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Gout, Taking Indomethacin, Family History Of Gout. Allopurinol Better To Prevent Subclinical Damage?

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Posted on Mon, 4 Jun 2012
Question: I am a 50 y.o. female. I was just diagnosed with gout. (flare up on my left toe last year, flare up on lower right middle finger joint last week). My doctor offered 2 choices: 1) Take indomethacin and lots of fluids with flare-ups; or 2) Take Allopurinol daily.
Since I've only had 2 flare-ups so far, I opted for option 1. But after thinking about it further, would I be better off to take the daily Allopurinol in order to prevent any subclinical damage that might be occurring on an ongoing basis? (My mother's fingers became deformed due to gout.) By the way, I don't smoke or drink. I weigh 153, and I'm 5'6" and I try to eat right.
Thank you for your response! XXXXXXX
doctor
Answered by Dr. Praveen Jadhav (9 hours later)
Hi,
Thanks for the query.

You are absolutely correct. Though not a rule, it is usually advisable to take allopurinol continuously after the second flare. Since your mother had the same problem, the enzyme defect
may be hereditary and chances of joint damage are also high.

So I would recommend you to take allopurinol on a on-going basis with dose adjustments to have
a minimum dose to keep your uric acid below 6 mg%.

Hope i have answered your query.I will be available for follow up.
Above answer was peer-reviewed by : Dr. Radhika
doctor
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Follow up: Dr. Praveen Jadhav (2 hours later)
Thank you for your fast reply.
How and how frequently should my uric acid level be tested, and do you recommend a starting dose of Allopurinol?
Thank you!
XXXXXXX
doctor
Answered by Dr. Praveen Jadhav (29 hours later)
Hi and thanks again,

The starting dose of allopurinol is usually 100 mg three times a day or 300 mg once a day of sustained release preparations. You may discuss about starting allopurinol with your physician and start the medications under their expert guidance.

Generally there are no fixed rules of how often to check uric acid levels. But I would recommend to check it once a month till the desired levels are reached and 3 monthly thereafter.

Hope this answers your query.

Wish you good healthy.

Regards
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Praveen Jadhav

Rheumatologist

Practicing since :1985

Answered : 45 Questions

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Gout, Taking Indomethacin, Family History Of Gout. Allopurinol Better To Prevent Subclinical Damage?

Hi,
Thanks for the query.

You are absolutely correct. Though not a rule, it is usually advisable to take allopurinol continuously after the second flare. Since your mother had the same problem, the enzyme defect
may be hereditary and chances of joint damage are also high.

So I would recommend you to take allopurinol on a on-going basis with dose adjustments to have
a minimum dose to keep your uric acid below 6 mg%.

Hope i have answered your query.I will be available for follow up.