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Tobra,
I only took the 440mg q4h for the acute gout attack, when the pain was so bad I couldn't walk! After the pain subsided, I went on 220mg q12h. I'm very cautious about meds because of my liver and we monitor my liver enzymes very carefully. I drink 1gal of water a day and no alcohol at all. I eat a mostly vegetarian diet (no red meat, chicken or fish once a week). I've cut HFCS out of my diet and I am at my goal weight, so I'm actively managing this.

It sure does seem like gout is on the upswing. Could it be related to the increased incidence of metabolic syndrome and fatty liver that also seems to be prevalent?