[Mauri]

Thaks! Will try 200 mg and see where it goes from there..
Best regards

[Mauri]

Hello everyone (specially gout guru Keith):
I wanted to touch base and tell you where I am now. It’s been 16 months (since Jan 17) on allopurinol 600 which has allowed me to keep my UA readings at a steady 3.1 and I have been 10 months without a single flare. Hurray! I believe I have been clearing crystals long enough and I could lower my allopurinol dose, correct? I don’t want to take more than necessary. What should be the goal now? Lower the dose to 100 and keep monitoring UA level and make sure it doesn’t get higher than let’s say 6.5? Is this a sensible approach?? I don’t think I need to stay forever on a 300 dose should I?
Of course whatever I do I will continue to eat sensibly and stay away from seafood, beer, red meat etc. as much as possible.
Any ideas on strategy to use once we believe crystal clearance has been achieved?
God bless
Maurice

[Mauri]

I don’t use it for treatment ; only for prophylaxis. Took it for 6 months to prevent attacks after starting allopurinol 600 and my dose was 0.5 real day. Did not have any issues. Good luck

[Mauri]

Thanks Keith: my UA level has dropped to 3.9 …. I expect crystal clearance will take months, therefore I don’t want to use too many anti-inflammatories. Don’t Think I should since this process will take a while. I of course will take indomethacine if I get a gout attack but for this diffuse articular pain I am willing to tough it out as long as I understand it is part of the process and shall pass!
Willing to wait and see; hopefully 6 months or so?
Regards

[Mauri]

Thanks again Keith. I am totally convinced about your strategy to control gout and clear the crystals.

My take/strategy is this: I will start again the colchicine 0,5 as prophylaxis and after a week or so will up the allopurinol dose from the 300 I take now to maybe not 900 but to 600. In three months I will have a blood test and check UA level; hopefully it will be under 4.0. I will take it from there.

In any case, how do you go about upping the dose from 300 to 600 ? Weekly increases of 100? Incrementally? Or just double it in one go? What is your experience with this? The actual dose of 300 sits very well with me; no side effects whatsoever. And also, should I split the 600 in two takes (breakfast and dinner)?

Thanks again for your efforts in summarizing these matters for us. Great help!

Best regards

Maurice

[Mauri]

Keith: first off let me thank you for a very well explained answer. Makes a lot of sense and you are awfully good at guessing… right on the money.
Let me then pick your brain a bit further: my Uric acid level has been below 4,5 since Feb 2016. A month after starting allopurinol 300 it went from 7,0 to 4,1. So I’ve been clearing crystals for a year now but according to your guesstimates, I could be clearing for 20 months since I have had gout for 20 years now. Therefore I could stay put for 8 more months -in theory- or increase the Allopurinol dose and get faster clearance. I am tempted to use colchicine as prophylactic and up the dose. What would be your dose of choice? 400? 500? Don’t worry, express your thoughts and I will run it by my doctor. This is the only med I take, my health is fine otherwise.
Best regards
Maurice

[Mauri]

Colchicine and Allopurinol

I have been on allopurinol 300 for a year now, started in January 2016 and have had three blood tests and all indicate my Uric acid is below 5.0. The last reading in December was 4,2. During this year I had a gout flare in June and the doctor said it was due to my body clearing the crystals because of the now low Uric acid and to avoid a new attack he gave me colchicine 0,5 to be taken as a prophylactic for 6 months. I did fine and by December my level was 4,3 and finished using colchicine. It is now January 2017 and yesterday I had a gout attack (as usual on the right toe) and I am taking now Indomethacine and hope to control this attack.
My questions are:
– is it possible that after 1 year on allopurinol 300 and readings below 5 I am still clearing crystals and can still get an attack? How long does this process take?
– should I go back taking colchicine as prophylaxis? I am afraid I could get another attack.
BTW: I am 61, normal weight and walk 5 miles every day and eat sensibly.

Any ideas? God bless.
Maurice

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