Allopurinol Withdrawal Made Safe for Gout Victims

Allopurinol Withdrawal for Gout Victims is my review of a game-changing allopurinol and gout management study. So I give you a summary of the gout investigation in layman’s terms. Then I explain how you can change the way you manage your gout.

Allopurinol Withdrawal Audience

I wrote Allopurinol Withdrawal for gout sufferers who do not want to start taking daily meds for the rest of their lives. Because most people think that once they start allopurinol, they can never stop. So many decide to look for other ways to control uric acid. But that often leads to no treatment at all. Then, uric acid becomes dangerous. Going beyond frequent agonizing joint pain to damage organs and cause early death.

Specifically, I want to help all gout sufferers avoid becoming victims. Also, this information might help Gout Patients get better treatment. But if you are not sure which type of gout person you are, you should leave this page and start with Questions for Gout Sufferers.

Allopurinol Withdrawal for Gout Victims Report

Here is my review of a gout treatment study about allopurinol^[1]. First, I summarize the report in ordinary language. Then I explain how you can apply these facts to your own unique situation.

Allopurinol Withdrawal Objectives

The most telling part of this gout study comes in the introduction. Because in explaining the need for this study, the authors tell us how allopurinol treatment fails to be effective for 4 in every 5 gout patients. Then they suggest that the prospect of lifelong treatment might be one of the reasons for lack of success.

However, each week in my gout forum, at least one sufferer cites fear of daily lifelong drugs as the main reason they do not want to consider allopurinol. So, I know this fear is definitely a significant reason why some people become gout victims.

Stopping Allopurinol

It is important to note that this investigation used ethical methods to ensure patients began stopping allopurinol safely. So 104 gout patients were selected only if they met the criteria:

Patients must have taken allopurinol for at least 5 years with no visible uric acid crystal deposits tophi. So if tophi have been present, they should have dissolved for at least 5 years.
Uric acid levels below 7 mg/dL before stopping allopurinol.
Patient agrees to annual uric acid test after stopping allopurinol.

What happens if I stop taking allopurinol?

In this study, patients were expected to show a rise in uric acid to over 7 mg/dL after stopping allopurinol. However, 3 patients dropped out of further analysis due to uric acid below 7 mg/dL. Because that suggests they were in the small group of people who permanently cured their gout. But I will explain that situation in a separate article for Secondary Gout sufferers.

Also, patients dropped out of the study for various other reasons. So we will see what happens when 89 people stop taking allopurinol. Because the study monitored these patients for 2 years on average (between 1 and 78 months).

In that 7 years:

Gout came back to 37 patients (41%). Including one person with a gouty tophus, but no gout attacks.
5 more patients had suspected gout attacks, which were finally diagnosed as not gout.
There is the least chance of gout returning after you stop taking allopurinol if uric acid is 5 mg/dL or lower during treatment. Also where uric acid remains less than 8.75 mg/dL after you stop taking allopurinol.
The year by year analysis of what happens if people stop taking allopurinol is included in a chart. So I took the data and reformatted it, as below.

Is allopurinol for life?

This investigation concludes that allopurinol need not be for life. Because it finds long periods when patients are free from gout symptoms after withdrawing allopurinol. So, it suggests that 5-year intermittent treatment is a viable alternative to allopurinol for life. However, this conclusion depends on proper uric acid control for at least 5 years prior to withdrawal.

Allopurinol Withdrawal study results chart — How long will you stop taking allopurinol?

Is allopurinol withdrawal right for you?

This study tells you that many gout patients can stop taking allopurinol once they have dissolved all old uric acid crystals. But, the results show a wide variety of outcomes. So you can never be certain that allopurinol withdrawal is right for you.

However, this study proves the principle that good allopurinol management allows people to safely stop allopurinol once it has dissolved all old uric acid crystals. So, your priorities should be:

Start allopurinol as soon as you can and gradually increase the dose to get uric acid as low as you can.
After 5 years of safe uric acid and no gout symptoms, discuss allopurinol withdrawal with your doctor.
Test your uric acid at least once a year. Then if it rises too high, consider starting allopurinol again.

At the moment, there are no clear guidelines on the best time to stop or restart allopurinol. But if you have feared it as a lifetime drug, it is definitely time to rethink your plans. So consult your doctor now. Then discuss your plans for allopurinol withdrawal in the gout forum.

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Common Terms: allopurinol, symptom, taking