Uloric

[Gary]

Hello,

I’ve been prescribed Uloric as allopurinol is ineffective for me. I also use colchicine and prednisone. I have severe attacks. Indomethacin is no longer used as it conflicts with my heart medicine – warfarin. I need about 30 mg of prednisone and 80 mg of uloric to kill the pain and swelling of a gout attack. I am required to take this and colchicine every day as I have a metabolism that is prone to unpredictable attacks of gout, usually not from diet. Is it safe to use this amount of prednisone? Is it possible most of my gout is gene-related as told to me by my rheumatologist? This is the first time I have understood this in 29 years of gout attacks since I was 25. And was that not an early age to have a gout attack, unless it was gene-related?

Thank you. I hope you can answer my questions.

Gary

[Keith Taylor]

I can’t answer your safety question about prednisone. I can give my personal views, but I’m not a doctor. As you have a heart condition as well as gout, you must take advice from appropriate specialists.

Colchicine should help you the most. Again, dosage is something your doctor should control. The best approach is to take one at night. If there is any sign of swelling or gout discomfort the following morning, take another. never exceed more than two in 24 hours. For most gout sufferers, this will limit the pain to acceptable levels. Where it does not, you must see your doctor or a pharmacist for advice on blocking or treating residual pain. There are many alternatives to prednisone. Acetaminophen (paracetamol) might be useful?

Most importantly, your pain relief should be a temporary fix for the long-term problem of excess uric acid. It is important that you know your number, and you know what your targets are. Low targets until the risk of attacks is gone. Then, no higher than 5mg/dL.

You are right that 25 is young for gout, but not unheard of. One of my nephews has similar problems. Both me and his father (unrelated except by marriage to my sister) have gout. There are many genes involved with increased gout risk. Obviously, some combinations cause gout earlier. The situation is complicated, as in earlier generations, gout diagnosis was restricted to the rich.

Gary, I’m really sorry you have had problems with your password login. I hope this is OK now. To any other gout sufferers who are having trouble logging into the forum, please use the orange Support button, or GoutPal’s Gout Helpdesk. It might take me a little longer to answer those tickets, but I will get there eventually.

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