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Is Diuretics Safe To Take Inspite Of Having Gout?
Question: My father has been receiving treatment for Rheumatoid arthritis for the past 10 years. But recently, a rheumatologist diagnosed it to be Gout after taking blood tests and x-rays. He is also taking medicines for heart ( beta blocker, ARB, calcium channel blocker, diuretics). His latest blood report showed creatinine to be 2.2 and uric acid 12. I read somewhere that diuretics should not be taken by people with gout. But my father has been taking it for more than 6 years. What should I do now? should I stop diuretics ( Olmersartan - Chlorthiodine combination)?
He is yet to start on Febuxostat and sodium bicarbonate.
He is yet to start on Febuxostat and sodium bicarbonate.
Brief Answer:
yes it is better to stop it.
Detailed Answer:
Hello,
Yes, very often gout is misdiagnosed as RA and patients continue to take the wrong medication for years. It is good that you have finally received the right diagnosis.
Yes, it is advisable to stop diuretics as they also tend to increase the levels of uric acid.
However this may have to be done gradually in consultation with a physician since his serum creatinine is high and that may also cause water retention.
He should be started on febuxastat and maybe colchicine in order to prevent any acute attack of gout.
Regards
yes it is better to stop it.
Detailed Answer:
Hello,
Yes, very often gout is misdiagnosed as RA and patients continue to take the wrong medication for years. It is good that you have finally received the right diagnosis.
Yes, it is advisable to stop diuretics as they also tend to increase the levels of uric acid.
However this may have to be done gradually in consultation with a physician since his serum creatinine is high and that may also cause water retention.
He should be started on febuxastat and maybe colchicine in order to prevent any acute attack of gout.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Thanks for the detailed reply, Mam.
I could not get this info on diuretics from the doctors in my city.
I have one more query.
I have uploaded all the x rays and blood reports in my profile. Pls let me know if my father has Rheumatoid arthritis or Gout. I would like to get it clarified from you.
Also, you had mentioned about Colchicine. My father is taking medications for both heart and Kidney. He had taken nimusulide for the past 10 years and now only stopped it. Now he is taking medrol 4mg. Can he take colchicine? will it affect kidney or heart?
Thanks in Advance.
I could not get this info on diuretics from the doctors in my city.
I have one more query.
I have uploaded all the x rays and blood reports in my profile. Pls let me know if my father has Rheumatoid arthritis or Gout. I would like to get it clarified from you.
Also, you had mentioned about Colchicine. My father is taking medications for both heart and Kidney. He had taken nimusulide for the past 10 years and now only stopped it. Now he is taking medrol 4mg. Can he take colchicine? will it affect kidney or heart?
Thanks in Advance.
Brief Answer:
it depends on the RF and anti ccp
Detailed Answer:
Hello,
It could be both because joints of both hands and feet are involved. The uric acid is high because of the raised creatinine.
I would like to know what his rheumatoid factor and anti ccp are. If they are positive then there is a higher chance that he has RA.
Also considering a high esr and crp it is obvious that he still has a lot of inflammation in joints.
Colchicine may not be safe in people with a raised creatinine but we may use it in low doses in order to reduce side effects. Moreover it is probably the nimesulide which has harmed the kidney since he has been taking it for such a long time.
So get back to me with the RF and anti ccp.
it depends on the RF and anti ccp
Detailed Answer:
Hello,
It could be both because joints of both hands and feet are involved. The uric acid is high because of the raised creatinine.
I would like to know what his rheumatoid factor and anti ccp are. If they are positive then there is a higher chance that he has RA.
Also considering a high esr and crp it is obvious that he still has a lot of inflammation in joints.
Colchicine may not be safe in people with a raised creatinine but we may use it in low doses in order to reduce side effects. Moreover it is probably the nimesulide which has harmed the kidney since he has been taking it for such a long time.
So get back to me with the RF and anti ccp.
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Above answer was peer-reviewed by :
Dr. Prasad
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