Colchicine vs Allopurinol – Which Is Better For Gout Treatment?

Gout is a form of arthritis which that can affect anyone. It is characterized by swelling, redness, and tenderness in the joints as well as severe attacks of pain.

The CDC reports that more than 8 million people in the United States are affected by this condition every year. It is the most frequent form of inflammatory arthritis in men, but women also become more susceptible to this painful condition, especially after menopause.

The large joint at the base of the big toe is the most common site for a gout attack. It can also affect other joints including – knees, ankles, fingers, wrists, and elbows.

Causes

This condition is caused by the accumulation of uric acid crystals in tissues of the body and too much uric acid in the bloodstream. Uric acid is a breakdown product of purines, chemical compounds found in most drinks and foods we eat. A problem in handling uric acid can cause gout as well as kidney stones.

Leading causes of an elevated uric acid level in the blood include:

  • genetics – more than 20 percent of individuals with this condition have a family history;
  • lead toxicity;
  • obesity;
  • alcohol – consuming too many alcoholic beverages keeps the human body from removing uric acid. In addition, beer is made with brewer’s yeast, that is very high in purines;
  • diet – a regular diet containing high-purine foods can lead to gout flares. These foods include – beef kidneys, gravy, game meats, herring, mackerel, liver, mushrooms, sardines, and animal glands;
  • certain drugs, especially diuretics. They reduce the kidneys’ capacity to get rid of urate properly;
  • other conditions, including – hypothyroidism (underactive thyroid gland), hypertension, psoriasis, hemolytic anemia, and some inherited conditions in which the enzyme helping control uric acid doesn’t work as it should. This condition is also frequent in individuals with transplanted organs due to the drugs which are required.

Symptoms

Common signs of a gout attack include:

  • stiffness in the joint;
  • tenderness in the joint;
  • sudden and severe pain in a joint, commonly early in the morning or in the middle of the night;
  • slight fever;
  • loss of appetite;
  • nausea;
  • the skin over the joint may be hot;
  • swelling of the affected joint.

Here are two medicines used for this condition:

Colchicine

It is a prescription drug which is available as the brand-name drug Colcrys. Also, it is available as a generic drug.

SEE ALSO:  List Of Celebrities With Turner Syndrome (Linda Hunt?)

This drug is actually a toxic natural product and secondary metabolite extracted from plants of the genus Colchicum. It works by lessening the build-up of uric acid crystals which cause pain in the affected joint and decreasing swelling. It does not cure this painful condition, but it will help prevent sudden gout attacks.

Uses

It is typically used to prevent attacks of gout, particularly when nonsteroidal anti-inflammatory drugs, like – ibuprofen or naproxen cannot be used.

Moreover, it is also used to treat familial Mediterranean fever (also called recurrent polyserositis) in children 4 years of age and older and adults.

Dosage

Take one tablet 2-4 times per day until the pain eases, unless your healthcare provider instructs you otherwise.

Important note – do not take more than 12 tablets during an attack.

Side Effects And Precautions

Gastrointestinal disorders are the most frequent side effects of this medicine. They may indicate that the colchicine dose needs to be reduced or stopped since these are the first signs of toxicity. These symptoms include – nausea, diarrhea, abdominal pain, and vomiting.

Rare side effects may include:

  • muscle weakness;
  • hair loss;
  • reduced sperm count;
  • blood disorders, especially with prolonged treatment;
  • damage to the kidneys or liver;
  • bleeding in the stomach;
  • change in the menstrual periods;
  • needles sensation in feet and hands.

Before taking this medicine, tell your healthcare provider if you have heart disease, kidney or liver disease, ulcerative colitis, a stomach ulcer, intestinal bleeding, or Crohn’s disease.

If you are allergic to any foods, drugs, or other substances also tell your healthcare professional about the allergy. Usual symptoms of an allergic reaction include:

This medicine should be used with extra-caution by debilitated patients, seniors, and people with renal, cardiac, hepatic, or gastrointestinal problems. Alcohol can considerably decrease this drug’s effectiveness and increase its possible side effects, thus, avoid alcoholic beverages while using this medicine.

Allopurinol 

It is an inhibitor of xanthine oxidase, a compound in the human body which is responsible for the production of uric acid.

Zyloprim is the brand name of this medicine. In 1966, it was approved for medical use in the US. It is on the WHO’s List of Essential Medicines.

SEE ALSO:  Top 10 Foods Highest in Caffeine

Uses

It is used to reduce the levels of uric acid in the blood which occur because of blood disorders linked to cancer, like – lymphomas (cancer of the white blood cells and immune system) and leukemias. Also, it is used to prevent kidney stones, gout, and kidney damage that are caused by uric acid.

Furthermore, this drug may be used to treat infections, seizures, and pain caused by pancreas disease.

Dosage

It comes as a tablet and is typically taken once or twice per day, after a meal. Also, it is recommended to take it around the same time every day. The usual recommended dose for gout is 100 mg per day initially, which can be increased weekly to 200-300 mg per day.

Side Effects And Precautions

Common side effects may include:

  • diarrhea;
  • vomiting;
  • changes in taste;
  • muscle pain;
  • headache;
  • drowsiness.

Rare side effects may include:

  • bleeding gums;
  • stomach pain;
  • cloudy urine;
  • agitation;
  • clay-colored stools;
  • anxiety;
  • incoherent speech;
  • yellow eyes or skin;
  • loosening of the skin;
  • bruising;
  • chest pain;
  • blood in the urine;
  • chills;
  • bloody nose;
  • tarry stools;
  • breathing problems;
  • unusual weakness;
  • confusion;
  • increased urination;
  • constipation;
  • hoarseness;
  • drowsiness;
  • depression;
  • redness of the skin;
  • dry mouth;
  • fever;
  • feeling light-headed;
  • loss of appetite;
  • swelling of the face, ankles, or hands;
  • irritability;
  • muscle twitching;
  • muscle weakness;
  • lower back pain;
  • irritated eyes;
  • painful urination;
  • unexplained weight gain;
  • swelling of the foot or leg;
  • severe stomach pain;
  • irregular heartbeat;
  • unusual bleeding;
  • wheezing.

This medicine should be used with caution in:

  • individuals with heart problems, kidney disease, or liver disease;
  • children;
  • people with hypertension;
  • seniors.

Avoid consuming alcoholic beverages while taking this medicine. More importantly, be careful if you drive anything which needs you to be alert, since this drug may impair your reactions.

Colchicine vs Allopurinol – Which Is Better For Gout Treatment?

Colchicine is a medicine which is rapidly effective (used only for acute gout flare-ups), however, it has many side effects, thus, it should not be the first choice for treatment of gout. Moreover, this drug should not be used in individuals with liver or renal dysfunction, those with gastrointestinal problems, or by seniors.

On the other hand, Allopurinol is a medicine used for chronic gout. It works by decreasing the production of uric acid. It does not have any effect during a gout attack, however, it is recommended to continue its daily use, even during acute gout flare-ups.

SEE ALSO:  Rytary vs Sinemet - Compare Differences Between Side Effects & Uses

8 Prevention Methods For Gout

#1 Avoid Alcohol

According to a study issued in the renowned Lancet Medical Journal, men who consumed alcoholic beverages regularly had a 100 percent increased risk of suffering from gout than men who didn’t consume alcohol on a daily basis.

#2 Drink Plenty of Fluids

Dehydration can considerably increase the blood uric acid concentration. More importantly, in susceptible individuals, dehydration can contribute to gout flare-ups.

#3 Lose Extra Weight

If you are overweight or obese, you can produce more uric acid. However, losing weight too fast can temporarily increase uric acid levels in the blood.

#4 Sleep

Having poor sleeping habits (like sleeping less than 7 hours per night) can trigger the essential cellular pathway which produces tissue-damaging inflammation.

#5 Physical Activity

The correct physical exercises can reduce pain related to arthritis as well as it can help you to maintain a healthy body weight.

Important note – exercising a joint which is already inflamed can actually cause more pain.

#6 Lower Your Stress Levels

When the physical body experiences stress, it releases the hormone cortisol. Too much cortisol can reduce your body’s capacity to remove uric acid. Moreover, stress depletes the body from vitamin B5, a B-complex vitamin that helps remove the excess uric acid.

#7 Avoid Unnecessary Aspirin Intake

Aspirin, also referred as acetylsalicylic acid, is a drug used to treat fever, pain, or inflammation, but it also increases the amount of uric acid in the blood.

#8 Nutrition

Avoid foods which are high in purines, substances that can raise the uric acid level in the blood. These foods include – seafood (such as – anchovies, sardines, salmon, and mussels) and organ meats (like – liver).

Instead, focus on foods that reduce inflammation in the body, like – papayas, pineapples, apples, sweet potatoes, watermelon, cantaloupe, cranberries, blackberries, blueberries, onion, grapes, garlic, turmeric, red cabbage, zucchini, bell peppers, cayenne pepper, turnips, bananas, pears, durians, litchis, radishes, broccoli rabe, flax seeds, pumpkin seeds, walnuts, almonds, or quinoa.

Note – according to research, purine-rich vegetables like – spinach, pulses, cauliflower, and mushrooms, do not increase the risk of developing gout, but actually, they decrease it.

References

https://www.ncbi.nlm.nih.gov/pubmed/23992557
http://www.nejm.org/doi/full/10.1056/NEJMoa1208536#t=article
https://www.ncbi.nlm.nih.gov/pubmed/24685969
https://www.ncbi.nlm.nih.gov/pubmed/26190562

Sharing is caring!

Leave a Comment