How I use Allopurinol

Dr Andrew Jordan explains how he uses Allopurinol in the treatment of gout to reduce uric acid levels. He discusses dosing of Allopurinol and what should be considered when using this medication. He also discusses how Colchicine is used in combination. Don't miss out on what he has to say with the specifics with prescribing Allopurinol.
As always, please speak to your treating doctor if you have any questions about this medication or any of the other medications you take.
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[@edwardbliss8931]

This is exactly what I'm doing, taking both colchicine and allopurinol. The problem is that prior to this, whenever I took colchicine for flare ups, it tended to mess up my stomach and GI system

[@michaelwalker6840]

This explains so much, you have made me understand what has been going on all these painful years...tyty

[@bjchealthAU]

Glad it was helpful and thanks for the feedback. Appreciate it.

[@blackbusiness7]

If colchicine/ibuprofen/naproxen and prednisone/methylprednisolone combo don't help, then look into Krystexxa. Specifically, step it up to pegloticase (Krystexxa) injection coadministered with Methotrexate.

[@cometcal2]

I was recently prescribed low dose allopurinol to see how my body reacts. Your intro to the medication was perfect.

[@bjchealthAU]

Thanks. Glad we could help. Good luck with it.

[@antoniocavalli5474]

How was it?

[@blackbusiness7]

You glossed over it, but I would mention doing a test for the HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol, especially for those of Asian and African descent.

[@JusticeForAll_4All]

if my eGFR is at 64 and my creatinine level at 1.22, should I be concerned about taking Allopurinol? I'm worried that it will make my kidneys worse...

[@richardwebb1516]

What are the causes for gout

[@JackyHapy]

My mom suffers with gout. This morning her GP confirmed x-ray results for arthritis and gout as she's having an episode right now. It's happening more frequently. She's prescribed Colchicine and and will take alpurinol after. I'm praying this will help as the impact on her and me great 😕. It's awful when she can barely walk as she's fiercely independent.

[@bjchealthAU]

Thanks for sharing Jackie. We hope your mother gets better soon.

[@blackbusiness7]

If colchicine/ibuprofen/naproxen and prednisone/methylprednisolone combo don't help, then have your mom look into Krystexxa. Specifically, step it up to pegloticase (Krystexxa) injection coadministered with Methotrexate.

[@010-e5f]

So gout attack also occurs when uric acid dropped? 2:15

[@bjchealthAU]

Yes, a gout attack can indeed occur as uric acid levels begin to fall, especially when starting treatment with medications like Allopurinol. This happens because lowering uric acid levels causes urate crystals, which have built up in the joints, to dissolve and shed into the joint space, triggering an inflammatory response and a gout flare. To prevent this, doctors often prescribe an anti-inflammatory medication, such as Colchicine, alongside uric acid-lowering therapy. This combination helps manage and minimize gout attacks during the initial phase of treatment. It's a temporary phase that's crucial for long-term control of gout and preventing future attacks.

[@tompetters3328]

Over the past 5 years I've all but eliminated gout attacks completely. Recently I went to an orthopedic doctor because of the early stages of an arthritic big toe likely the result of severe gout from earlier years. He recommended allopurinol 300mg. Since I started about 6 weeks ago I've suffering chronic gout that I haven't had in years! But my family doctor is saying not to quit the allopurinol. I feel like a masochist taking a medication for an ailment I already had under control.

[@beniirama4076]

your uric acid start to reduce, and ends up with dislodged uric acid crystal. this dislodged crystal are identified as foreign object by body immune system, thats why you start experiencing "attack". that doesnt mean the meds not working. that is also why it is reccomended to do regular blood uric acid level check (if possible together with kidney function test also) when taking uric acid lowering therapy. i personally still prefer to use cellery seed extract since it's herbal base (have lower risk of side effect)

[@pram9832]

@Tom letters Hi hello sir, are you using allopurinol?? What is your diet along with medicine?? Do you eat chicken, eggs, fish, meat etc.. Please reply

[@aa6757]

5 weeks in taking allopurinol and still getting regular gout attacks, I heard the dissolving crystal theory and that it can take up to 2-5 months to get full relief so I am sticking with it. It dropped my uric acid blood test from 8.7 to 4.1 with a 300 mg daily dose. I can say that my foot feels different tho, I have more feeling in it and it’s more flexible. I’m vegetarian, no soda, sugar, alcohol, refined carbs, or seafood. In the gym 40 minutes 5 days a week. Fit as a fiddle with a right foot that I want to chop off with an ax just to get the pain to stop

[@pram9832]

​@@beniirama4076 Hello sir, what are you using for uric acid problem?? I want to know your diet?? Your reply helps.

[@Servingthetruth24.]

Hello dr , normally my dictor told me to take 1 tablet ( 100 mg) in the morning but i asked him is it oley if i took 2 times a day he told me yes you cal take IF YOU WANT , 1 MORNING AND 1 EVENING . But when i take evening time i didn't feel confort not the same like morning time that means i should stop evenning time ?

[@bjchealthAU]

Sorry but it is not appropriate to comment on your prescription. You should seek advice from your doctor again. It is specific to you and your medical history. Thanks for understanding.

[@Servingthetruth24.]

@@bjchealthAU thanks doctor fir ur advice

[@pram9832]

​@@Servingthetruth24. Hello sir, How are you?? Are you using allopurinol daily? What is your diet sir? Your reply helps.

[@Servingthetruth24.]

@@pram9832 i already stopped to take allopurino

[@pram9832]

@@Servingthetruth24. what is your diet now?? Did you get the pain again?? Reply bro

[@netkotreci3135]

Can I take aloputinor 100mg the rest of my life. I am 30 years old and have gout. Can alopurinol make damage to my kidneys?

[@bjchealthAU]

It is best that you speak to your treating doctor. Everyone is just a bit different and giving general advice is not appropriate on this platform. Good luck with it.

[@harrisoningham9213]

I'm right here with ya bud.

[@pram9832]

​​@@harrisoningham9213 hello bro, are you using allopurinol daily?? What is your daily dosage?? How are you feeling. What is your diet?? Your reply helps.

[@pram9832]

​@@harrisoningham9213 Hi , from how many years are you taking Allopurin?? What is your diet??

[@colinwoods5663]

Ive been on 300g of allopurinol for a week now and i got a gout attack again my doctor said not to use my colchicine while taking allopurinol. But you say its ok please explain. Plus, my uric acid level is at 5.3 I don't understand why this is continuing to happen and i police my diet too no alcohol, no chocolate or sweets cut my sugar intake by about 95% and am drinking 3 liters of water a day as water, herbal tea with lemon, coffee with cinnamon, tea with a little milk only.

[@bjchealthAU]

It can be frustrating to experience a gout attack after starting allopurinol, especially when you're careful with your diet and hydration. Here's a bit of insight into what's happening: Allopurinol is a long-term treatment that lowers uric acid levels, which helps prevent future gout attacks, but it doesn’t treat acute attacks directly. When you start allopurinol, your body begins to adjust, which can sometimes trigger a gout flare in the short term. This is why doctors often prescribe colchicine or an anti-inflammatory medication to be taken alongside allopurinol when first starting it, to help prevent these flares. If your doctor advised against taking colchicine now, it's likely due to a specific concern related to your health situation, so it's essential to follow their advice. Regarding your uric acid level being 5.3, this is within the target range, but flares can still occur as your body adjusts. It's great that you're taking care of your diet and staying hydrated-these are important steps. Continue working closely with your doctor to manage these early flares, and over time, allopurinol should help reduce the frequency and severity of gout attacks. If you’re still confused or concerned, it’s a good idea to discuss this with your doctor, as they can provide personalized advice based on your specific health needs.

[@bradfry5403]

I have been put on Allopurinol I was tried on it a few years ago but I had massive flare-ups of gout a new doctor has put me on a 3 week courses of prednisolone is this a good idea?

[@K69g-m7n]

I take declofenac with prednisolone over cereal drink...3 hrs later, i can walk again...

[@aa6757]

I have been on and off prednisone for 13 weeks. It’s that or I am on crutches. Hoping the allpurinal will help

[@bradfry5403]

@@aa6757 I'm now on Allopurinol non stop for 7 months and all is going great I had to take prednisolone for the first couple of months to counteract the side effects but fingers crossed.

[@MrAndyHTC]

@@K69g-m7n interesting what is the dose like

[@aureliapittilla1526]

Thank you.🙏

[@antoniocavalli5474]

I had weird paind in foot area i think it was gout attacks, but they were different sometimes in side of foot, sometimes in second toe joint, sometimes under my ball of foot....My UA is 550 umol su its 0.55 mmol, and now im on allu 2 weeks, and i have a severe real gout attack in big joint.. Is that normal?

[@EnigamiNetshinobi]

Yeah, I've read everywhere that having attacks is normal during allo treatment. Allo dissolves the crystals and this helps the crystal travel easier, this doesn't mean that it isn't working. It takes time for the allo to help break and dissolve what has been built up over the years. Doctors prescribed me prednisone to deal with the pain whenever I get a flare up. Another is colchicine, but that only works 1/5 tumes whenever I try taking them. Good luck!

[@hammadghani7346]

Allopurinol and eyesight? Thanks for the informative video. My Uric acid levels are always at the upper limits probably due to genetic reasons. In 2014 the level was around 8.4 mg/dl and in 2021 it went up to 8.6 mg/dl. In the past 7 years, I have experienced only two gout attacks. From last year October, I suddenly started to have more attacks and inflammation in joints but the values were still the same. I started taking allopurinol 150 mg which brought the level down to 6.2 mg/dl. Now I am experiencing that my eyesight is getting weaker very fast and often the traffic signs seem blurry. I checked with an ophthalmologist, she prescribed the glasses with very less correction (0.25 and 0.5). My personal feeling is that my power of vision is reducing faster. Does allopurinol have any side effects on eyesight, as well as on kidneys? if yes what is the better way forward?

[@bjchealthAU]

Allopurinol does not affect your eyesight. You should be looking for other causes for you visual changes. Please see your doctor.

[@privatesuzie4071]

I highly recommend you read the research of Dr Pearlmutter, Dr Johnson, and a gout expert on You Tube Dr Pete who has brought his gout in to remission, is currently on Allopurinol (200 mg) as well as some supplements that are showing up in valid research. He quotes and refers his analysis to the association (not causal)between high uric acid and issues with heart, diabetes, and kidney. The point for me is high uric acid mine never below 8 is not just about gout. I have multiple health issues. A recent study also revealed uric acid in the eyes….see Dr Pete a PhD in biology who refers to this study has made uric acid management his life’s work. I am disappointed that most doctors see Uric Acid as a gout issue, but many many people have high UA and never have gout. Dr Pete answers your questions if you don’t understand something.

[@pram9832]

Hello sir, how are you now?? Do you eat meat?? What is your diet??

[@danecory1236]

What can I take if I’m also on carvidelol and atorvastatin which are contrained with colchicine? Been on allo for months and still having flare ups.

[@bjchealthAU]

Two options if you cannot use colchicine are low-dose daily NSAIDs (anti-inflammatories) or low dose prednisone. You should discuss these options with your treating doctor.

[@danecory1236]

@@bjchealthAU thank you!

[@bjchealthAU]

Hope it goes well @@danecory1236

[@colycody]

Hi Doc. I just have a question. If its a good idea to take an anti inflammatory medicine while there is a gout attack during the Allopurinol medication?

[@bjchealthAU]

It is fine to take an anti-inflammatory for a gout attack whilst on allopurinol. You should not stop allopurinol for a gout attack, just continue the dose you are on.

[@cameliaa8069]

Very clear. Thank you!

[@bjchealthAU]

Appreciate the feedback. Thank you

[@pram9832]

@@bjchealthAU does uric acid medicine like allopurinol and feboxstat effect our kidneys and liver damage?? Can we use them for long years. Please suggest.

[@bjchealthAU]

@@pram9832 The medications are safe in the long term. Your doctor will usually recommend periodic testing to ensure they are safe for you and are effective.

[@robertasapp6183]

How do you know if you have gout ? My legs and ankles are not swollen

[@negerimeme4125]

Blood test, uric acid

[@motivationwithgod3966]

Can I take allopurinol and colchicine together?

[@bjchealthAU]

The answer to this is around the 2 minute mark. I think it is best to watch the whole video to get context.

[@beniirama4076]

say doc, if my uric acid level already in normal range (6.4 mg/dL), and i dont have any attacks or other symptoms, should i continue the meds untill it reach 6 mg/dL or i can just stop taking it and start focus on my low purine dietary intake?

[@bjchealthAU]

Your uric acid level is likely to be low because you are taking the medications. Most people get gout because their kidney don’t control uric acid correctly. Not many people have gout because of high purine diets. It is thus very hard to maintain low uric acid levels with diet control alone.

[@beniirama4076]

noted. thanks for the reply doc

[@glaizabrondo3436]

Can i take allupurinol without doctors prescription?

[@bjchealthAU]

Not in Australia

[@Jaesuuun]

Can i take alluporinol even if im currently having gout attacks atm?

[@bjchealthAU]

The 3 minute mark of the video should answer this. Good luck with it.

[@bonifaciomalilapedro1533]

@@bjchealthAU i hope you are doing good! Can I take alluporinol after taking turmeric with black pepper?

[@bjchealthAU]

@@bonifaciomalilapedro1533 not sure if that has been researched. Don't think it would be an issue but if you can always speak to your treating health professionals.

[@maeangeliesanchez5771]

Pwd bang uminom ng allupurinol with out doctor recita

[@tompetters3328]

300mg Allopurinol destroyed my liver. I'm in the process of suing the physician that suggested it.

[@pram9832]

@Tom Petters Hello sir , How are you?? May I know what happened to you. How are you controlling uric acid problem? What is your diet?? Your reply helps..

[@tompetters3328]

@@pram9832 My uric acid problem is also worse than it was before I started with allopurinol. I might try Febuxostat 80mg but very concerned about potential side effects.

[@pram9832]

@@tompetters3328 which is safer allopurinol Or febuxostat sir?? What about dosage?? And your diet?? For how many years are you suffering?? Reply sir.

[@pram9832]

​@@tompetters3328 hello sir, how are you doing?? What is your diet?? Do you eat meat, chicken, fish etc?? Are you taking febexostat??

[@patoni860]

I had severe gout in both feet ankles and knees... You must stop drinking all alcohol eating all sugar, no bologna, no shellfish and you must sweat. You must sweat... In the most important thing that you can do is massage your feet every night. And talk cherry juice does very little but, pomegranate juice before you go to bed will really help you.... But it's going to take a minimum of 2 years to heal up if you're not willing to do that you just going to be in pain and you going to be miserable

[@bjchealthAU]

For gout management, some lifestyle changes like reducing alcohol and certain foods (like shellfish, sugary items, and processed meats) can help, but strict avoidance isn't always necessary for everyone. Sweating through exercise and staying hydrated can aid in managing uric acid levels. There is no strong evidence that pomegranate juice is more effective than cherry juice for gout, though both have antioxidant properties. Gout can often be managed effectively in less than two years with proper medical treatment, such as medications to lower uric acid levels. Always consult a healthcare provider for personalized advice.

[@patoni860]

@@bjchealthAU the strong evidence is I just told you make pomegranate juice works. I just told you that I had super severe swollen feet knees ankles and I told you. You ain't telling me and you ain't had it. You got to cut out all shellfish you got to cut out everything that will trigger.... You have to fast exercise sweat and massage your extremities... I can walk again... I don't have any gout symptoms.... And it's going to take 2 years to get yourself healed up

[@leelemon007]

Good info terrible video production