Allo vs. Uloric

[Toby]

This is my first posting but have been reading posts for a couple of months.   Great Learning – many thanks to all!  My background:

52 yr. old male, 5'10 and 175 lbs. fairly active and in decent health.   Last and only UA reading was 12 mo. ago at 5.4 (prior to the attack)  One and only major attack was 10 months ago.  I have tried to cut back on my Purine intake and given up beer completely – now drink wine 3 – 5 times per week (1 – 2 glasses per)  I have a first appointment with Rheumatologist scheduled in 6 weeks (Sept. 2010)  Went on 300 mg. daily of Alllopurinal shortly after first attack – Sept. of 2009 and still had daily “twinges” so tried Uloric – saw no difference.  To save money, went back to Allo.   Not sure if I can tell any other differences between the two medications.  I have some other things going on that I don't understand such as my wrists started hurting fairly badly 2 -3 months ago when active (fishing, golfing or riding my bike and leaning on handle bars).   Also experienced very hot and sweaty feet or sometimes cold and sweaty feet all of last winter – never had this before.   Do any of these symptoms relate to side effects of the Alllo or Uloric?   If cost is not a problem, is Uloric better to take than Allo?

[zip2play]

A gout sufferer wants to have his serum uric acid below 6.0 mg/dL, better yet 5.0, and the best way to do it is to do it as cheaply and risk free as possible. You get  the benefits of a 5.0 serum uric acid no matter HOW you achieve it.

Keeping that in mind, allopurinol is orders of magnitude cheaper and has been used far longer, since 1966,   and thus is less likely to cause unforseen probelms after decades of use, it would seem that allopurinol is the far wiser first choice. Uloric was only approved last year and there is no way to ascertain any problems it might cause  with daily use a decade from now.

In the unlikely event that one has problematic side effects from allopurinol, or cannot get enough SUA lowering, then there is always a second choice (actually a third, becasue cheap probenecid might be a logical second.)

A BIG consideration for Uloric users…who is going to pay the cost. It's about $2000 a year IF you can do the lowest dose. Multiply that by 20 years and you have a chunk of change.

p.s. For gouties, hot and sweaty feet is a LOT better than cold and sweaty feet. COLD = low solubility for urate = precipitation of crytals. I've never heard of either being casued by allopurinol.

[davidk]

I agree w/ Zip.  Allo is cheaper and been around a lot longer.  the efficacy of each seems to be about the same.  sounds like Allo is getting your UA down, so no need to try Uloric (more expensive and could have side effects yet unknown).

I was a rare one who had side effects to Allo (dizziness, light headed, inability to think clearly), so I had to use Uloric.  Fortunately, it works well for me (UA below 5 for 6 months now) and I have pretty good insurance, so my portion is about $500 per year; expensive, but no choice.

For you and most others, I think allo is the better way to go.  Only use Uloric if you cant take allo.  (I've also never heard of the symptoms you describe as being related to either allo or uloric).

[Author]

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