How To Take Allopurinol
- Before you start the treatment, read the manufacturerâs printed information leaflet from inside the pack. It will give you more information about allopurinol and will provide you with a full list of the side-effects which you may experience from taking it.
- If you have recently had a gout attack, make sure your symptoms have completely gone before you start taking allopurinol tablets.
- Take allopurinol exactly as your doctor tells you to. The usual starting dose is one tablet each day, although this may be increased as you go on. Your dose will be adjusted in line with how much uric acid is in your blood.
- Swallow the tablet with a full glass of water, preferably just after a meal. Itâs also important that you have plenty to drink throughout the day. Aim to drink 2-3 litres of fluid each day.
- You can take allopurinol at whatever time of day you find easiest to remember however try to take your doses at the same time of day each day, as this will help you to take it regularly.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the forgotten dose. Do not take two doses at the same time to make up for a missed dose.
How Can I Self
The methods of managing an acute attack of gout differ from the ongoing methods for managing gout. If youve been diagnosed with gout, youll benefit in the long term from making healthy changes to your lifestyle, such as:
- maintaining a healthy body weight. If you do need to lose weight, make sure your weight loss is gradual as crash diets can increase uric acid levels
- drinking alcohol in moderation and avoiding binge drinking
- drinking plenty of water, and staying hydrated
- avoiding, or eating in moderation, foods that are high in purines. Talk with a dietitian for tips and advice
- exercising regularly aim to complete at least 30 minutes of physical activity most days of the week
- working closely with your GP to prevent further attacks and actively manage your condition.
Drink Plenty Of Water
This wont likely provide immediate relief, but inadequate hydration is known to contribute towards the creation of urate crystals.
Drinking water may flush uric acid crystals out of your system.
Preliminary research suggests that adequate water consumption during the 24-hour period before a gout flare can decrease recurrent gout attacks.
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Time To Call The Doctor
A gout attack will usually go away in about 3 to 10 days. But you can feel better sooner if you treat it. To be sure that you have gout, see your doctor. Theyâll examine you, and they might do some tests.
These test help your doctor know if you have gout, or something else with similar symptoms:
- Joint fluid test. Fluid is taken from the painful joint with a needle. The fluid is studied under a microscope to see if the crystals are there.
- Blood test. A blood test can check the level of uric acid. A high level of uric acid doesnât always mean gout.
- X-ray. Images of the joints will help rule out other problems.
- Ultrasound. This painless test uses sound waves to look for areas of uric acid deposits.
Managing Symptoms And The Underlying Triggers
Gout is a form of arthritis caused by the buildup and crystallization of uric acid in a joint. Depending on the severity of an attack, treatment may involve over-the-counter anti-inflammatory drugs to alleviate pain, as well as behavioral modifications to reduce the frequency of attacks. Chronic attacks may require prescription medications to help reduce uric acid levels in the blood.
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Take Your Prescription Drugs
If you’ve had a gout attack before, your physician may have prescribed drugs to treat attacks. This may be your first line of defense or you may decide to use them only when NSAIDs fail to relieve your pain.
Prescription medications to treat gout include:
- Prednisolone oral tablets, which has been shown to work as well as NSAIDs and often doesnt cause the same stomach upset. Prednisolone is a type of corticosteroid and does carry other potential side effects, particularly if it is taken for longer than the recommended 5 days.4
- Colchicine, which has been shown effective in reducing pain and inflammation if taken in the first 24 hours of an attack. Always follow your physicians instructions regarding dosing to decrease your risk for potential complications and side effects.
Opioid painkillers, such as codeine, hydrocodone, and oxycodone, are not recommended to treat the pain caused by gout.
Chronic Gout Signs And Symptoms
- Compared with the dramatic nature of acute gout pain, chronic gout pain is more of a soreness or persistent ache.
- Pain that tends to be a more continuous feeling of dull aching or soreness in the joints
- Hard white deposits or lumps under the skin, called tophi, found on the elbows, ears, or fingers.
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The Role Of Diet In Gout Prevention
Dietary control may be sufficient in a patient with mildly elevated uric acid, for example, 7.0 mg/dL
For those with a higher level, for example, 10.0 mg/dL, diet alone will not usually prevent gout. For the latter, even a very strict diet only reduces the blood uric acid by about 1 mg/dL- not enough, in general, to keep uric acid from precipitating in the joints. The cutoff where patients with gout seem to dramatically reduce their number of attacks is when their uric acid level is taken below 6.0 mg/dL.4
If You Are Having Repeated Attacks See Your Doctor
Some patients can go a long time between attacks. In fact, for 62 percent of patients the next attack will be more than a year away, and some won’t have another attack in the next 10 years. However, if you begin to have more frequent attacks, talk to your doctor about escalating treatment. People think its normal to have flares every now and then, but its not. The gout can be doing damage to your joints. It means you still have too much uric acid, says Shakouri. In particular, ask about allpurinol. It wont help with an acute attack but will help prevent future attacks by reducing uric acid production.
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Other Uses For This Medicine
Allopurinol is also sometimes used to treat seizures, pain caused by pancreas disease, and certain infections. It is also sometimes used to improve survival after bypass surgery, to reduce ulcer relapses, and to prevent rejection of kidney transplants. Talk to your doctor about the possible risks of using this medication for your condition.
This medication may be prescribed for other uses ask your doctor or pharmacist for more information.
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Gout Myths And Misconceptions And The Facts
Gout was once called the disease of kings, because of its propensity to affect overweight, rich men throughout history. Famous gout sufferers have included Alexander the Great, Charlemagne, Henry VIII of England, and Benjamin Franklin.
While gout is no longer thought to be a disease of the wealthy, it is more common in men and people with weight-related health problems including high blood pressure and type 2 diabetes.
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How Can I Manage My Gout And Improve My Quality Of Life
Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.
For gout in particular:
- Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines , and limit alcohol intake .
CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.
When Is Medication An Option
Treatment with medication is especially recommended if
- gout attacks have become frequent or are very distressing,
- joint damage is already visible in x-rays,
- tophi have already formed, or
- increased uric acid levels have caused kidney stones.
Treatment with medication may also be recommended if changes to your diet are not enough to lower the uric acid levels, or if they are very high.
If someone has had a gout attack for the first time, its not clear whether treatment to lower uric acid levels makes sense. Some people donât have any more problems after their first attack, while others only have them very rarely. Thatâs why some medical societies dont recommend starting treatment with medication right away.
Its not always clear whats meant by âfrequentâ gout attacks. Usually, it means more than one or two gout attacks per year. Other factors that play a role include the how severe the attacks are and how well the medication for lowering uric acid levels is tolerated. And some people donât want to take tablets every day. Others may be more concerned about the long-term effects of gout, and find peace of mind in taking medication.
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What Are The Signs And Symptoms Of Gout
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Symptoms in the affected joint may include:
- Pain, usually intense
What Should Be Considered When Taking The Medication
Especially during the first few months of treatment, uric-acid-reducing medications may even increase the risk of gout attacks. The reason for this is that any uric acid crystals already present only break down gradually. When this happens, small particles of the crystals may be washed into the joint, where they then cause an inflammation that leads to a gout attack. That happens quite often. It is thought that it can take up to two years for the body to get rid of all uric acid crystals.
To prevent gout attacks during this time, low-dose colchicine is often also prescribed for the first six months. That effectively reduces the risk of those kinds of attacks. But even if one occurs, it’s not necessary to stop taking the uric-acid-reducing medication.
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The End Of Gout Your Quick Start Approach
Shelly Mannings The End of Gout is not only a fascinating read its also refreshingly practical.
Shelly gives you two simple quick-starts:
Eat more of these
Eat fewer of these
This simple adjustment can correct years of gout-causing errors in your eating. And you can start on this straight within minutes of receiving the program away.That really helped my problem of How To Get Protein If You Have Gout.
The next step is to follow Shellys 7-day plan.
It tightens up the quick start advice and turns it into a solid, follow-along program.
The 7-day plan was the real clincher for me.
I am a pretty average cook Im competent but not at all skilled or adventurous. Turns out I didnt need to be.
The plan takes away all the thinking and gives me, for the first week, something I can simply copy.
After the first 7 days I used Shellys advice to adapt the plan according to my own tastes.
Which was pretty easy the plan is full of options so you can try different foods and see what you like best.
Its all food you can buy in your supermarket. And it includes lots of nice stuff the chocolate and strawberries desserts were real winners in my house!
What Can Increase Your Risk
A high level of uric acid in the blood is the main factor that increases your risk of developing gout. However, itâs still uncertain why some people with a high level of uric acid in the blood develop gout, while others with an equally high level donât.
Other factors that may increase your risk of developing gout are outlined below.
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Who Gets Gout Gout Risk Factors
Gout happens when too much uric acid builds up in the body. Uric acid is a normal waste product in the blood resulting from the breakdown of certain foods. Uric acid usually passes through the kidneys and is eliminated from the body in urine. But it can build up in the blood and form painful, spiky crystals in your joints. This may happen if the body is making too much uric acid or if the kidneys are having a hard time filtering it out.
Having too much uric acid in the blood is a condition called hyperuricemia. Certain foods, medicines, and lifestyle factors can cause high uric acid levels in the blood, triggering a gout attack.
Your risk of gout goes up when your diet is high in naturally occurring compounds called purines. When purines break down in the body, they cause uric acid to form. Purines are found in certain high-protein foods and some drinks. It used to be thought that gout was caused only by lifestyle and diet, but new research has found that’s not true instead, gout is thought to have a genetic link. Diet, however, does play a role in the disease.
Other risk factors for gout include:
- Being a man
- Type 2 diabetes
- Health conditions that cause rapid turnover of cells
- KelleySeegmiller syndrome or LeschNyhan syndrome
Checking Your Uric Acid Level
When you take uric acid medicine your target is to get your uric acid levels down to 0.36. You need to get your uric acid level checked regularly. You might need to take a stronger dose of your uric acid medicine if your levels dont come down. If you have tophi you might need to get your uric acid levels down to 0.30 to get rid of your tophi.
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How Can An Attack Of Gout Be Treated
The management of an acute attack of gout is very different from the prevention of subsequent attacks.
Treatments used for prevention, such as allopurinol can actually make things worse if given during an attack, and so need to be held back until the attack has resolved for several weeks.
There are a number of measures that can help resolve an attack of gout. See Table 2 for summary of treatment strategies for acute gout. One principle is that treatment for an attack of gout should be instituted quickly, since quick treatment can often be rewarded with a quick improvement.
If an attack of gout is allowed to last more than a day or so before treatment is started, the response to treatment may be much slower.
Table 2: Medications to treat acute attacks of gout
The Pathology Of Gout
Gout is primarily a metabolic disorder in which uric acid accumulates in blood and tissues. When tissue levels reach saturation, needle-like crystals form, causing inflammation. This occurs most commonly in the cooler joints, notably the metatarsophalangeal joint of the big toe.
Many people with hyperuricemia never develop gout, but those with the highest levels are most likely to suffer episodes. Hyperuricemia may also lead to kidney stones.
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What Foods Should You Eat
Although a gout-friendly diet eliminates many foods, there are still plenty of low-purine foods you can enjoy.
Foods are considered low-purine when they have less than 100 mg of purines per 3.5 ounces .
Here are some low-purine foods that are generally safe for people with gout (20,
- Fruits: All fruits are generally fine for gout. Cherries may even help prevent attacks by lowering uric acid levels and reducing inflammation (
- Vegetables: All vegetables are fine, including potatoes, peas, mushrooms, eggplants and dark green leafy vegetables.
- Legumes: All legumes are fine, including lentils, beans, soybeans and tofu.
- Nuts: All nuts and seeds.
- Whole grains: These include oats, brown rice and barley.
- Dairy products: All dairy is safe, but low-fat dairy appears to be especially beneficial (
- Beverages:Coffee, tea and green tea.
- Herbs and spices: All herbs and spices.
- Plant-based oils: Including canola, coconut, olive and flax oils.