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I know many people here are on Allopurinal. Allo is supposed to be fairly inexpensive but I have read it can make you tired. I just found out about Urolic but it is new and fairly expensive. Do any of you use Urolic and how well does it work? This is starting to get confusing.
Allopurinol works…$4 a month.
Uloric works…$150 a month.
U.S. prices.
I recommend Uloric to anyone who has a rare hypersensitivy reaction to allopurinol…and to all the multi-millionaires I know.
A real consideration is that Uloric is a new drug and taking a new drug forever carries certain unknown risks. People have been taking allopurinol for more than a half century so a lifetime of taking it is pretty well documnented as safe. Very few drugs can one take that long without severe repercussions.
A gout study specialist has told me that AlloP has about 20-30% chance of working and Uloric is 70-80%. Of course Uloric is way more expensive and it has been 'indirectly connected' to heart attacks (no this doesn't mean you'll get heart attacks taking Uloric but people taking Uloric have had heart attacks so there are currently studies to set this straight).
monaco said:
A gout study specialist has told me that AlloP has about 20-30% chance of working and Uloric is 70-80%.
AlloP seems to be working 100% for me. On what basis does he say ONLY 20-30% chance of working? If it lowers your SUA is that not working enough for him?
I too take that estimate of allopurinol's effectiveness with a grain of salt. If alloprurinol's effectiveness was 20% you'd have a world filled with gout cripples.
It sounds like a ploy to sell Uloric.
Often when allopurinol is used in studies it is used in 200 mg. or 300 mg. doses. When it is shown ineffective, the correct and logical procedure is to increase the dosage to a point where it IS effective…up to 800 mg./day but this is often not done.
There are lots of studies showing low effectiveness rates, and many seemed to be published during the run up to febuxostat approval (or is that me being cynical?).
The answer seems to lie in the fact that Uloric (febuxostat) figures are based on the clinical trials where people are paid to take the drugs, and monitored on a regular basis. Also, many of these trials deliberately focused on gout patients who reported allopurinol intolerance.
This compares with most allopurinol effectiveness studies that are based on real-life effectiveness. Most of the ineffectiveness in these studies is either inadequate dosing or patients forgetting to take the pills. Once febuxostat is widely used, I'm certain that these factors will also render febuxostat 'ineffective'. Expect publicity on this when the next uric acid lowering treatment is nearing approval stage.
The other side to this story is that febuxostat trials were supported by comparitive studies of 40 or 80 mg febuxostat versus 300 mg allopurinol. Now, for many, 300 mg allopurinol is an OK dose, but many need up to the maximum of 900mg. This is like comparing different brands of pants without checking if they cover your butt
. Cheekily pointless.As ever, zip2play's advice is all you need. Go for allopurinol, and you are almost certain to find a cost-effective gout treatment that works. If you fall into the minority of people who are allopurinol-intolerant, then give febuxostat a try. Failing to lower high uric acid is not an option.
The studies produced to support febuxostat approval show many similar side-effects to allopurinol. Personally, I believe that many of these are simply due to our body's reaction to lower uric acid levels, and our mind's reaction to the stress of treatment. Dietary lowering of uric acid, in my experience, also causes tiredness, unfamiliar pains, feverishness etc. These are mostly cured with a determination to see the treatment through, and a pint.
I’ve been taking Uloric (febuxostat) for almost a year now and it seems to work fine for me. It does cost more than allo but my expensive insurance coverage has my co pay very reasonable for a 30 day supply. My biggest complaint is that my specialist started me out on 40mg which as I later learned was not a large enough dose and it wasn’t until after I fought for the 80mg dose that I improved and SUA really went down. (Seems to be common to be prescribed a low dose initially as more of a law suit protection than anything to do with therapy.) During the past ten months I have gone from crawling to the bathroom to being back to a normal work schedule and almost all gout related symptoms are a memory. I have (on my own) increased my dosage to 120mg of Uloric to see if I can pay no attention to diet and still maintain a low SUA level. I go back to see my specialist later this month so I’ll see how the higher dose is working out now that barbeque season is well under way.
(There is definitely an anti Uloric mind set on this forum but “gouty’s” have good reason to be a little cynical over anything coming from the medical/pharm industry that basically ignored our plight for so many years.)
Richard,
I'm pretty sure that with 120 mg. Uloric you will be able to eat and drink anything you desire.
After a while, perhaps you will be able to do the same with 80mg.
Richard Bell said:
(There is definitely an anti Uloric mind set on this forum but “gouty’s” have good reason to be a little cynical over anything coming from the medical/pharm industry that basically ignored our plight for so many years.)
For me it's a simple case of taking the best and most proven Gout med out there. That in my humble opinion seems to be AlloP. Uloric is too new for me to trust. Once all the guinea pigs have tested it for many years and if it proves to be superior to AlloP then I will switch in a heart beat, until that time AlloP goes with me to my grave
Hopefully we will get new drugs in the future that are 100 times superior to AlloP and Uloric.
I agree with Zip's first comment. Take Allop unless for some reason you cant. I tried Allopurinol, was in the 1% that could not tolerate it. Started on Uloric. UA went from 9 down to below 5 within weeks and has remained there for 5 months. I am tolerating the Uloric perfectly with no side effects that I know of. (but who knows, it's a very new drug, so I could sprout a 3rd arm at some point) (oh and the side effect of the painful $120 copay every 3 months).
Interestingly, this week my rheumatologist suggested taking my Uloric back down from 80 to 40 because I am running at about 4.3 (I was below 5 on 40 mg too). I've still had 3 flare ups in the last 2 months, so he thinks maybe we're running so low that it might be causing fluctuations in UA which can cause flare ups. Not sure any of that seems logical to me, but I'm going to do what he says anyway because a) I think I'll stay below 5 even on 40 mg, b) I had a kidney transplant 15 years ago and have less than 50% kidney function, so any time I can reduce a med in my system, that's a good thing, c) my rheumatologist seems to know what he is talking about regarding gout, so I'll give him the benefit of the doubt. For me I've found 2 of my 3 flare ups seem to have correlated with a very small amount of shell fish intake, so I'm staying completely off that. Plus, he suggested next flare up, immediately take 30 mg of prednisone for a few days and try to stop it before it gets too bad, so hopefully we're going to find a way to control it while we keep flushing out the UA deposits.
For me it’s a simple case of taking the best and most proven Gout med out there. That in my humble opinion seems to be AlloP. Uloric is too new for me to trust. Once all the guinea pigs have tested it for many years and if it proves to be superior to AlloP then I will switch in a heart beat, until that time AlloP goes with me to my grave
Hopefully we will get new drugs in the future that are 100 times superior to AlloP and Uloric.
I reported in one of my earlier post, I know a person, who was on Allopurinol for more than 15 years, it had been working fine but recently he was finding it less effective and getting Gout Attacks. His doctor told him to move to Uloric and that worked well for him. After 15 yrs on Allop( 600 mg before going to Uloric), he had to move on to Uloric. He seems to be very happy with Uloric. So, I guess there are more reasons that just being proven…I have not taken Uloric but somehow there seem to be many people with better success story with Uloric than Allopurinol.
Utubelite said:
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…I have not taken Uloric but somehow there seem to be many people with better success story with Uloric than Allopurinol.
Utubelite, you got to take the “success stories” with a grain of salt. It depends who reports them. I feel that a nearly 50 years record of success (partial as it may be) is hard to beat within a couple of years with figures which do not even come close to the numbers of people who have sussessfully used Allopurinol, and I am NOT even one of them since I was allergic to it.
hansinnm said:
Utubelite, you got to take the ?success stories? with a grain of salt. It depends who reports them. I feel that a nearly 50 years record of success (partial as it may be) is hard to beat within a couple of years with figures which do not even come close to the numbers of people who have sussessfully used Allopurinol, and I am NOT even one of them since I was allergic to it.
I think, the new medicines in most cases are supposed to be better. And if we are taking something which is there for 50 years, we are already an outdated treatment( which may still work though as in my case of taking Allop). This theory of comparing recordsw ith number of people does not make much sense. If that was the case, the innovation will stop. I think, it is our mindset only. The new medication is supposed to be developed to remove some of the ill effects of older medicines.
If I have to take Uloric, I would not even blink in taking it.
By nature, I always believe in trying new things as soon as they are available. Technology I buy while medicines I depend on doctors. I took Allop because doctor told me so. If he tells me Uloric, I am a game for it.
Remember, scare word comes from -So (much of) care – which means Scare.
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