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I thought I found the miracle cure for my gout when my doctor prescribed colchicine for me. But I've developed terrible nausea, diarrhea, and sometimes vomiting. I've stopped taking the drug but my symptoms are coming back. What do you suggest?

Colchicine was approved in 2009 by the Food and Drug Administration for the treatment of gout. This medication has an anti-inflammatory effect. It also inhibits urate crystal from forming deposits (the basic problem with gout). Colchicine isn't really a new drug -- it's been used for gout for 200 years. But the FDA has never formally approved it. As a result of reviewing the effectiveness and safety of this drug, a new nongeneric drug (Colcrys) has been developed, approved, and is now available. Studies show that low-doses of this drug within 12 hours of an acute attack are very successful. Too high of a dose can result in the type of symptoms you experienced. For those who can't tolerate colchicine, there are other choices. Allopurinol is another possibility. This drug is one of the serum uric acid (SUA)-lowering therapies. It works by inhibiting a substance called xanthine oxidase, which then reduces the production of urate. Zyloprim is the brand name for allopurinol. Zyloprim does not take away the acute attacks of gout. But it is useful in preventing recurrence. Other allopurinol drugs on the market include Allohexal, Allosig, Progout, and Zyloric. As with all drugs, there are some patients who can't tolerate allopurinol. They develop an itchy skin rash, severe diarrhea, and fever. Having a reaction to colchicine doesn't necessarily mean you'll have a similar adverse response to allopuriol. Your primary care physician (or rheumatologist if that's who you are seeing) will monitor you closely for any problems. Don't give up. It can take a bit of time to find the right medication that works best for you. Getting hold of the symptoms early on can help prevent long-term problems (e.g., bone and joint destruction) later.

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