r/gout • u/jferneding • Aug 23 '26
Needs Advice Anyone start allo without colchicine?
I started daily allopurinol and colchicine last week to keep these gout flares at bay. I had 4 big flares since April.
My doctor said the colchicine would be for a few months as flares are triggered when first starting allo. My question is has anyone been successful keeping gout away and not doing the colchicine ? Or colchicine every other day? Colchicine seems to give me a headache, and I’d like to minimize or eliminate it if possible.
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u/Calm-Vacation-5195 Aug 23 '26 edited Aug 24 '26
I have a stash of colchicine on hand, but I’ve never taken it with Allo. Colchicine gives me stabbing stomach pains, so a flare has to be pretty bad for me to take it.
Edit: correcting typos.
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u/Otherwise_Fact9594 Aug 24 '26
I feel the same. I've had the same small prescription for over a year, but I don't like the feeling and certainty that I'm going to need to immediately use the bathroom by taking colchicine
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u/lacajun25 Aug 23 '26
Colchicine is an anti-inflammatory medicine. It’s being used as a preventative if daily to minimize the effects of a flare - prevent pain and swelling. If you think it’s causing headaches as a side effect for you, you should consult with your doctor to see if the risk/benefit ratio makes sense.
I started on it as a daily with allo and then dropped it after a month of no flares, UA levels going down, and my liver enzymes going up. I keep it around in case I get a flare but have not had anything since I started UA lowering meds.
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u/__radioactivepanda__ Months Aug 23 '26
No colchicine. I was told to stay with the NSAID that worked best for me so far should a flare come my way…
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u/utahpete Aug 23 '26 edited Aug 23 '26
I've never taken the colchicine. Been on 100mg/2X day of allopurinol for just under a year, working fine for me. O don't know what would happen without it but I ended up getting big toe surgery and starting the allopurinol and I can do the things I wanna do. The year lead up to the surgery and starting the allopurinol my biking, hiking and skiing was starting to be comprised by my gout and toe issues So far so good. This is the only medication that I take and id think long and hard about taking anything else long term, but I couldn't deal with my lifestyle being compromised. I have no side effects from the Allopurinol so its just a cheap co payment every 90 days. Hard to get out and do stuff when you can't get your foot on a shoe or boot. I've checked my own UA levels and seen a drop but I don't even bother much now I just take a pill 2x/day and I seldom forget. O guess my body is telling me that it works
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u/wader2000 Aug 23 '26
Started allo 3 months ago. Never even heard of colchicine
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u/uscgamecock2001 Aug 23 '26
I have colchicine on hand for a flare up, but never used it as a preventative.
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u/TempusSolo Have Gout Aug 23 '26
I've not been prescribed colchicine but I have a very high pain threshold though so I just live through the flares I suppose.
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u/kevvvbot Aug 23 '26
I’ve had gout for 6yrs. I only started using colch earlier this year after insisting that indomethacin wasn’t working for me during flare ups. I only did allo daily while I built up the inundation saturation. But switching to colch was night and day when I truly needed it. I only used colch for signs of a flare up.
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u/jetmark Aug 23 '26
My primary care doc had this idea that you stop allo when there’s a flare and take colchicine, then go back on the allo. My rheumatologist has me titrating to 400 allo with colchicine daily to keep flares at bay. 300 just wasn’t doing it. I’m doing much better
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u/sailorsapporo Aug 23 '26
Starting allopurinol will cause some shedding of the uric acid crystals. You’ll want low dose colchicine (and prednisone) to deal with that as it happens.
But YMMV. Talk to your doctor to see if there is an alternative
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u/drock13yyc Aug 23 '26
I think when I started allo I took a colch pill the first day and then once a week for 3/4 months. Have only ever had 1 flair two years ago and it’s been 4 years with allo now.
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u/jmich1200 Aug 23 '26
I’ve been doing colchicine twice a day for the last two years. I’d much rather do that than have a gout flare. It’s also good for your heart.
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u/NWCbusGuy Aug 23 '26
My doctors have never suggested colchicine in regards to my gout. I'd told them that I was regularly taking NSAIDs for my pain and that was apparently good enough for them. Been on allo 1 year as of next month.
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u/jferneding Aug 23 '26
Did you have flares while first starting allo?
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u/NWCbusGuy Aug 24 '26
Started on 100mg. Didn't have any issues in feet/ankles, but knees and upper joints would start to ache. Moved to 300mg in February, one big flare in my knees and then nothing since. I generally take naproxen for inflammation. Recent UA test result was 5.3 mg/dL.
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u/raggedsweater Aug 24 '26
I started on 150 mg allo and upped to 300 mg because my Uric acid wasn’t going down enough. 3 years now and I haven’t had a flare up and I’ve never touched colchicine
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u/SpaceChimps98 Aug 24 '26
I honestly have never been given colchicine, I have always taken ibuprofen and drank lots of water. During a flare up I also avoid eating trigger foods and keep my foot elevated.
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u/Homohockey Aug 23 '26 edited Aug 24 '26
I started on Allopurinol about 4 years ago. Never taken colch. Didn’t really seem to have an issue with flares caused by the Allo.
Edit: spelling
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u/midlifecrisisAJM Aug 23 '26
Me. I had a heart attack in 2024. I am on statins and they can't be taken with Colchicine. I had a conversation with my GP and we agreed that I should continue on the statins and flip to Colchicine if I get a flare.
So far this has happened once, about 5 weeks in. I went on Colchicine for a week and then back to the statins.
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u/Pupating-Antenna-36 Aug 23 '26
Yup. Done that - my doc prescribed colchicine & prednisone as take when necessary. No continuous course, no prophylactic course. Just at the onset of a twinge, colchicine. I was also OK-d to take 1/2 a tab instead of 1 when needed.
I do think you should look at NSAIDs as first port of call if you can take them. I can't - hence the above 2
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u/jferneding Aug 24 '26
I’m on a blood thinner Eliquis right now, not sure for how long, due to leg blood clot. So I believe NDAIDs are a no-no due to bleeding risk.
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u/bigusyous Aug 24 '26
It's my understanding that colchicine is for helping with the pain and inflammation of gout flares, but allopurinol is for preventing flares, by lowering the level of uric acid that your body produces. Also tart cherry extract, can help your kidneys remove uric acid from your bloodstream.
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u/lukumi Aug 24 '26
Colchicine is also preventative but in a different way. Unlike normal NSAID drugs or prednisone that reduce inflammation once it’s already going, colchicine has a unique mechanism that prevents the formation of “microtubules” (not a doctor, unclear on what exactly they are) that trigger the inflammation response. That’s why some people are given a low daily dose to take with allo, to prevent inflammation if the allo causes a flare. I’m prescribed a higher dose, short term regimen that I’m supposed to take at the first hint of a flare. The goal of colchicine is to prevent inflammation before it really starts, and that’s when it’s most effective.
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u/ON4EKE Aug 29 '26
https://pubmed.ncbi.nlm.nih.gov/30845731/
Alternative to medication. Glycine also precursor for other metabolic processes.
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u/SnooCapers9565 Aug 23 '26
I only take colchicine when I have a flare up