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Karen on Facebook is very concerned about the conflicting advice her husband is getting about Puricos. Puricos is a South African brand of allopurinol.
One doctor says to continue with allopurinol during a gout attack. Another doctor says to stop taking allopurinol during a gout attack.
Here is the Facebook post:
Post by Karen Galloway.If that does not show in your browser, you can see it at https://www.facebook.com/GoutPal/posts/10152448704125785
Well both doctors can’t be right. Which one’s top of the class, and which one needs to sit on the naughty seat?
Top of the class is the specialist who said your husband “should NOT STOP taking the Puricos during an attack.” If that specialist wants to graduate, he must arrange proper follow up testing. This should be monthly at first, but can become less frequent as uric acid stabilizes. Blood tests are needed for uric acid, kidney function, and liver function. Puricos (allopurinol) dose should be increased until uric acid is no higher than 5mg/dL. I recommend aiming for a much lower uric acid level for a year or so. This speeds up dissolving old uric acid crystals, and reduces the period of time you are at risk of more gout flares.
The only reason to stop taking allopurinol is if the other blood tests show abnormalities. If that happens, other tests might be required to try to prove if allopurinol is causing the kidney or liver results. If it is, then try another uric acid lowering drug such as febuxostat.
Stopping allopurinol for other reasons is very naughty indeed. If you stop taking allopurinol just because you get a gout flare, how are you ever going to control gout? I’m happy to help your GP off the naughty step with some friendly gout advice if he/she wants to learn.
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