Benzbromarone

[marky 5]

Ihave suffered from gout since the age of 32 (now48) clasically with the big toe 1st. Since then I have had both my elbows operated on. One with infected gout in it . They are currently growing back! I have also had infected gout in my right hand this was operated on 6 times resulting in my hand now being paralysed due to severe tendon damage. I was in hospital 8 weeks and at the same time the infection or the gout (unknown) went into my spine, I was unable to walk and came out of hospital in a wheelchair. I am now walking again. My left hand is covered in gouty tophi as are my feet. I recently visited a Mr Roddy a gout specialist who has prescribed me Benzbromarone. Iam due to start this soon.Do you think this will help as I have had bad reactions to Allurpurinol, Probenicid, and Sulphipyrozone? 

[zip2play]

Marky,

It seems you have little choice.

What country are you in? The drug was pulled by it's maker SANOFI due to rare liver toxicity (hepatitis to the point of liver failure) but is still sold in some countries, but I think NOT in the United States.

It is a very effective uricosuric agent generally very well tolerated expecially by people who have trouble with allopurinol.

I would recommend regular live function testing espepecially if you are looking for a lifetime of use.

You also have the option of the new febuxostat but as with all new drugs there's always the question of $$$$expense$$$$.

[marky 5]

I'm in Britain the doctor has explained the liver problems and we are unable to get febuxostat till later this year.

[vegetarianGuy]

marky5 I am 35 and about to start my Gout journey All the problems you mentioned happened despite taking Allurpurinol for last 16 years? OR could you not take them due to adverse reactions? Could you please clarify.

Either way I felt your pain on reading your post I hope you find some relief.

[marky 5]

could not take allurpurinol massive headaches praying benzbromarone works!

[zip2play]

Benzbromarone will probably work for you! It's a good drug.

[Keith Taylor (GoutPal Admin)]

Interesting stuff. As long ago as last year, I reported how benzbromarone seems much more effective than probenecid, and is often successful where allopurinol fails.

There has since been other reports supporting the efficacy of benzbromarone, including an Australian report (“A benefit-risk assessment of benzbromarone in the treatment of gout. Was its withdrawal from the market in the best interest of patients?”) that questions the withdrawal in some countries. In particular, they question the link between benzbromarone and liver problems. They conclude that, even if there is a link, the risks are so slight as to be far outweighed by the benefits.

I feel sure that if it’s use in those countries that allow it continue to show safe use, then it can only be a matter of time before it is re-launched in the USA and other countries.

Curiously, when looking at recent research, I noticed a study (“Mechanisms of antihyperuricemic effect of Phyllanthus niruri and its lignan constituents”) that compares extract of a member of the euphorbia family (Phyllanthus niruri Linn) favorably with benzbromarone. Apparently this plant, common in traditional South American medicine, exhibits both uricosuric, and xanthine oxidase reduction properties.

South American folk medicine, eh? Well, they still have to Peru-ve it to me. (bet that gets a Chile reception)

[zip2play]

Per-UVE….ROFLMAO

Trouble with euphorbia is it's hard to eat much of it because of those pesky thorns. And that bloody mouth announces your gout to the whole world.

http://www.euphorbia-internati…..godana.jpg

But seriously, Marky, it is such a shame that you have spent 12 years growing tophi and having them cut away. Don't let another week go by without uric acid control, WHATEVER you need to do. Since the disease is an eventual killer, maybe some side effects MUST be tolerated. Perhaps something like LOW DOSE allopurinol mixed wiith LOW DOSE probenecid. The combo of uricosuric and uric acid blocker can REALLY lower your serum UA.

If Britain will not allow febuxostat til December, then consider getting it somewhere else for several months if it becomes your last option. It's clumsy, but it can be done.

[trev]

I'm wondering if the OP -Marky ever got established on this Benzbromerone- it seems to be useful, if liver toxicity is watched for.

I'm not sure if it's available in the UK -NHS.

[Keith Taylor (GoutPal Admin)]

Yes, benzbromarone is approved for UK use by the NHS, but as a 'specialist medication.'

In practise, I think that means that your GP is highly unlikely to prescribe it, though I know that some GP's work with specialists to take on some of the routine monitoring work. I would imagine that, with the approval of febuxostat, the chances of a specialist wanting to use benzbromarone are reduced.

It definitely falls into the 'discuss with your doctor' category. There is no way, even where it has not been banned, that benzbromarone can be regarded as mainstream gout treatment.

[trev]

Thanks GP- The medicine alternative to AP that cropped up in the surgery was Anturvan (Sulfinpyrazone) which has been mentioned here.

I think it's yet another 'hard on kidneys', but that can be monitored and is probably a better option than long term high SUA.

Uloric didn't scan, but I'll ask if Adenuric is available.

[Keith Taylor (GoutPal Admin)]

Adenuric and Uloric are both febuxostat. Uloric is Takeda's brand name in the States, Adenuric is for Europe (and I think rest of world, but happy to be corrected)

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