Guest guest Posted September 24, 1999 Report Share Posted September 24, 1999 Amy and grp: Maybe you can help me? I have RA (4yrs)- I took my 4th(5days) round of Clindy IV - 2 weeks ago. I am herxing and I don't know how much more I can take. Your post really gave me some ideas. The first week of IV'S in May- I took a 40mg depo-medrol shot right before the IV therapy started. I was in so much pain but I had also read that the antibiotic can get to the joint easier if the inflammation is down. So I made sure I took the steroid shot. Then I did better than ever for 8 straight weeks- actually thought I was cured --- Around the 8th week everything started to fizzle- so the week before the 3rd round I took another 40mg depo-medrol shot and did well for 4 weeks. I definitely can only give the steroid shot credit for 2 of those weeks; the depo-medrol lasts around 14 days then joint pain always return fast. So the Clindy was helping. This last round 4th round I did not take a steroid as I am very concerned about the long term side effects. Since the 4th round - I am going downhill daily. Basically I am miserable. 2 weeks of hell. Aching all over- and severe joint pain. The weakness and fatigue is terrible. Can not sleep because of the pain. Flulike symptoms for sure. I am supposed to have my next week of Clindy the second week of October. *** Should I get another depo-medrol injection at the same time as the IV to help me through this flare? and to help the Clindy get to the joints? *** Does it sound like I am having a herx from the IV? Also- can anyone tell me what the comparison is 1 cc depo-medrol (that Amy mentioned in the protocol) to 40mg depo-medrol. Thanks for your help- I NEED IT! Carol* Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2006 Report Share Posted February 20, 2006 In a message dated 2/20/06 6:40:33 PM, bayabas76@... writes: I took the Metformin first to see any effect it may have on my bp. My bp stayed the same at 124-130/78-84 region for two days of Metformin 500mg. Based on this, it seems to me that Metformin does not upset my bp. On the third day (yesterday), I began Allopurinol, my first 100mg tablet. Last evening, I monitored my bp at 140/90. This morning, it reads 160/100. Don't know of a BP allopurinol interaction. I do know that Losartan lowers uric acid and BP. What is your HbA1c and what is the goal HbA1c to which he is giving you the metformin to get there? Wonder why he did not choose to try a uricosuric drug first? Drugs. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin 2004;64(21):2399-416. Related Articles, Links Management of acute and chronic gouty arthritis: present state-of-the-art. Schlesinger N. Department of Medicine, University of Medicine and Dentistry of New Jersey- Wood Medical School, New Brunswick, New Jersey 08903-0019, USA. schlesna@... There are three stages in the management of gout: (i) treating the acute attack; (ii) lowering excess stores of uric acid to prevent flares of gouty arthritis and to prevent tissue deposition of urate; and (iii) providing prophylaxis to prevent acute flares. It is important to distinguish between therapy to reduce acute inflammation in acute gout and therapy to manage hyperuricaemia in patients with chronic gouty arthritis.During the acute gouty attack nonpharmacological treatments such as topical ice and rest of the inflamed joint are useful. NSAIDs are the preferred treatment in acute gout. The most important determinant of therapeutic success is not which NSAID is chosen, but rather how soon NSAID therapy is initiated. Other treatments include oral and intravenous colchicine, intra-articular and systemic corticosteroids, and intramuscular corticotropin.Optimal treatment of chronic gout requires long-standing reduction in serum uric acid. The urate-lowering drugs used to treat chronic gout are the uricosuric drugs, the uricostatic drugs, which are xanthine oxidase inhibitors, and the uricolytic drugs. Xanthine oxidase inhibitors such as allopurinol, oxipurinol and febuxastat should be used as first-line treatment in patients with renal calculi, renal insufficiency, concomitant diuretic therapy and ciclosporin (cyclosporine) therapy, and urate overproduction. Uricosuric drugs include probenecid, benzbromarone, micronised fenofibrate and losartan. They are the urate-lowering drugs of choice in allopurinol-allergic patients and underexcretors with normal renal function and no history of urolithiasis. The use of recombinant urate oxidase in patients with chronic gout is limited by the need for parenteral administration, the potential antigenicity and production of anti-urate oxidase antibodies, and declining efficacy.The effectiveness of colchicine prophylaxis as an isolated therapy is still to be confirmed by placebo-controlled trials. Another issue is prophylaxis with NSAIDs. There are no comparative studies with colchicine. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2006 Report Share Posted February 22, 2006 > What is your HbA1c and what is the goal HbA1c to which he is giving you the > metformin to get there? > > Wonder why he did not choose to try a uricosuric drug first? > My blood sugar level is 122 mg/dl and he wants to bring it down within range of 60-110 with metformin in two weeks. I was given Metformin and Allopurinol to address my elevated sugar and uric acid respectively. I took Metformin first for two days. my bp stayed ok. So I next took the Allopurinol. That night my bp went up. The day after, I stopped taking Allopurinol(Zyloprim) but continued taking Metformin. Bp still reads high as of this evening. I will stop Metformin tomorrow and see the effect on bp. I guess it may take around two days to see an effect, hopefully, better readings since I have it for six months now with the Spiro+Furosemides+ Lacidipine combination. Will post results of this experiment. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2010 Report Share Posted October 17, 2010 Lottie, You have a point about the pharmacy's not being aware of the contraindications because the CML patients are probably getting there meds from another pharmacy or a trial and the pharmacy they use for other meds are not aware that you are on Gleevec or any other med for CML med so they are unaware of the interactions. That is what happend to my mom. She was getting her gleevec through a bioscript pharmacy that delivers it to her home and her regular pharmacy was not aware she was on gleevec. I'm not an oncology nurse I am a cardiovascular nurse at the #1 Heart Hospital in Carmel, Indiana. I have been doing alot of research myself for my mother since I am her advocate! I am making sure that I am on top of things for her and all of you. I want her around for a long time. I am not ready to lose another parent! ________________________________ From: Lottie Duthu <lotajam@...> CML < > Sent: Sat, October 16, 2010 11:21:34 PM Subject: [ ] Allopurinol  Dear Karine, I never took allopurinol with Gleevec. I was taking Hydrea and ATRA in my first trial. I am glad that you mentioned that because all doctors do not tell you everything you need to know. You either have to know what questions you need to ask or get the information from people like you. I am not on any CML drug until I start the new Ariad trial next month, but I will have to remember to ask that question. I have a medical history every time I see a doctor, as it changes every month, but they may let that one slip by, because I have so much information on that sheet, now going into 2 sheets. Even the pharmacy can't advise you because they don't know what is in that trial drug. In your experince as an oncology nurse have you ever administered ATRA to a patient or do you know of any patients that were on it for CML. I think it is now being used for AML. Carpe Diem, LOttie Duthu Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2010 Report Share Posted October 17, 2010 I have been on Allopurinol for years, one every other day. I was on it I think for the last two trials, xl228 and Ariad. a ( Bobby ) Doyle, dob 12/17/29 DX 5/1995 Interferon 9 weeks/Hydroxyurea 5 years 02/2000 to 06/2002 Gleevec trial, OHSU 06/2002 Gleevec/Trisenox Trial, OHSU 06/2003 Gleevec/Zarnestra Trial, OHSU 04/2004 Sprycel Trial, MDACC, CCR in 10 months 04/2008 XL228 Trial, U of Mich. 01/2009 PCR 5.69 04/2009 Ariad Trial AP24534 09/2009 PCR 0.01 11/2009 PCR 0.034 02/2010 PCRU #840 Zavie's Zero Club From: Lottie Duthu <lotajam@...> Subject: [ ] Allopurinol " CML " < > Date: Sunday, October 17, 2010, 12:21 AM  Dear Karine, I never took allopurinol with Gleevec. I was taking Hydrea and ATRA in my first trial. I am glad that you mentioned that because all doctors do not tell you everything you need to know. You either have to know what questions you need to ask or get the information from people like you. I am not on any CML drug until I start the new Ariad trial next month, but I will have to remember to ask that question. I have a medical history every time I see a doctor, as it changes every month, but they may let that one slip by, because I have so much information on that sheet, now going into 2 sheets. Even the pharmacy can't advise you because they don't know what is in that trial drug. In your experince as an oncology nurse have you ever administered ATRA to a patient or do you know of any patients that were on it for CML. I think it is now being used for AML. Carpe Diem, LOttie Duthu Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2010 Report Share Posted October 19, 2010 Truthfully? I don't remember, but I will email my trial nurse and ask her how long I have been on it and why. a ( Bobby ) Doyle, dob 12/17/29 DX 5/1995 Interferon 9 weeks/Hydroxyurea 5 years 02/2000 to 06/2002 Gleevec trial, OHSU 06/2002 Gleevec/Trisenox Trial, OHSU 06/2003 Gleevec/Zarnestra Trial, OHSU 04/2004 Sprycel Trial, MDACC, CCR in 10 months 04/2008 XL228 Trial, U of Mich. 01/2009 PCR 5.69 04/2009 Ariad Trial AP24534 09/2009 PCR 0.01 11/2009 PCR 0.034 02/2010 PCRU #840 Zavie's Zero Club From: Lottie Duthu <lotajam@...> Subject: [ ] Allopurinol " CML " < > Date: Monday, October 18, 2010, 4:14 PM  Dear Bobby, Did they give you Allopurinol specifically when you were on Ariad, or where you already taking it every other day for another problem? I need to know that if I am going to be in the Ariad trial, God willing that I get into it. For other health reasons, not everyone is a candidate. " Many are called, but few are chosen. " Mt. 24:14. Have a good Monday, Lottie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2010 Report Share Posted October 19, 2010 Hi, I was put on Allopurinol at dx, together with Hydrea and a saline drip. The goal was to get my counts down to where I could participate in the Gleevec high-dose trial. I was told that the Allopurinol + IV fluids was to aid the liver an kidneys in processing the white cells killed by the hydrea, and to prevent clots. Like many other drugs on my list, the Allopurinol caused a rash, so I was glad to stop it after a week. Leah > > Dear Bobby, > Did they give you Allopurinol specifically when you were on Ariad, or where you already taking it every other day for another problem? I need to know that if I am going to be in the Ariad trial, God willing that I get into it. For other health reasons, not everyone is a candidate. " Many are called, but few are chosen. " Mt. 24:14. > Have a good Monday, > Lottie > > Quote Link to comment Share on other sites More sharing options...
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