Allopurinal

[kellyscats1]

Has anyone who is usine Alopurinal been tested f aluporinal hypersensitivity bfor starting it. What is the starting dsage most have had.

I have had a few fares of gout and my uric acid is off ghe charts. My nehrologist had neer heard of the hypersensitivity test .. I asked him to google it and lo and behold he looked surprised and rdered it. I had it done today, but I wanted to start with a low dose.. he said 300 mgs.. I wont do that.. I can half the pils so... but meanwhile i will set up appointment with rheumatologist..My Nephrologist is only in town once a week and in case I have a bad flare I want a doc who can inject steroids into the joint.

I was dissapointed that my kidney doc did not know of the test as I imagine he treats a lot of gout..

Thanks

Kelly

[Bassetmommer NKF Ambassador]

Yes I am on allopurinol and have been for years. It is a life saver. Scary that your Neph never heard of it because it is the Gold standard for gout, and uric acid kidney stones. I have Psoriatic Arthritis and that raises your uric acid levels. I had stones for two years before the put me on it. Stopped the stones. I am also on sodium citrate and that helps the blood levels stay where they should. I never has an issue with either drug.

[kellyscats1 in reply to Bassetmommer]

Thanks... My nephrologist knew of allopurinal.. he did not know about the allopurinal hypersensitivity test.. lol..which i wanted befor i started..but decided to also see rheumatologist in case i need injection into jint during flare...lol.. thanks a bunch

[Skinnyblue in reply to Bassetmommer]

I did not know Gout is related to CKD !!

[kellyscats1 in reply to Skinnyblue]

Sadly it is... one of the painful possibilities with CKD... not filtering the uric acid...sigh

[drmind]

I had one gout flare up and never wanted another. Initially I was put on 100 mg of allopurinol several years ago, but uric acid levels remained high and my dosage was changed to 200 mg daily. I have taken this dose for several years and never had another flare up. Uric acid levels remained at recommended levels. My primary doctor Initially prescribed the medication and eventually my nephologist monitored it Neither doctor ever mentioned taking a sensitivity test. There has never been any obvious problems with allopurinol and my CKD. BTW I'm usually sensitive to medication and often get side effects, but never had any with allopurinol. Hope sharing my experiences with gout has helped.

[Hily in reply to drmind]

I was down to 100 a day Allopurinol and my e GFR dropped. I told my chemist and he examined my medicines for me. He said the Allopurinol can cause damage to kidneys. He suggested that I took one every other day or halved them to 50, but if gout reappeared to go back to 100. This I did and have been on 50 for over a year-no gout. So better for me.

I hear the 100 has been deleted and 300 is the smallest dose. I hope this is not correct.

[kellyscats1 in reply to Hily]

the pils can be cut...what ws your uric acid level....aside from gout kidney stones are also a problem for high uric acid levels and can also effect heart and kidneys.. so we learn to find a sweet spot...

[kellyscats1 in reply to Hily]

from what i read from naional institute of health allopurinal reduces CRP... c-reactive protein and slows pregression of ckd

[Dana66CKD]

Found an artcle on nih.gov. No mention of sensitivity test, but does offer info for starting dose in USA vs UK. Here is link I copied. Hope you can find. I'm not very good at "sharing" this type of info via internet/computer.

According to article, starting dose depends on uric acid levels and severity of gout... mild, moderate or severe. Also discusses creatinine clearance in patients with CKD. Very long read.

ncbi.nlm.nih.gov/books/NBK2....

[Jinkybhoy]

I'm on Allopurinol(100mg) also for about the last 18 months. I never knew or was told about a sensitivity test. I'm stage 4 ckd funnily enough my egfr dropped from 32 to 25 when I started Allopurinol but I also got my 3rd covid jab at the same time so not exactly sure what caused the drop. I started 1 tab every other day then increased to 1 a day. It's worked great for me but this last 2 months I started getting a pain on the right side of my stomach so I cut back the Allopurinol to every other day again and this seems to have stopped the pain. I also get my liver enzymes monitored every couple of months because Allopurinol can affect the liver. But I've had no gout flares since I've been on it thankfully.

[orangecity41 NKF Ambassador]

I was prescribed 100mg Allopurinol 4 years ago and have had no side effects and it has worked for me. I had high uric acid. So far no side effects.

[Turtlepad513]

i was put on 100mg to start by nephrologist, and after the low dose didn’t work, I was sent to rheumatologist who did sensitivity test before moving me to 200mg daily. No side effects.

[Beachgirl32]

I don’t recall having a hypersensitivity test for it but started out 100 then eventually 200 a day. 300 seem high to start out with also watch what you eat a lot of foods can flare up gout.

[hardrock430]

my husband was prescribed Alpurinol 300 mg and then 100 mg and was told to take both doses and he wound up being allergic to it and he passed away a week and a half later so please be wary of that medication please

[kellyscats1 in reply to hardrock430]

Thank all of you for the insightful information. I insisted on the sensitivity test and am awaiting results.. Meahwhie i took another covid booster so must wait 2 weeks before pred. I also insisted on low dose pred when i strt as it reduces chances of gout flare..I will not tart the 300 mgs.. pills can be cut so i plan on starting at 50 for a few weeks as long a my hpersensitivity test is ok...and i also sent my records to a pheumatologit to hav him treat my gout.. so dissapointd that my nephroogit wanted to start me on 300..my uric acid is very high but will go very slow.. anf will be under rheumatologist care..andd oh.. mu diet is good as i am a vegeterian anyway.. it i crappy kidneys..

thaks so muc...

Kelly

[kellyscats1 in reply to hardrock430]

So so sorry about husband.. and so sd that docs do not do hypersinsitivy test.. whih is genetic test..I am witing for results ad will start at 50 mgs not the 300 hundres nephrologist wanted..pills an be cut..an also swithing to pheumatologist to manage gout..I have probbly ad this outrageous high uric level for som time.. so a few weeks more sure wont mak a diffrence.. thaks for reply an agn so veyr sorry...

[hardrock430 in reply to kellyscats1]

Thks, my husband had Gout in his knuckle on one of his fingers and he used to have it in his feet also, very painful I know

[JD4020]

I've taken 100 mg a day for many years to prevent gout. sorry, but did not know of a sensitivity test for it, but in some that could be quite helpful. Last year a mass was found on my liver, after biopsy, determined to be a granuloma. The doctors were happy, thinking it was not cancer, but I wasn't becouse it was continue to grow. After research, the medication in question can cause granuloma's . So I took myself off the medication in question, also due to gallbladder issues, I cut back on fats, which lead to decreased protein intake. I see the hepatologist every 6 months for testing and mri due to cirrhosis due to diabetes/nafld/nash. The last scan showed that the mass in question was no longer visible. When talking to the hepatologist, they had no reason for it, then I explained my research on granuloma's and causes, and due to that discontinued the medication in question. They had not heard of that reaction to that medication in question.

So with gout, if you need the medication, take it, but if possible keep dosage down, cut down on protein/purines, same with liquior. In renal patients, a raise in uric acid levels can be elevated, and cause problems such as gout. But the good news is, research has shown that lowed protein intake with CKD stage 3 and 4 can benefit the kidneys.

But once dialysis has started, then the processs depleates protein, and thus, usually dialysis patients are required to consume more protein.

my wish is that you do not wake up with a swollen, red, throbbing toe, that you can not stand even a sheet on.

good luck !

[kellyscats1 in reply to JD4020]

Thanks a bunch. Ys my diet is purine restricted already and i will do on meds after sensitivty test results and go very slowly.. will now see rheumatoogist.. and yes two episodes in 6 months were enough..lol

thanks

[allene7]

I have been on allopurinol for a long time. I had no test done prior to taking it. I take 100 mg daily. I have had no problems at all taking this drug. Good Luck.

[kellyscats1]

Thank you so much.. my uric levels warrant a higher dose..and the higher the dose the greater the risk..I have come to realize that it is the rheumatologists that are far more careful with this med..and mre apt to do the test.. I have jusg been made aware of a few fatalities due to the severe reaction to this med and the test is very simple and not expensive..the condition of Stevens- Johnson syndrom has a high mortality rate.can also be caused by other meds... it is the ounce of prevention..thanks again

[renegade70]

i have been on allopurinol for a few years . i am on 200 mg per day. it was prescribed for a couple of nasty bouts with gout. never told or knew about any sensitivity test. but have never had a problem with it . it has kept my uric acid levels under control. now (colchicine?) another drug they prescribe for uric acid and gout was another story. i had to stop after 2 days caused gastro intestinal problems.

[kellyscats1]

test came beckk neg and will now see a reumatologist for the gout