Overload

Gout drugs

Category: Medicines

Type

Involuntary

Introduction and description

 

Gout treatments are [fairly obviously], pharmaceuticals that are used to treat gout.

We have included an extensive description of gout and its causes, if you follow the link.

Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory red, tender, hot, swollen joints. Many pathogens and toxins can cause exactly the same sort of symptoms, but be classified medically by a different name.  The disease called rheumatoid arthritis, for example, results in similar excruciatingly painful joints and swelling.

To be classified as gout, the ‘pathogens’  have to be uric acid crystals.  The needle-like crystals of uric acid precipitate in joints, tendons, capillaries, skin, and other tissues. Kidney stones can also form through the process of formation and deposition of sodium urate microcrystals.

BUT Uric acid or ‘urate’ is not a toxin.  It is present in the blood naturally.  In humans, over half the antioxidant capacity of blood plasma comes from uric acid.  Uric acid is a very powerful antioxidant and scavenger of singlet oxygen and radicals. Its presence provides the body with considerable protection from oxidative damage. 

Raised uric acid is a symptom, not a cause, it is an indicator that the body has NEEDED to raise the scavenging and anti-oxidant activity in the blood, because there are pathogens in the blood.  The technical term for raised uric acid levels is hyperuricemia.  Hyperuricemia does not need to be treated, what needs to be treated and eradicated are the pathogens that have triggered its elevation.  I repeat, it is a symptom and not a cause.

 

In effect we are asking the same question when we ask 'what causes the crystal to form' and then 'what has raised the uric acid levels' - because it is probably the same pathogen.

Gout crystals grow because there is a ‘seed crystal’ already in the joints – an agent or a toxin around which it can form.  Heavy metals appear to be one sort of seed, and lead and mercury have both been already implicated as agents of gout. In thinking about this one should not forget the effect of faulty dental amalgam fillings.

The smoke from smoking could act as a seed, and practically all pharmaceuticals are crystal based and thus capable of being pathogens. 

The eHealthme website has a number of pages that correlate gout with specific pharmaceuticals.  The eHealthme web site base their tables on  Adverse Drug reports submitted by doctors to the FDA and SEDA, as such this is actual experience not anecdotal.  This LINK should take you to that table.  If the link is broken use the 'conditions' look up list to find gout, then scroll down to the section 'drugs that could cause'.  In early 2017, about 1,250 pharmaceuticals were implicated in causing gout.

 Viruses are crystalline and so are bacteria.

Thus to treat gout we need to find the pathogen.  In the gout section we have provided a detailed step by step guide on how you can help yourself and fight gout.  It may incidentally also help with rheumatoid arthritis.

Thus treatment is based on finding the cause.  It makes the use of pharmaceuticals to treat the symptoms somewhat suspect, so bear this in mind as you continue with this section.

Types of drug

Medications most often used to treat hyperuricemia [gout] are of two kinds: 

  • xanthine oxidase inhibitors - Xanthine oxidase is responsible for the successive oxidation of hypoxanthine and xanthine, resulting in the production of uric acid, the product of human purine metabolism.  Xanthine oxidase inhibitors decrease the production of uric acid, by interfering with xanthine oxidase. 
  • Uricosurics - Uricosurics increase the excretion of uric acid, by reducing the reabsorption of uric acid once the kidneys have filtered it out of the blood

In effect both types of pharmaceutical interfere with production of uric acid, when the cause is not the uric acid.  Given the importance of uric acid in our bodies, one might expect that these pharmaceuticals thus produce a plethora of side-effects - and they do.

Side effects

Using the figures from the eHealthme website, collated from the Adverse Drug Reports submitted to the FDA and SEDA in the US only, we find that there are very few drugs whose side effects can be used as an example.  The use of many drugs is too low to be representative, or they are used outside the US.  Furthermore the off-label use of the other drugs makes it difficult to separate the actual side effects from the effects of misapplying the drug.  Thus looking at Allopurinol:

Most common Allopurinol side effects:

  • Fever  (3,298 reports)
  • Weakness  (2,897 reports)
  • Diarrhea  (2,808 reports)
  • Anaemia (2,698 reports)
  • Breathing Difficulty  (2,696 reports)
  • Nausea  (2,672 reports)
  • Renal Failure Acute  (2,660 reports)
  • Fatigue (2,515 reports)
  • Hypotension  (2,407 reports)
  • Rashes  (2,244 reports)
 

 But other drugs are not without similar effects.  For example the most common Colchicine side effects are:

  • Diarrhea  (89 reports)
  • Weakness  (76 reports)
  • Fever (74 reports)
  • Nausea (70 reports)
  • Gout  (61 reports)
  • Renal Failure Acute  (57 reports)
  • Fatigue (52 reports)
  • Cardiac Failure Congestive  (48 reports)
  • Acute Kidney Failure (47 reports)
  • Blood Creatinine Increased (46 reports)

These are the symptoms of being poisoned and are the beginnings of delirium, which is when you get hallucinations.  Note that the gout is still there.  As it appears to be with all the medications.  Most common Uloric side effects:

  • Gout in Uloric (51 reports)
  • Renal Failure Acute in Uloric (42 reports)

Most common Krystexxa side effects:

  • Infusion Related Reaction in Krystexxa (36 reports)
  • Gout in Krystexxa (34 reports)
 

Death

Allopurinol and its trade names

  • On Aug, 29, 2015: 50,605 people reported to have side effects when taking Allopurinol. Among them, 1,114 people (2.20%) have Death
  • On Aug, 12, 2015: 1,718 people reported to have side effects when taking Zyloprim. Among them, 33 people (1.92%) have Death
  • On Sep, 9, 2015: 50,631 people reported to have side effects when taking Lopurin. Among them, 1,116 people (2.20%) have Death
  • On Sep, 9, 2015: 15 people reported to have side effects when taking Aloprim. Among them, 2 people (13.33%) have Death

Colchicine

  • On Aug, 17, 2015: 1,367 people reported to have side effects when taking Colchicine. Among them, 10 people (0.73%) have Death

Uloric

  • On Aug, 18, 2015: 676 people reported to have side effects when taking Uloric. Among them, 25 people (3.70%) have Death

 Krystexxa

  • On May, 23, 2015: 147 people reported to have side effects when taking Krystexxa. Among them, 1 people (0.68%) has Death

Benemid and trade names

  • On Sep, 9, 2015: 108 people reported to have side effects when taking Benemid. Among them, 3 people (2.78%) have Death.
  • On Aug, 10, 2015: 275 people reported to have side effects when taking Probenecid. Among them, 16 people (5.82%) have Death.

Fenofibrate

  • On Aug, 24, 2015: 8,861 people reported to have side effects when taking Fenofibrate. Among them, 104 people (1.17%) have Death
  • On Sep, 9, 2015: 15,003 people reported to have side effects when taking Tricor. Among them, 202 people (1.35%) have Death

Losartan and trade names [Losartan is not a gout medication but it is a uricosuric]

  • On Sep, 7, 2015: 13,098 people reported to have side effects when taking Losartan. Among them, 160 people (1.22%) have Death
  • On Aug, 22, 2015: 11,852 people reported to have side effects when taking Losartan potassium. Among them, 153 people (1.29%) have Death
  • On Sep, 9, 2015: 969 people reported to have side effects when taking Losartan potassium and hydrochlorothiazide. Among them, 6 people (0.62%) have Death
  • On Aug, 30, 2015: 25,594 people reported to have side effects when taking Cozaar. Among them, 495 people (1.93%) have Death

 Sevelamer and trade names [not all deaths attributable to off label use]

  • On Sep, 9, 2015: 3,294 people reported to have side effects when taking Renagel. Among them, 229 people (6.95%) have Death
  • On Aug, 28, 2015: 43 people reported to have side effects when taking Renvela. Among them, 84 people (100.00%) have Death

Summary figures

exit, stage right ...........

In total, according to the eHealthme website the number of deaths caused by gout drugs and those drugs that are used off label to treat gout or those which have as a side effect the lowering of uric acid , as at early September 2015 was :

3,753

this figure being applicable to the US and not the rest of the world and only including those Adverse drug reports submitted by doctors to the FDA and SEDA

How it works

Why the hallucinations?

Allopurinol can lower blood pressure in mild hypertension, thus in overdose proportions in those who have normal blood pressure it may be producing hypotension and hypotension can lead to hypoxia and hypoxia [see separate section] can give you a spiritual experience.   I have provided a paper in the observations section to give you more background on this.

Anothe contributory factor may actually be the extreme pain of gout itself in which case the cause is not the treatment but the gout.  Thus extreme pain.

But in the end these drugs are acting as toxins, the symptoms are the symptoms of delirium and one of the side effects of delirium is hallucinations.

References and further reading

 

The sculptures on this page are by Geoffrey Gorman. 

Made of rusted metal, discarded cloth, twigs, and anything else he finds. "They stalk, stare, and fly through an imaginary world". Gorman only started creating his own art about five years ago, after a career of helping other artists market their work and establish their businesses. A fiftieth birthday trek through India and the Himalayas rekindled his lifelong connection with the natural world.

More on Geoffrey Gorman can be found on his webpage Geoffrey Gorman Art:

Observations

The following figures for hallucinations come from the eHealthme website, and were collated from the Adverse Drug Reports submitted to the FDA and SEDA.  The link should take you to the eHealthme website where a more detailed and up-to-date description of side-effects can be found.  If the link does not work it may be because eHealthme are in the process of updating the figures; the drug has been discontinued; or the name of the drug has been changed.  This latter possibility is a not infrequent occurrence.

Drugs

No of hallucinations

Allopurinol + Zyloprim, Lopurin, Aloprim

315 + 7 = 322

Colchicine

6

Febuxostat trade names Adenuric in Europe and New Zealand, Uloric in the US, Goturic in Latin America

4

Pegloticase trade name Krystexxa, formerly Puricase *

0

Probenecid trade name Probalan and Benemid *

0

Sulfinpyrazone BrandName Anturane *

0

Benzbromarone *

0

Isobromindione *

0

Fenofibrate **

200

Losartan and Cozaar ++

80 + 77 + 8 + 169 = 334

Oxypurinol brand name Oxyprim *

0

Tisopurine

0

Sevelamer trade names Renagel and Renvela $$

79

Rasburicase brand names: Elitek in the US, and Fasturtec in Europe %

0

TOTAL

945

 

 

* A number of these drugs have very very low usage within the US, as such no reports may have been submitted because of this

** Fenofibrate also has an unlabeled – ie off label - use as an added ‘therapy’ of high blood uric acid levels in people who have gout [Ref "2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia". Arthritis Care Res (Hoboken) 64 (10): 1431–46. doi:10.1002/acr.21772. PMC 3683400. PMID 23024028]

++ Losartan is not a gout medication but it is a uricosuric.

££ Tisopurine (or thiopurinol) is a drug used in the treatment of gout in some countries other than the USA.  It reduces uric acid production through inhibiting an early stage in its production

$$ Sevelemer is not a gout medication but can significantly reduce serum uric acid

% Rasburicase is an enzyme that metabolizes uric acid to allantoin.  It is used in cancer treatment, thus the figures at the moment are not for gout, but it is being investigated for treating severe hyperuricemia from other sources ie gout and even other rheumatologic conditions.

Related observations