desires. It depends on a target that is safe. That’s below 5mg/dL for most people. But, personal circumstances can dictate a higher or lower target.

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Allopurinol Side Effects are not as bad as Excess Uric Acid!

Also, if you’re thinking of stopping allopurinol because you think it’s causing too many gout attacks, watch Allopurinol for Gout video.

[André Chénier]

Initial effect of taking allopurinol

I would like to share information about what can happen for a short while after you start to use Allopurinol.

I read somewhere that this medication can cause a gout flare-up when you start using it.

I experienced such a flare up about a week or so after starting.

The base of my left big toe started to ache, then a dark spot appeared there. Then my urine started to cause a burning sensation at the tip of my penis.

I was concerned because web sources of information advised to stop taking the medication immediately if you experienced a burning sensation during urination.

Well, I gave it a bit more time, and very soon (2 days) the toe pain subsided, and so did the urination issue. Now everything is fine.

Thought this info could be useful.

[d q]

Hello Andre,

Thank you for your informative post.

It’s always helpful for any new gout sufferer starting Allopurinol to get the widest level of knowledge possible. Please make sure you monitor your Uric Acid levels with your GP (preferably Rheumatologist) in a few weeks to make sure things are on the right track.

Regards,
James

[ken]

Does anyone experience muscle twitches or weak feeling in your legs?

I’ve been on allopurinol for 3 and a half months and these issues have been with me for a while now.

I am not taking any other meds except occasionally a quick dose of colcrys and indomethacin when I have had flares (3 since starting allopurinol )

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Allopurinol Side Effects are not as bad as Excess Uric Acid!

[Jean Clyne]

On allopurinol for 2 months now, dose up to 300 mg, have acid reflux with most foods in evening, gaviscon works on it. For 1st month had loss of appetite and loss of taste as well, that is mostly gone now. Still more tired than usual, hope that adjusts itself as well. Hope this drug helps because it has really been kicking my butt, will stick with it. I turned vegetarian a yr. ago after gout diagnosis and that has helped, at first lost abt. 8 lbs but since starting allopurinol have gained it back.

[Keith Taylor]

Hi Jean,

I wonder if you’ve tried varying the time you take allopurinol to see if that has any effect on your digestive problems. For example, you could try one of the following for a few days:
– Take allopurinol before eating.
– Or, take allopurinol during your meal.
– Or, take allopurinol after eating.

Then, if you make a careful note of your symptoms, you can compare strategies to see if any works best. Also, you could vary the amount of time between eating and allopurinol. Or, experiment with breakfast, lunch, or tea.

Also, have you seen the Gout and Antacids topic? We discuss different types of antacid and their possible effects on gout. I haven’t included Gaviscon yet. But, I can see there are different formulas under the Gaviscon brand. So, there could be different effects on gout sufferers. For example, I noticed that one of Gaviscon’s antacid formulas contains Sodium Bicarbonate. Which, is not great for gout sufferers, or anyone else, if you’re taking it every day.

[Ryan D]

Uric Acid level of 10.0

Hi. Hoping to get some answers.

I was just tested for Uric Acid after my foot/ankle has been hurting for a month when I walk.

The results came back 10.0 and my doctor prescribed 100 mg of allopurinol.

I just have two questions:

1) Is 10.0 really that high that I need to take medicine (allopurinol)?

2) Another doctor friend told me to be careful because allopurinol will break down the crystals in my body and could form a kidney stone. Is this true???

3) How long will allopurinol take to lower my levels to normal?

Thank you.

[nobody]

Hi!

1) I’m no doctor but 10.0 seems high enough to be dangerous. You might want to double-check that value with a second test before starting a daily medication though.
Among things which can raise uric acid are: certain foods and alcohol (when consumed without moderation), strenuous exercise, certain drugs as well as certain serious diseases. So you want to make sure you aren’t taking a drug which increases uric acid (in that case, perhaps you could change that medication instead of adding yet another drug to your regimen). And if you have had old blood tests showing a much lower value for uric acid, you want to make sure you’ve been checked for the most common diseases which can increase uric acid.

2) Allopurinol could in principle lead to kidney stones for a different reason. But so far as I know, it’s on balance more likely to protect you from kidney stones in the long run. Breaking down the crystals might lead to an existing stone passing though. Anyway, that’s not a reason to avoid allopurinol.

3) It’s different in every case. It depends on how efficient your body is at getting rid of uric acid and on how much allopurinol you’re taking (you’ll probably need more than 100mg per day but it’s safer to start with a small dose). In any case, your will most likely need to keep taking allopurinol for quite a while after the level in your blood has dropped before your body is cleansed of the crystals.

[Ryan D]

Thank you for your answer nobody.

My uric acid tests in the past year are:

January 2017: 17.4
May 2017: 10.0
March 2018: 10.0

The last one (March 2018) is when I had my bad ankle/foot issue (still have it) and that lead the doctor to prescribe me Allopurinol.

[nobody]

Unless you’ve exercised vigorously before every one of these tests or something, it definitively looks like your uric acid level is high enough for concern.
Even if uric acid has nothing to do with your ankle/foot issue, chances are that letting it remain that high will in time cause you harm. There are risks involved in taking any drug as well of course so this is a matter of getting the balance right. That’s your doctor’s job. Just make sure they’re dutifully monitoring how your body handles allopurinol (blood tests for liver and kidney function in particular are recommended after starting the drug).
Be aware that if you are prone to gout, taking allopurinol could trigger a violent attack (in which case it was only a matter of time before you experienced something like that) and that it will take a long time before your symptoms are cured. In other words, allopurinol doesn’t replace a drug which controls inflammation. If you experience swelling and/or are in pain, you will need at least one other drug on top of allopurinol so make sure you have it on hand. You don’t want to wait for an appointment with your doctor when gout strikes.

[Barbara Patterson]

Withdrawal from Allopurinol

I have been taking Allopurinol for approximately 7 weeks. I started with 100 mg. And after few weeks reduced to 100 mg. I got an itchy rash on front of my my, and my liver enzymes started to increase. My dr said to stop taking it. Are there any known side effect when stopping this drug that important to know.

[nobody]

Hello,
Be aware that side effects such as your rash (if it is indeed due to allopurinol) may take a few days to go away after discontinuing allopurol.
It’s not really a side effect but discontinuing allopurinol might trigger gout. There are other uric acid drugs you might take instead of allopurinol to avoid this problem.
Good luck!

[Pat Stanton]

I’ve never heard of this… but I’m not a doctor either. I’ve been taking 300 mg once a day for a long time and it has been very beneficial to me not getting flare-ups. And I eat and drink things a lot that would give me gout if not for the medicine

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