Long term side affects of allopurinal

[charlton]

Firstly, as a newbie i'd like to say hi to everyone and say thanks for such a great website, I've managed to learn a lot more about this condition. In the last few days since finding this site than I have in recent years.  Is it me or is there a lot of contradiction about it on the internet?

Right about me, I'm 29 and I've suffered from gout for about 4 years, my doc first put me on allopurinal a few years back and I worked up to 200mg per day, this was working fine until I read that it can have long term side affects  (one of which was kidney damage) in later life, so being what I'd like to think as quite young I thought I'd be at a higher risk of this because I'd be taking the medication for longer.  So that’s my first question, has anyone else heard of long-term effects?

So, because of this I stopped taking allopurinol and tried endless types of natural remedies, and although I had a sore toe every now and again it wasn't crippling…….. until last week and I've been in agony since, the pain has been so bad even the diclofenac the doc prescribed doesn't seem to make any difference, It felt like it might even have made it worse. Has anyone experienced that before or was that just in my mind?

Lastly, I went back to the doc a few days ago he prescribed me prednisolone, I'd never heard of this but it had almost instant affects and although didn't totally ease the pain it made it much much easier, so why don't they prescribe this more often? 

So now you know more about me, I'd like to ask all your advice on what action to take next, I can't go through the same pain again because it's affected me at work but i'm dubius about taking allopurinal long term !  Have I got any thing to worry about ?  And have I got any other options ?

Sorry for the long post but I've tried to give you as much info as poss

Thanks in advance
Charlton

Sorry I forgot to say that i'm not over weight, I do alot of fitness, eat quite healthily and i do drink alcohol but not excessively.

thanks

[zip2play]

Charlton,

I have been on allopurinol for about 20 years and only in the last two years have I been hearing that there are side effects, probably the worst claim was immunological damage, the lesser one's talked about RASH. I have also heard firsthand from people on boards like this that they CANNOT take allopurinol becasue of hypersensitivity reaction…but that's a different thing. But I have never had a single bit of evidence of anything untoward and I take either 300 or 400mg./day.

Before that time, allopurinol was considered among the SAFEST of drugs for long term use, with virtually NO side effects. Puzzling 😉 .

How's THIS for conspiracy theory. Development of $$$febuxostat$$$ as an alternative to allopurinol has been in the works for several years and this wouldn't be the first time a drug company MASSAGED the facts a tad to generate future profits for a NEW development. Remember, the more badmouthing of allopurinol the more people willing to pay $5  a pill for the new stuff. Furthermore since allopurinol has LONG been a cheap generic, there's no money behind it to defend it's reputation. I'm not saying I have any facts, but having long watched the lies and half truths to spur drug profits, I think that there's likely more than a grain of truth here.

IF long use allopurinol is rife with problems, let's see the STUDIES…I haven't seen one yet!

Untreated GOUT is a killer and treating the pain of acute attacks is NOT treating gout. Even without acute attacks, high uric acid is doing insidious damage to the kidneys and arteries and probably joints and organs. THe end point of gout before allopurinol was death. So don't content yourself with the “natural” treatments…they do not lower your uric acid.

So, do not be afraid of allopurinol because the odds are STRONGLY in your favor that you will never notice a single side effect becasue the huge majority of users never do and your dosage is very low. Perhaps after febuxostat goes generic and is tested in the general population for half a century, a switchover might be advisable. But here's a prediction from me: febuxostat will show  MORE side efffects than allopurinol as the years go on…that's ALWAYS the story with a new drug.

There are cheap alternative URIICOSURIC drugs, that have more problems than allopurinol, like probenecid and phenylbutazone. For people with hypersensitivity to allopurinol they are an option. THey work by causing the kidneys to eliminate uric acid rather than by preventing its production.

[Keith Taylor (GoutPal Admin)]

charlton said:

Is it me or is there a lot of contradiction about it on the Internet?

There's a lot of out of date stuff about purines. There's a lot of self promotion by people selling “cures”.

There's an obsession with pain relief at the expense of uric acid management, but unfortunately that is not limited to the Internet.

There are lots of opinions espoused as facts, but again that isn't limited to the Internet (or limited to gout)

Gout can be very complicated, or also very simple – take allopurinol, measure uric acid, relax and enjoy life

Lastly, I went back to the doc a few days ago a he prescribed me prednislone, I'd never heard of this but it had almost instant affects and although didn't totally ease the pain it made it much much easier, so why don't they prescribe this more often? 

Prednisone is a corticosteroid. It supports our own natural anti-inflammatory steroid – cortisone. Unfortunately, prolonged use can inhibit our own ability to produce it naturally. It is only suitable for short term use.

i'm dubious about taking allopurinal long term !  Have I got any thing to worry about ?

I concur with zip2play. You need not worry about allopurinol – it is very well tolerated in most cases, and much more tolerable than crumbling gouty joints. It is sensible to keep hydrated when taking it so that it does not build up in the kidneys.

[Kvalhion]

Good question about the long term effects.  I just started taking allopurinol and was wondering the same thing.  It is an excellent point, however, that not treating hyperuricemia is a lot worse than the potential for possible side effects of allopurinol.   It's also an excellent point that most people are concerned more about avoiding attacks and pain relief than monitoring the underlying condition.   This is especially true for people who believe they can 'cure' gout by stopping attacks before they get very painful.

I'll admit I am not thrilled with the idea of taking a drug every day for the rest of my life, however it certainly beats dealing with prolonged gout attacks that severely affect the quality of life.   Not to mention that in this day of medical breakthroughs, it is quite possible that in 10 to 15 years gout may in fact be curable.    It's impossible to say now, but I wouldn't gamble on future cures by not treating gout with the best treatment currently available – allopurinol.

Good luck and let us know how you are doing 🙂

[charlton]

Thank you all for all your usefull information, you've made my mind up for me and I'm going to start taking my allopurinal again. I know in the past I was advised to wait until my gout had cleared up before starting taking it, is this common practise or could I start now while I've still got a slight pain ? And is it advisable to go straight into taking 200mg per day or should I slowly build up that ?

Alo has anyone got any experience of taking prednislone because I've been given enough for 5 days but I'm a bit concerned as I'm over half way through this now and I'm still in pain, I'm due to take my last on saturday and I don't want to be suddenly struck with crippling pain on sunday when the pain killers have worn off and there's no way of getting anything else to ease the pain til mon day morning when the docs open ! Am I right in thinking that prednislone is just a strong pain killer and doesn't do anything to break down the uric acid/crystals (please excuse my ignorance) ? And is there anything I could do to speed up this process ?

Thanks again for all your help, it's such a relief to find others that suffer with the same problem as me but actually know what they're taking about !!

Cheers

Charlton

[zip2play]

charlton,

Prednisone has two methods of acting in gout, like many analgesics. One, it directly cuts down pain and swelling. Two, cutting down INFLAMMATION prevents the continuing acidification of the area which causes more urate precipitation.

I think colchicine is a better agent for doing this…and less dangerous than prednisolone over the long haul.

I would wait until the pain is gone and then start the allopurinol and I'd start with the 200 mg. right away…it's a small dose.

(As your doctor for an Rx for colchicine…it's a good emergency aide for your medicine chest.)

[Keith Taylor (GoutPal Admin)]

charlton said:

Firstly, as a newbie i'd like to say hi to everyone and say thanks for such a great website, I've managed to learn alot more about this condition in the last few days since finding this site than I have in recent years.  Is it me or is there alot of contradiction about it on the internet?

Right about me, I'm 29 and I've suffered from gout for about 4 years, my doc first put me on allopurinal a few years back and I worked up to 200mg per day, this was working fine until I read that it can have long term side affects  (one of which was kidney damage) in later life, so being what I'd like to think as quite young I thought I'd be at a higher risk of this because I'd be taking the medication for longer.  So thats my first question, has anyone else heard of long term affects?  So, becuase of this I stopped taking allo and tried endless types of natuarl remedies, and although I had a sore toe every now and again it wasn't cripplng…….. until last week and I've been in agony since, the pain has been so bad even the diclofenac the doc prescribed doesn't seem to make any difference, It felt like it might even of made i worse, has anyone experienced that before or was that just in my mind?  Lastly, I went back to the doc a few days ago a he prescribed me prednislone, I'd never heard of this but it had almost instant affects and although didn't totally ease the pain it made it much much easier, so why don't they prescribe this more often? 

So now you know more about me, I'd like to ask all your advice on what action to take next, I can't go through the same pain again because it's affected me at work but i'm dubius about taking allopurinal long term !  Have I got any thing to worry about ?  And have I got any other options ?

Sorry for the long post but I've tried to give you as much info as poss

Thanks in advance

Charlton  

Sorry I forgot to say that i'm not over weight, I do alot of fitness, eat quite healthily and i do drink alcohol but not excessively.

thanks 

Charlton, please get off Prednisone and do not use it again. Although it may be the greatest drug known to man, it also has dangerous side effects. I used it a few times for gout and it certainly was a wonder drug. However, it slowly ate away at my hip and at age 44 I needed a hip replacement. Mind  you, I only took Prednisone a few times, so I was shocked when I found out it probably destroyed my hip. I wish I had answers to rid you of Gout but the only advise I can offer is for you to watch closely what you eat and drink. I wish I took others advice, but at 51,  I am chronic and have just started using Allopurinal after years of taking Indomethacin. I first started getting gout when I was around your age and have suffered with it often.

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