I wonder what is the relative efficacy of allopurinol to febuxostat. The latter does seem better tolerated but I wonder if it has lower efficacy. And both I think work by reducing uric acid production while I think it would be better to have medication enhance excretion.

For chronic bouts, steroid injections into affected joints brings quick relief as well as prophylactic benefits. But injections should be done sparingly as they are not without side effects either.

Beer and peanuts seem universal triggers. Other purine sources are debatable and likely depend on the person. Dehydration is an enemy. Also, my understanding is that something related to gout is fat soluble and can be stored in fat. As one loses weight/fat, a bout could be triggered.

OP, hope you get that taken cared off before it becomes serious. Didn't know what it actually was until I went to Youtube. Couldn't make it through a whole video. I considered myself to have a very strong stomach but half way through I almost blew chunks on the keyboard.

https://www.youtube.com/watch?v=qH5x3h1y2uM

Thanks for the thoughts. Everything seems to be well under control with the Allopurinol 100mg.

quote:

Originally posted by konata88:
I wonder what is the relative efficacy of allopurinol to febuxostat. The latter does seem better tolerated but I wonder if it has lower efficacy. And both I think work by reducing uric acid production while I think it would be better to have medication enhance excretion.

1- Febuxostat (Uloric trade name) is more effective than allopurinol in lowering uric acid (UA) levels in patients with gout in a large retrospective study. However, it's unclear how that translates into clinical gout (i.e., flare-ups). Although one would be tempted to equate lower UA levels to less flare-ups, the study only addressed the UA levels, not the flare-ups frequencies.

2- The FDA has recommended that Uloric should not be offered as 1st line treatment of gout. It should only be offered if allopurinol is not doing its job (be it due to drug allergy, intolerable side effects, kidney disease, or still having frequent flare-ups). Reason is that the postmarket safety clinical trial found an increased risk of heart-related death and death from all causes in patients treated with Uloric. The FDA subsequently required this medication to have the so-called "Black Box Warning":
• Gout patients with established cardiovascular (CV) disease treated with ULORIC had a higher rate of CV death compared to those treated with allopurinol in a CV outcomes study.
• Consider the risks and benefits of ULORIC when deciding to prescribe or continue patients on ULORIC. ULORIC should only be used in patients who have an inadequate response to a maximally titrated dose of allopurinol, who are intolerant to allopurinol, or for whom treatment with allopurinol is not advisable.

3- Allopurinol has been around since 1966. Sure, it has potential side effects, just like all meds, but it is overall a very safe medication.

Allopurinol, Idon'tknowwhatthepossiblesideeffectsmaybebutitdoesn'tseemtohaveanyeffectonmeatall.

I've been on 100mg allopurinol for over two decades now and no more gout attacks. unknown if any side effects but i have gotten more assholey as i get older.