Allopurinol

[Forkinhades]

My doctor has put me on a 3 month course of allopurinol. That is ok whilst I am in the UK.

Was wondering if this drug is available in the pharmacies in Thailand?

Or if I brought a load in, should I carry an personal prescription with me?

Edited August 14, 2012 by Forkinhades

[Mosha]

I've no problem buying it, I forget the brand name but I get 100 3mg tabs for 300 baht, I break the tab in half.

[lopburi3]

Every pharmacy has over the counter and not expensive. But yes if you bring in you should have prescription and not more than a month. This is normal gout medication and often for life but should have occasional tests so best to keep under supervision of a doctor. If for something other than gout have no idea. I have been taking for 25 years.

[lopburi3]

I've no problem buying it, I forget the brand name but I get 100 3mg tabs for 300 baht, I break the tab in half.

Are you sure that is not 300mg? Have not seen lower than 100mg.

[Mosha]

I've no problem buying it, I forget the brand name but I get 100 3mg tabs for 300 baht, I break the tab in half.

Are you sure that is not 300mg? Have not seen lower than 100mg.

Oops yes 300mg, brand is something like Allopin. White bottle orange top.

[Forkinhades]

Thanks guys, I will leave my pills at home

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[Forkinhades]

Just wondering if you could get urate levels checked by a local doctor?

[Sheryl]

Any hospital or lab can do uric acid test for you.

[Mosha]

I did have a scare last time I bought some. I didn't check until I got home. They gave me angaina tablets. 60km round trip, and even then I had to argue. With them insisting the tabs will do the job. Doctors and chemists will be the death of me lol.

[Gary A]

I was taking 100 mg every day for several years. I don't watch my diet and I eat whatever I want to eat. Once in a while I could feel a gout attack coming on. The pills come in 100 mg and 300 mg size. I increased my dose to the 300 mg size. During my last checkup, the doctor told me to lower the dosage. I now break the 300 mg size in half and so far everything is fine.

[phuturatica]

I take Zyloric Allopurinol 100mg tablets. Cheap and available at most pharmacies. (Zyloric is the brand name)

[lopburi3]

Unless things have changed that brand is anything but cheap. But it was 15-20 years ago when I was shocked at the amount being charged and the lack of any alternative at most drug stores here. But my experience was the 300mg version and most places did not have any alternative as they had to buy too large a quantity in bottles to make it worthwhile keeping a stock.

I suspect they are cheaper now as foil paks of local brands should be available anywhere these days. But 20 years ago as I recall the 300mg was about 10 times the price I paid in the US for non-brand name version and a real shock.

[Gary A]

The brand name on my allopurinol is Puride. They are 300 mg. I don't remember how much they cost but it was not too expensive or I would have remembered. I now break the 300's in half so that makes them even cheaper to use. There are fifty bubble packs of ten pills each in a box of five hundred. My doctor told be that if I couldn't break them in half to take one every other day. The pills are scored in the middle so I am able to break then in half.

[lopburi3]

That is the brand, Puride, that I get from hospital now and do not consider it expensive - even from hospital at 7 baht each. It was just the Zyloric that most stores stocked when I moved here full time 20 years ago and the price asked was a real shock.

[Forkinhades]

Just wondering if you could get urate levels checked by a local doctor?

I am going to buy this http://www.amazon.co.uk/Benecheck-Plus-3-In-1-Cholesterol-Monitoring/dp/B003I5SWUE/ref=sr_1_1?ie=UTF8&qid=1346831924&sr=8-1

Amybody know off hand what the safe levels are? is it between 200-400

[lopburi3]

Would really use that money to have local tests done under supervision of a doctor. You are talking about something that you do not appear to need and expect you will have more troubles using that it is worth - not to mention the short shelf life of the testing materials.

As for range that would be "safe" not sure if you are asking normal range or not but it varies by the equipment/tests used so you would have to get that from the unit itself - local labs will provide a normal range (and even that can change from time to time). For me it is about:

Uric Acid 3.4 - 7.0

Total Cholesterol150-200

FBS 70-100

But as this is a UK unit believe a different scale is normally used (at least for cholesterol).

[Sheryl]

Every lab has its own reference range for normal values, this is because of differing degrees of sensitivity according to the regents etc used. The results are usually provided on a piece of paper which gives the normal range for that particular lab. In addition, if comparing between countries, the unit of measurement may differ whcih will completely change the meaning iof results.

[Forkinhades]

Would really use that money to have local tests done under supervision of a doctor. You are talking about something that you do not appear to need and expect you will have more troubles using that it is worth - not to mention the short shelf life of the testing materials.

As for range that would be "safe" not sure if you are asking normal range or not but it varies by the equipment/tests used so you would have to get that from the unit itself - local labs will provide a normal range (and even that can change from time to time). For me it is about:

Uric Acid 3.4 - 7.0

Total Cholesterol150-200

FBS 70-100

But as this is a UK unit believe a different scale is normally used (at least for cholesterol).

Indeed, but Thailand can be a minefield finding 'bonafide' services, unless I was to go to a hospital, then the cost would be a major factor.

Do you have experiences of these tests at a local doctor/clinic? if so, how much?

The strips last 9-12 months, and in the pack comes 5 uric 5 cholestoral and 10 glucose.

[Sheryl]

Small clinics usually do not have labs and would have to send out to a hospital, you are better off going to a hospital to start with unless there is a stand-alone lab nearby.

Should not cost more than a few hundred baht at a hospital. go to the health check up section.

[lopburi3]

I paid 160 baht at moderately high priced private hospital last month for uric acid test but it is part of scheduled checkup but even with doctor oversight it would only be a few hundred baht at lower priced hospital (even in mine it is less than 1,000).

Another thing with self testing strips is the humid conditions here along with the heat can be very unkind on them so unless you also need the other testing done believe it would be best to use professional labs.

[Forkinhades]

Thanks lopburi, probably just the uric, as my cholesterol and glucose are very good, got results back recently. Intend to keep the strips in the fridge.

So whether 160, or 200 baht, a go, seems fairly high.

So I am thinking that the unit is slightly winning.

Thanks for your replies, and indeed welcome your thoughts

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[Sargento]

This is normal gout medication and often for life but should have occasional tests so best to keep under supervision of a doctor. If for something other than gout have no idea. I have been taking for 25 years.

lopburi3,

I have been given 2 separate prescriptions of Allopurinol for gout (by 2 different American doctors) in the past couple of years.

But I avoided starting Allopurinol and tried changing my diet and alkalizing - but after more gout attacks I am going to start Allopurnol for the first time (by buying it OTC here in Asia).

I'll start it on January 1.

You note in bold that we should have occasional tests. - What kind of tests? For uric acid? Liver?

Thanks if you can help if any info. My American doctors do not communicate very well. They just write the prescription and send me out the door.

Thanks.

Edited December 28, 2012 by Sargento

[lopburi3]

Both tests are recommended I believe. I have Uric Acid tested on each 3 month visit and ALT SGPT done at same time and yearly seem to have ALT SGOT. But that is my doctor, for me, for my conditions so you may well have a different schedule/tests. But best to be under some form of care/testing in case a change occurs you may catch before it is too serious. These tests are not very expensive and just a simple blood draw and likely could be less often if cost is a concern. But not having gout attacks is a really nice thing.

[Sargento]

Both tests are recommended I believe.

OK

I have Uric Acid tested on each 3 month visit

Pardon my ignorance. Lopburi, if you've been taking Allopurinol for so many years is a UA test every 3 months necesarry? Perhaps this is recommended by the doctor so you can reduce or increase you daily dosage? Or, perhaps this UA test is one of several tests you get done. If the latter, then I understand.

ALT SGPT done at same time and yearly seem to have ALT SGOT.

This "ALT SGPT"' test must be for the liver. Enzymes?

Thanks for you information Lopburi. I appreciate it. I wish doctors would be more clear. I do ask specific questions and I do my own research but doctors (and I do not have a regular one) don't give clear answers.

[Beechboy]

A safe addition to your diet by eating cherries during an attack will also benefit. Serious.

Check it out.

http://www.medicalnewstoday.com/articles/250862.php

[lopburi3]

Both tests are recommended I believe.

OK

I have Uric Acid tested on each 3 month visit

Pardon my ignorance. Lopburi, if you've been taking Allopurinol for so many years is a UA test every 3 months necesarry? Perhaps this is recommended by the doctor so you can reduce or increase you daily dosage? Or, perhaps this UA test is one of several tests you get done. If the latter, then I understand.

ALT SGPT done at same time and yearly seem to have ALT SGOT.

This "ALT SGPT"' test must be for the liver. Enzymes?

Thanks for you information Lopburi. I appreciate it. I wish doctors would be more clear. I do ask specific questions and I do my own research but doctors (and I do not have a regular one) don't give clear answers.

Yes am having multi tests so the blood is available and test is only 160 baht and have insurance that pays most of that.

[Sargento]

I appreciate the information, lopburi3.

I start Allopurinol in 2 days and get the tests recommended.

[Wrong Turn]

I take Zyloric Allopurinol 100mg tablets. Cheap and available at most pharmacies. (Zyloric is the brand name)

I just bought the Zyloric Allopurinol brand today. You pay more but it's still very reasonable (actually cheap).

I buy 300 mg tablets and cut them in half.

Quick question:

On rare, rare occasions, I feel a minor gout attack comming on.

There seem to be 2 recommendations with Allopurnol when and attack is coming.

1. you stop taking it, becaus Allopurinol can exacerbate and intensify the attack, and

2. keep taking Allopurinol as usual.

Anyone have any solid info on the best route to take?

[Sheryl]

Allopurinol works as a preventive by decreasing the accumulation of uric acid in tissues. It cannot do anything to relive the pain of an attack as this is due to inflammation in response to uric acid crystals that have already formed.

Pain of gout attacks is usually manged with NSAIDs or colchicine and in really sever cases sometimes steroids, either as pills or injected into the inflamed area.

Reducing allopurinol at the time of an attack isn't AFAIK going to do anything in terms of the pain of that attack. However it is true that gout attacks sometimes increase in frequency during the first few months of taking allopurinol as the body starts to mobilize and excrete uric acid, for which reason it is often recommended to start at a low dose and then build up to full dose gradually. And if that was not done and the attacks do indeed increase in frequency then it woudl usually be advsied to cut the dosage back -- not to stop the immediate pain of a current attack but to decrease the frequency of future ones in the near term until utic acid levels have gone down. This may be what you are thinking of/have heard.

Gout is a fairly complex problem. People who have had it for a long time often get very well informed about the various meds and their use, lab tests and their interpretation etc to the point that they can self-manage pretty well. But for someone newly suffering from the disease, a doctor's supervision (preferrably one who takes the time to explain things to you) is important.

Some good sources of info:

http://www.mayoclinic.com/health/gout/DS00090/DSECTION=treatments-and-drugs

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001459/

[Wrong Turn]

Quote below: Yes, I usually use Indomethacin and Colchine when an attack first occurs, and during the attack, and discontinue when it subsides.

Pain of gout attacks is usually manged with NSAIDs or colchicine and in really sever cases sometimes steroids, either as pills or injected into the inflamed area.

Reducing allopurinol at the time of an attack isn't AFAIK going to do anything in terms of the pain of that attack. However it is true that gout attacks sometimes increase in frequency during the first few months of taking allopurinol as the body starts to mobilize and excrete uric acid, for which reason it is often recommended to start at a low dose and then build up to full dose gradually. And if that was not done and the attacks do indeed increase in frequency then it woudl usually be advsied to cut the dosage back -- not to stop the immediate pain of a current attack but to decrease the frequency of future ones in the near term until utic acid levels have gone down. This may be what you are thinking of/have heard.

I've become a pseudo expert on gout for prevention, cause, and trying to quell it.

I only recently started taking Allopurinol. Started on January 1st, 2013 - only 9+ weeks ago. I started at 150 mgs and am still at that amount. I have delayed/not increased the dosage to 300 mg - yet - if I ever need to.

Some good sources of info:

http://www.mayoclinic.com/health/gout/DS00090/DSECTION=treatments-and-drugs

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001459/

Thanks for the link and help Sheryl.

I also switched brand of Allopurinol and bought Zyloric (a French brand) today that a poster mentioned. I figure it will possibly be a higher quality than the East Asian brands I've been taking.

Thanks for the info.