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What Causes High Uric Acid Levels?
Question: Hello,
I cant get my uric acid under control (its not diet) - I take 300 Allopurinol - is there another way and are there other causes of high uric acid - because I have other healthj issues, like low blood O2
I cant get my uric acid under control (its not diet) - I take 300 Allopurinol - is there another way and are there other causes of high uric acid - because I have other healthj issues, like low blood O2
Brief Answer:
increase the dose, or change over to another drug
Detailed Answer:
Hello,
For a high uric acid level, the dose of allopurinol may be increased further. In fact it may be increased upto 800 mg. The other option is to change it over to another drug called febuxostat, this works better than allopurinol and at lower doses of 40-80 mg.
The last is to avoid certain foods like fish, sea food, red meat, alcohol, soda drinks and fruit juices.
Besides that, there are certain other medications which increase the excretion of uric acid, they are uricosurics like probenecid - these are also useful in combination with the other drugs.
Regards
increase the dose, or change over to another drug
Detailed Answer:
Hello,
For a high uric acid level, the dose of allopurinol may be increased further. In fact it may be increased upto 800 mg. The other option is to change it over to another drug called febuxostat, this works better than allopurinol and at lower doses of 40-80 mg.
The last is to avoid certain foods like fish, sea food, red meat, alcohol, soda drinks and fruit juices.
Besides that, there are certain other medications which increase the excretion of uric acid, they are uricosurics like probenecid - these are also useful in combination with the other drugs.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Thanks for the reply, I kind of feel that the uric acid is more likely to be coming from low O2 or cell death, however I recently saw a new rhuemo - she suggested lowering the Allopurinol to 250mg - I did mention the probenecid, but she said you cant take the both together at the same time Allopurinol+ Probenecid_ I guess I am looking for other things that may cause high uric acid and also wondering if there are ay side affects or gut or lung reactions that can happen from allopurinol - it really seems to irritate my stomach? I have read that high allopurinol can affect red blood cells and O2 levels being read by pule oximeters
Can Psoriatic Arthritus affect the lungs at all?
I asked my specialist to look into febuxostat - the belwo was his reply......
As for Febuxostat as a second-line agent in your case, accessibility is currently a major issue.
Further, this has been the conclusion from Medicare/PBAC (March 2014) recently after trying to acquire it for another patient under my care (has refractory gout with intolerance to Allopurinol and Colchicine):
"The PBAC did not recommend the listing of febuxostat. The PBAC considered the submission did not establish that febuxostat is superior in terms of comparative effectiveness over allopurinol. The PBAC considered that the trials presented in the submission overall did not demonstrate superior effectiveness to allopurinol for patient-relevant outcomes such as reduction in acute gout attacks or tophi, or improvement in quality of life (QoL).
The PBAC considered that the advantage of a faster reduction in serum uric acid (sUA) did not translate into benefits over allopurinol for more clinically meaningful outcomes such as flare reduction, tophi resolution or health-related quality of life (HRQoL). Therefore the PBAC did not support the submission’s assumption that attaining the biological sUA target would lead to clinically meaningful outcomes.
The PBAC recognised that there is a clinical need for an alternative treatment for patients, who are intolerant of allopurinol. The PBAC considered that an allopurinol-intolerant population consistent with the definition used in the NICE guidance for “Febuxostat for the management of hyperuricaemia in people with gout” may be an appropriate basis for defining a second-line treatment setting for febuxostat. However the PBAC noted that the submission did not present clinical evidence to support the use of febuxostat in a second-line setting"
If you are willing to self-fund it,
I can approach the Menarini representative in Brisbane (who currently also is applying for Aclinidium bromide used for COPD treatment) for do a trial, say, for two months.
Can Psoriatic Arthritus affect the lungs at all?
I asked my specialist to look into febuxostat - the belwo was his reply......
As for Febuxostat as a second-line agent in your case, accessibility is currently a major issue.
Further, this has been the conclusion from Medicare/PBAC (March 2014) recently after trying to acquire it for another patient under my care (has refractory gout with intolerance to Allopurinol and Colchicine):
"The PBAC did not recommend the listing of febuxostat. The PBAC considered the submission did not establish that febuxostat is superior in terms of comparative effectiveness over allopurinol. The PBAC considered that the trials presented in the submission overall did not demonstrate superior effectiveness to allopurinol for patient-relevant outcomes such as reduction in acute gout attacks or tophi, or improvement in quality of life (QoL).
The PBAC considered that the advantage of a faster reduction in serum uric acid (sUA) did not translate into benefits over allopurinol for more clinically meaningful outcomes such as flare reduction, tophi resolution or health-related quality of life (HRQoL). Therefore the PBAC did not support the submission’s assumption that attaining the biological sUA target would lead to clinically meaningful outcomes.
The PBAC recognised that there is a clinical need for an alternative treatment for patients, who are intolerant of allopurinol. The PBAC considered that an allopurinol-intolerant population consistent with the definition used in the NICE guidance for “Febuxostat for the management of hyperuricaemia in people with gout” may be an appropriate basis for defining a second-line treatment setting for febuxostat. However the PBAC noted that the submission did not present clinical evidence to support the use of febuxostat in a second-line setting"
If you are willing to self-fund it,
I can approach the Menarini representative in Brisbane (who currently also is applying for Aclinidium bromide used for COPD treatment) for do a trial, say, for two months.
Brief Answer:
the other options are listed below
Detailed Answer:
Hello,
It is really difficult for me to say, because probenecid and allopurinol may be used together. There is no absolute contraindication that it should not be used together.
I never realised that that febuxastat is not freely available there. If that's the case then the only option is dietary changes and uricosuric drugs like probenecid.
Certain other drugs are known to be uricosuric as well like losartan and fenofibrate. It is also known that psoriasis per se raises uric acid levels. So a control of the same may also help you.
The last is a medicine called pegloticase (uricase) which is used in resistant cases. However it is injectable, and has other issues related to its use.
Regards
the other options are listed below
Detailed Answer:
Hello,
It is really difficult for me to say, because probenecid and allopurinol may be used together. There is no absolute contraindication that it should not be used together.
I never realised that that febuxastat is not freely available there. If that's the case then the only option is dietary changes and uricosuric drugs like probenecid.
Certain other drugs are known to be uricosuric as well like losartan and fenofibrate. It is also known that psoriasis per se raises uric acid levels. So a control of the same may also help you.
The last is a medicine called pegloticase (uricase) which is used in resistant cases. However it is injectable, and has other issues related to its use.
Regards
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Prasad
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