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Hi All – here in France, we have quite a few medicines that are based on the persons weight – the heaver and bigger you are, the higher the dose will be – and dosages are based on per 10kg of body weight.? The principal (for me, a non medic person) sounds good theory.
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I had 2 attacks in the last month after 6 months of over indulgence and diet out of the window. I took colchimax for the very first time – 1mg, with 3 tablets a day for first two days, then 2 tablets for next 2 days, then dropped down to 1 tablet a day for next 10 days. I never had any side affects at all, but it took 3-4 days for the main pain to go away and two weeks after i still have a 'bruising' feeling and i'm still limping slightly. So, did i not take enough because others seem to suggest that pain will go in one day?
I'm 117 kg ( 263lb, or 18 1/2 stone). Should i take more than the 'normal guy in the street' due to me being a porker??
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Also, i'm about to start TODAY taking Allop for the first time. I've been given 200mg tablets. Is this enough for me? I bought a test kit last week, and my levels are between 7.3 – 7.6
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I'd love some assitance in working out what's right for me !?? (and loosing weight slowly is on my long-term plan, in fact i've already lost 20kg in the past 2 years…)
cheers !
Yes, James,
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To stop an attack in a day with a small amount of colchicine requires IMMEDIATE action. Once the pain has gone on for a day or more, a great deal more is required. I agree that most meds should be prescribed on the basis of body weight but it seems that calculation is only used for pediattric doses.
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Your uric acid is not extreme and you MIGHT get away with 200 mg. allopurinol, but if I were you, I would start off with a standard 300 mg. dose. If I got spectacular results, like numbers in the 4's after 6 months, THEN I would consider dropping down to a 200 mg. dose. Why risk even ONE unnecessary?debilitating attack?
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(I? went down to 200 mg for almost a year but got a lab reading of 6.7 and a couple suspicious foot twinges over the time, a couple stopped with low dose colchicine,?and returned to 300 mg. In the U.S. it is actually HALF the price to take 300 mg./day then to take 200.)
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I weigh about 210# at 6'2″.
Thanks for the info…
I know everyone is different, but i have a trip planned the 3rd week in Jan, and want to be able to walk withoiut too much pain…
With starting Allo today, am i likely to have pain in a months time (due to the crystals 'thawing' ?), or does the initial flare-up come on, and go away, quite quickly? If i upped to a 300mg, do you think that would get it over and done with quicker? I remember seeing a chart which suggested more than 50% people got rid of the initial flare up in the first month…
Again – my current level at 7.6 isn;t too high reading others stories…. (if my meter is accurate!)
Hi jamespond, (some type of 007 fish?
?)You are doing everything right with the gradual weight loss, the allopurinol and the meter.
Though at least 80% of doctors don't seem to get it, allopurinol is one drug at least that should never be dose adjusted based on weight.
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The correct way to use allopurinol is a 3 phase dosage, based only on uric acid numbers.
1. Target setting (titration) phase. You start with 100mg to ensure you are not in that tiny minority who are allergic ? signified by rash. Up the dosage in-line with tests every one or two weeks until you reach well below 6mg/dL. The exact number will vary from person to person according to how they react to the drug. Ideally you get down to the 2 to 3 range for a few months, but anything below 6 is OK.
2. Urate debulking phase. You maintain the uric acid level from phase 1 until you have gone 6 months without a gout flare. Tests only need to be done every 1 to 3 months, though as you have your own meter, you'll probably do more. The only thing certain about this period is that it will fix your gout, and the lower your target level is, the quicker it will happen. You cannot be certain about gout flares except to say that they may not happen, but if they do, they will get less intense and less frequent as the weeks pass. You cannot be certain about how long this debulking will take. In theory it is a product of how long you have had gout, and how low you maintain uric acid levels. Significant improvement in the first month, with a lingering tail of indeterminate length is the best guess.
3. Maintenance phase. If you managed a uric acid level of 2 to 3, then you can relax allopurinol very gradually (say 50mg between tests with at least one week between tests). Settle on a dose that keeps you between 5 and 6 for the rest of your life. With careful monitoring, studies have shown that is possible to take a 'alopurinol holiday', but this is only if you get frequent tests to make sure you never go over 6mg/dL.
As for your trip, you can see that there are no certainties. Based on percentages, you will have less chance of a gout flare in January if you start allopurinol than if you do nothing. You have to accept that, whatever you do, there is a risk of a flare for a few months. Be prepared with colchicine, or tough it out.
I decided to start at 300mg….
My first 2 readings before starting (1 week after a BAD attack and foot still feeling bruised) was 7.3, 7.6…. not bad, i thought.
Started taking Allo, then got the following daily readings (all taken 1st thing in morning).. 6.7, 7.0, 8.8, 6.7
The 8.8 threw me a little, and i wondred if taking the Allo would increase my levels in the blood, but it's back down to 6.7 this morning??
I havn't calibrated the meter yet, but took the wife's as a control test and she was 4.7 the first day, and also 4.7 the day i got my high reading… ?
James,
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Give it a month before making a judgement. Allopurinol is quickly broken down by xanthine oxidase (making XA unavailable for making uric acid,) The allopurinol is converted to OXYPURINOL which has a long half like and also blocks XA and is probably the chemixal which exhibits the most anti-urate properties.
It takes a week or so to get up to steady state oxypurinol levels (adding more and more each day.)
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So after 2 weeks you should be getting readings that are better. But if you are still over 6.0 you will then probably need to up the ante to 400 mg. allopurinol after about a month. Before you do though, get a proper lab test.
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Who knows though, maybe initial dosing frees up enough friable (loose)?deposits and sends them on their way, thereby keeping serum urate temporaily high.
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I am going to disagree with Keith on the issue of allopurinol and body size. It seems logical to me that dosing?should depend on body mass, at least LEAN body mass.?
Allopurinol works on xanthines and nucleic acids?on a proportional level (One molecule allo attaches to one molecule XA nad saves one molexule xanthine from being converted to uric acid.)?
Thus the bigger man>> the?more food?he eats>> the more purines?he eats>> the more nucleic acids he breaks down>> the greater the need for allopurinol to control to safe levels.
zip2play said:
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I am going to disagree with Keith on the issue of allopurinol and body size. It seems logical to me that dosing?should depend on body mass, at least LEAN body mass.
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Zip, I think, both, you and Keith are correct.
You said: “Thus the bigger man>> the more food he eats>> the more purines he eats>> the more nucleic acids he breaks down>> the greater the need for allopurinol to control to safe levels.”?
I agree with you on that point. ?
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Keith said: “The correct way to use allopurinol is a 3 phase dosage, based only on uric acid numbers.”?
I agree with Keith on his point.
And I don't believe that there is much of a disagreement that the SUA level?must?be below 5 in order to live a care/flare/attack-free gouty life, regardless of weighing a 100 pounds or three hundred pounds.
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hansinnm said:
zip2play said:
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I am going to disagree with Keith on the issue of allopurinol and body size. It seems logical to me that dosing?should depend on body mass, at least LEAN body mass.
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Zip, I think, both, you and Keith are correct.
?You said: “Thus the bigger man>> the more food he eats>> the more purines he eats>> the more nucleic acids he breaks down>> the greater the need for allopurinol to control to safe levels.”?
I agree with you on that point. ?
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Keith said: “The correct way to use allopurinol is a 3 phase dosage, based only on uric acid numbers.”?
I agree with Keith on his point.
And I don't believe that there is much of a disagreement that the SUA level?must?be below 5 in order to live a care/flare/attack-free gouty life, regardless of weighing a 100 pounds or three hundred pounds.
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I hope the Wise One has clarified this for all allopurinol takers.
Weight is a factor.
Height is a factor.
Diet is a factor.
Climate is a factor.
Parents are a factor.
etc.
But the only way to control allopurinol dose is by uric acid test. It's only my opinion, but those that try to control dose by the weighing scale, and not the uric acid test result, are negligent.
jamespond said:
I decided to start at 300mg….
My first 2 readings before starting (1 week after a BAD attack and foot still feeling bruised) was 7.3, 7.6…. not bad, i thought.
Started taking Allo, then got the following daily readings (all taken 1st thing in morning).. 6.7, 7.0, 8.8, 6.7
The 8.8 threw me a little, and i wondred if taking the Allo would increase my levels in the blood, but it's back down to 6.7 this morning??
I havn't calibrated the meter yet, but took the wife's as a control test and she was 4.7 the first day, and also 4.7 the day i got my high reading… ?
Allopurinol will not increase uric acid levels in your blood, but results will vary due to many factors. Best to look at weekly averages if taken daily, monthly averages if taken weekly, etc.
I didn't realize calibrating the meter was an option. Is it necessary?
8 days continous testing – same time of day (9.00am) gives me…
7.3
7.6
6.7
7.0
8.8
6.7
4.7
6.0?
i never realised that it would vary so much !? Anyone else have the same kinda readings?
jamespond said:
8 days continous testing – same time of day (9.00am) gives me…
7.3
7.6
6.7
7.0
8.8
6.7
4.7
6.0
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i never realised that it would vary so much !? Anyone else have the same kinda readings?
The meters do seem sensitive to droplet size – a fairly common problem until one gets totally familiar with the testing routine. Look carefully at the test strip after surprisingly low or high readings, then retest if the test area looks sparsely covered or overfilled.
Keith (Gout Admin) said:
The meters do seem sensitive to droplet size ? a fairly common problem until one gets totally familiar with the testing routine. Look carefully at the test strip after surprisingly low or high readings, then retest if the test area looks sparsely covered or overfilled.
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I, definitely, agree with you on that. ?It took me me several weeks to get it pat. 1/8 of an inch or ~3mm diameter is needed for the blood drop.
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Here are my figures for the time I have been on Uloric
Date SUA Reading Date ? SUA Reading ? mg/dl ? mg/dl 7/1/2010 6.5 10/2/2010 6.5 7/1/2010 5.5 10/9/2010 6.4 7/3/2010 7.2 10/14/2010 7.3 7/10/2010 5.8 10/16/2010 6.8 7/17/2010 7.3 10/23/2010 9.5 7/24/2010 6.4 10/24/2010 6.7 7/31/2010 7.0 10/25/2010 4.9 8/7/2010 6.4 10/30/2010 6.1 8/14/2010 6.3 11/6/2010 6.5* 8/21/2010 6.6 11/13/2010 4.1* 8/28/2010 6.7 11/20/2010 6.1 9/4/2010 7.5 11/22/2010 7.0 9/11/2010 6.1 11/22/2010 5.2 9/15/2010 5.8 11/27/2010 6.5 9/15/2010 7.5 12/4/2010 5.7 9/18/2010 7.9 12/11/2010 5.7 9/25/2010 5.9 12/18/2010 5.3* *=Uloric 80 mg ?
I tried to add a nice colored picture for better understanding, but Keith would not let me. What do you have against my art work, Keith???
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