I had a gout flare before and I had not have one for couple years. I had a flare up beginning of December and my Dr. put me on Colchicine and Allopurinol. Colchicine .06mg twice a day as needed. Allopurinol 100mg twice a day. This is my first time being on these medication. I used NSAID for my previous flare up.
I took both Colchicine and Allopurinol as directed for a week and I finally was able to walk. I stopped taking Colchicine per Dr. order and direction of as needed only. My big toe although swelling around joint has subsided it is still tender when I put pressure on it. I continued with my Allopurinol medication.
My question to all is how long should I take the Colchicine? As long as I take Allopurinol? When does one stop Colchicine since it is a as needed medication. Will stopping Colchicine prematurely trigger another gout flare up?
Any advice is very much appreciated. Thank you in advance and I look forward to hearing from all.
I think you're just about on target, when you can walk again stop the colchicine, and unless there's another flare you just stay on the allopurinol for some time, including at least until your blood tests say your blood urates are down to a normal level.
Hi Jay
The Dr is doing the right thing.
The only additional advice would be drink plenty of water and during the first couple of weeks look out for a skin reaction. It’s very unusual in Caucasians, but it does happen - all your skin falling off. If you’ve been On allopurinol and not had it yet, you’re in the clear.
The colchesine is there to stop gout flairs by calming down the immune system. I found I took one from time to time as needed. In my experience if you take a colchesine as soon as a hint of a problem it stops it.
Allopurinol is for life. For probably a genetic reason (and age) your kidneys aren’t removing Uric acid properly and it builds up in the tissues. As your blood urate falls more is released from the tissues, which may trigger gout (hence the colchesine. This process will take time. Only 30% of people stick to the allopurinol possibly because they think they are cured or because they don’t understand that gout not only attacks the joints,?but causes damage to the arteries (and kidneys), which years down the line leads to heart attack and stroke.
It would be beneficial for you to get your body down to its correct BMI (around 22-24) if you’re overweight. If you drink alcohol it’s sensible for everyone but even more so with gout to drink occasionally and moderately.
You need to have blood tests probably 2 x a year to check you’re on the right does of allopurinol.
With allopurinol you can eat whatever you like. Can’t emphssise enough to drink plenty of water - helps the body to flush the excess urate.
Taking The allopurinol will become as easy as cleaning your teeth.
NB I found that allopurinol made me very tired for the first few weeks.
Colchesine will give you diarrhea if you over do it. If that happens, stop a few days before you take another.
Oh yes - don’t take aspirin as it exacerbated gout.
Hi Jay wishing you a very free from Christmas gout.this time of the year. is watch what you eat. with me i take cholochine at the very first twinges and signs of gout.the swelling will go and you will feel better.not sure about taking allopurunol sometimes it will cause gout. I have been told. until your body gets rid of the urites.you must be free from this and have a blood test before they give you allopurunol.
Thank you for your advice. I stopped the Colchicine after a week and the swelling went down but the spot is still tender. I also started taking Allopurinol for the first time with the Colchicine. At the moment, I am only on Allopurinol. However, the tender spot just will not totally go away. The reason I questioned about continuing the Colchicine is I read somewhere that some may get a gout trigger when they first get in the Allopurinol regime. Am I experiencing that? Should I start taking the Colchicine again? Any advice is greatly appreciated. Thank you all for answering my question and I am glad I found this forum. Seasons Greetings to all.
Thank you Rusty for the comprehensive explanation of Gout and its medication. Like my replied on the other post above, I quit taking Colchicine after a week when the swelling subside but the joint is still tender. I started the Allopurinol regime with the Colchicine and the only thing I am taking is the Allopurinol. My question is I read somewhere that for some going on Allopurinol for the first time can at times trigger a gout attack. My tender spot never did go away, its still a little sore to walk but not enough to debilitate me. Am I experiencing the side effect of Allopurinol (triggering a gout attack)? Should I start taking the Colchicine again? Do I need to stop Allopurinol until all signs of Gout is gone? Any advice is greatly appreciated.
Just a FYI, I actually lost 40lbs after starting a low carb diet so my BMI is the best I ever been. I don't drink alcohol and no sugar for me since July. I drink PLENTY of water during the day so I am just confused as to what is going on that is causing this sore/tender area to linger. Thanks again Rusty for your advice and reply. Seasons Greeting and Happy Holidays.
Happy Gout Free Christmas to you too, David. Thank you for your reply. Like my previous replies to the others I am questioning about Allopurinol and causing a Gout attack for some that is taking it for the first time. I have a tender spot on the affected joint that will not go away. Its not bad enough for me to be off my feet but its there and if bump in an angle can cause some soreness. Wonder if I should stop taking Allopurinol and start taking Colchicine again until all is clear and then go back on Allopurinol? Any advice is greatly appreciated.
Allopurinol will trigger gout as the crystals are exposed (which were previously covered by layers of protein to get them out of the blood). However you should be able to control it with the occasional colchesine. Be aware that if you have a heavy infection stop The colchesine as it reduces immune activity.
As for the allopurinol it will eventually sort you out. The most common dose during the cleaning out phase (fist couple of years) is 300mg. You may find 200 is enough, but you need blood tests to confirm it.
NB as a gout sufferer you need to get the urate down to under 4, not under 6.5 as per a normal male.
NB2 the faint gout you have now could be the crystal release or it could be long term damage already done to the joint. I thought for a year or so I had permanent damage done to the joint but after a couple of years of allopurinol it 98% disappeared (leaving a small pain if I push my toe up hard).
Merry Christmas and good health.
THe quick answer - the soreness is not a side effect of allopurinol- it’s the allopurinol doing its job. You might take low dose colchesine (eve half at a time to see if that works for you). FYI losing weight often triggers gout as effectively while losing weight you are consuming extra meat each day (your own body meat).
If the soreness continues you may be stuck with it, but I found that the residual soreness in one toe (and thumbs) went after a good year or more. I’d describe mine as sore rather than pain. Colchesine helped it.
Thank you for your explanation. I am glad I found this forum.
Cheers and Happy New Year
Jay,
Sorry to hear about your flare up. They are the worst. Take it from someone who has suffered them for years, and sometimes a new flare up every week! I've actually had an attack simultaneously in the big toe and knew of the same leg!! Which has to be the worst combination.
You should never take Allopurinol while taking Colchicine. Allopurinol technically is for long term control, while Colchicine should only be taken during a flare up. During your flare up, typically 6 -12 days (1 pill a day) of Colchicine should clear it up. After the symptoms are gone, that's when you get back on the Allopurinol. If youre in a full blown flare up, the Colchicine can take 2 days until you notice a difference.
Another tip- If you're insurance provider is like mine, they won't pay for Colchicine. If that is the case, checkout the Good RX app, they have a coupon code that can knock 40%-50% off the price.
And as far as things to do to keep the flare ups away. I read all about the diets, meats, alcohol, etc, etc. I cut all those out systematically to see if any of them made a difference. And cutting them out didn't keep my weekly attacks from occurring. Just recently I cut out all caffeine and bam, the attacks stopped. Strange right! Hopefully that info helps, if not I hope you find your trigger!
Good luck!
Hey W, sorry to hear about your flares. You ever try taking celery seed (or just plain celery), before, during, or after? I've got to try that GoodRX for another condition, actually.
My worst attacks, of gout or pseudo-gout, are when the get into the tiny joints in the foot! It doesn't even hurt as badly as some other but you just can't use it.
I seem to be clear of regular gout now but have had what must have been pseudo-gout, now that I'm taking celery seed continuously I haven't had either and hope to keep it that way.
Thank you Wulongheyot for the advice. I did stop taking Colchicine for now as I am taking the Allopurinol. Hopefully it will keep a flare up away. The GoodRX is a great way to save. At times it has better price than if I go through my own's prescription plan from work. The pharmacist where I go was kind enough to run through Good RX and my own. I wonder why am I paying for prescription plan when I can get discounts for free. As for caffeine, I hope that is not my case as I love coffee. Thanks again for the advice and reply.
Have to check into the celery seed/celery. Is it a supplement? Does it comes in pill format? I am taking cherry extract and it is helping. Great advice. Thanks so much.
jx, never tried Celery seed, but yes I've eatin my weight in celery. I think once or twice it helped with an attack, but in all honesty it's so difficult to say whether or not that was the one thing that actually helped. Mainly because, when in paid I'd try every remedy possible, which I'm sure is counter-productive. I'm more than confident (for me at least) it's the caffeine. Maybe i'm allergic to it? Jay, I have to say i'm a Debbie-downer (wahh wahh) when it comes to Allopurinol. It never did anything for me. Little disheartening when you're taking a medication that is suppose to assist with keeping an attack from occurring while constantly getting an attack. Colchicine on the other hands is gods gift to gout sufferers. It has always been my best friend to clear an attack up, but again not very sustainable when you go off of it and the attack is just waiting around the corner. Hence the reason I've been more focused on cutting things out of the diet versus relying on remedies.
Jay, yes celery seed comes in convenient capsules. It also comes loose, for cooking, and I rather like it actually!
I tried cherry juice and dried cherries, and for me it did nothing. I don't know that there is any known active ingredient in cherries, the way there is in celery seed, "3nb".
W, have you ever looked seriously into pseudo-gout? It works off calcium, it is not supposed to be linked to any particular diet, and allopurinol won't touch it. Neither will celery seed. That's why I finally started paying attention, and concluded much of what I have had is the pseudo- variety. I think colchicine would still work on an attack as it's a general anti-inflammatory or pain-killer or something.
This advice is wrong.
It is completely 100% normal to take allopurinol and colchesine.
It is the standard advice by NICE.
Don’t stop taking the allopurinol. The Allopurinol is providing a constant downward pressure on the blood urate. If you stop taking it the system goes into reverse putting down crystal deposits again.
The crystals don’t cause pain. What causes the pain and swelling is the white blood cell immune attack. The colchecine inhibits that attack, thus reducing swelling etc till the body has a chance to flush out the crystals causing the problem.
The advice in the past was to stop the allopurinol. This advice has long since been superseded.
This advice is totally incorrect. Who told you this?
Following this regime it is not surprising that you have weekly attacks. What you are doing is constantly turning the system off and on, this almost guaranteeing gout.
Additionally the dosage advice for allopurinol is also wrong.