Brief Answer:
Allopurinol and Uloric belongs to same group

Detailed Answer:
Hi
Thanks for writing
After going through your query, the allopurinol and uloric (febuxost) both belongs to the same group (xanthine oxidase inhibitor) and hence the side effect like itching (rash) may occur with uloric. In the follow up query please tell me about the-
Number of joints having pain and swelling along with being warm to touch. Because uloric is used to lower blood uric acid levels in adults with gout. Uloric is not for the treatment of high uric acid without a history of gout.
To avoid the possible side effect it may be started at low dose.

In addition to medication, the following suggestion may help your gout flare-up pain--
1. Ice fomentation- If the pain is not severe, try cold packs or cold compresses on the joint to lessen the inflammation and help the pain. Ice the joint for 20 to 30 minutes several times a day.
2. Rest the joint.-. Raise the joint if you can on a pillow or other soft object.
3. Plenty of water -A lack of water in your body can makes your uric acid levels raise even higher than they already are. Drinking water will help your body stabilize uric acid to a normal level.
4 Dietary advice- The Purines, which are chemicals found in some food, when they are taken in food are broken down into uric acid. A diet rich in purines can raise uric acid levels in the body, Meat and seafood may increase your risk of gout. Dairy products may lower your risk.
Hope this information suffices and I shall be glad to answer any further query.
Regards
Dr.chugh, Orthopaedic surgeon
http://bit.ly/drmchugh

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Brief Answer:
Alcohol in excess is harmful; avoid crash dieting

Detailed Answer:
Hi
It’s good to see you again
After going through the whole discussion, the food items rich in purines-
1. Organ meats, such as liver, kidney and brains. Meats, including beef, pork, and lamb that is red meat.
2. Anchovies, sardines, herring, mackerel, and scallops, gravy and Beer.     
Food items which are moderately high in purines, but may not raise your risk of gout if are not taken in excess like fish and seafood (other than high purine seafood) oatmeal, wheat XXXXXXX and wheat germ.
Foods that are safe to eat that is they are low in purines like-Green vegetables, tomatoes, fruits and fruit juices, breads and cereals that are not whole-grain,butter, buttermilk, cheese, eggs, chocolate and cocoa coffee, tea, and carbonated beverages, peanut butter and nuts.
To prevent gout attack from occurring, my suggestion would be-
1. Try to keep serum uric acid level below 6mg/decilitre.
2. Drink plenty of water and increase it proportionate to your physical work and weather condition. Follow the dietary advice as written above. Take citrus fruit /tab.Limcee to have your daily dose of vitamin C.
3. Try to avoid stressful situation by better planning, weight control and regular exercises helps.
4. If an attack of Gout occurs while on allopurinol, you should increase the dose besides taking pain killer. You may change to febustat if have side effects to allopurinol.
5. Do not discontinue (allopurinol) until and unless advised by your doctor to do so.
6. Avoid drugs which may raise the uric acid level like-aspirin, drugs which causes increased urination (Diuretics).
7. Low fat yogurt and milk may lower your risk of gout.

As far as taking alcohol is concerned, Beer was more likely to be associated with gout than spirits, and spirits in turn more than wine. Chronic alcohol intake is a bad idea for gouty patients in at least two ways. The production of oxypurinol, the active metabolite of allopurinol, may be impaired by high alcohol intake; and urate production is stimulated by it. Avoid crash-dieting which could provoke acute gout.
I usually advise my patients- Don’t drink to excess, especially if your father had gout. If you must drink to excess, don’t stop eating. If you do eat, rethink your diet. If you are on allopurinol, watch your urate level if you drink.

Wishing you good health.
Regards.
Take care
Dr.chugh

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