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Ask Dr Uzair Your Own Question
Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 7956
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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I have been in excruciating pain with gout, first in my right

Customer Question

I have been in excruciating pain with gout, first in my right ankle, now the base of the big toe, days now. I have been taking Co-codomol, Neurofen plus, Codeine phosphate 15mg tablets prescribed some time ago), but to little effect and the instructions indicate not to be taken than 3 days. I have been taking them in various combinations than this , but attempting to limit the daily dosage.
My ankle is still very swollen and and I cannot get to a GP and I am not convinced the can do anything anyway. I am at a loss what to do know, having got very little sleep last night because of the pain.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Uzair replied 2 years ago.
Dr Uzair :

. Welcome to JustAnswer. I shall try my best to assist you while you are corresponding with me.

Dr Uzair :

What is the combination of the medication that you are taking? How much and frequency?

Dr Uzair :

Please enter chat to respond.

JACUSTOMER-w8i4lfxe- :

It varies. Because of the addiction problem with codeine, I have been trying to limit it and so too with Neurofen (possibly irritating my stonmach) and paracetamol (which I don't like taking). I have been taking medication of one sort or another 2-3 times a day

Dr Uzair :

Okay. Let me help you with the combination, which should work. And you will not get addicted to the codiene in 3 to 4 days of its use.

Dr Uzair :

The neurofen you are taking has 200 mg of Ibuprofen in it. Which is not a dose that will provide you with much pain relief. This dose is good , since it has codiene in it as well, so it is effective pain and inflammation.

JACUSTOMER-w8i4lfxe- :

I have been using the codeine in co-codomol, Neurofen plus over 11 days !

Dr Uzair :

I would suggest that you take Ibuprofen 600 mg thrice a day, take it 10 - 15 minutes after a meal, so you're stomach will not get irritated. Start simultaneously on Omeprazole 20 mg twice a day, take this empty stomach 10 minutes before the meal. And Get Ketoprofen liquigel and apply it on the painful area four times a day and then keep the foot wrapped in an ACE or crepe bandage and elevated above the heart level by putting two pillows when lying down.

Dr Uzair :

Yes, since the dose is inadequate it will not suffice as an anti inflammatory nor as a pain killer.

Dr Uzair :

You can add the codiene phosphate as an adjunct to the above every 8 hours if required. I doubt you'll require it with the above regimen.

Dr Uzair :

This regimen should provide relief in about a few hours after you start it.

JACUSTOMER-w8i4lfxe- :

Thanks. Can I get these over the counter at a chemist (i.e. without prescription)?

Dr Uzair :

Yes, these are all over the counter.

Dr Uzair :

If you have no further queries, please leave a positive rating service.

Dr Uzair :

Thanks in advance and best wishes.

Dr Uzair and 3 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

I have checked with my local pharmacist. Ibuprofen 600mg and Omeprazole 20mg are only available on prescription. Hopefully the former at 400mg and the latter at a lower dose will do

Expert:  Dr Uzair replied 2 years ago.
You can try the 400 mg thrice a day or you can take 1 and a half of the 400mg to make it 600 mg, it should work as well. Omeprazole is over the counter in the UK, I am sure of that but if it is really not available OTC in your area, then you can ask your pharmacist OTC substitute protection or a 10 mg dose.
Best.