Allopurinol is a medication that helps prevent attacks of gout.
Allopurinol reduces the body’s production of uric acid by inhibiting an enzyme called xanthine oxidase. This enzyme is involved in the chemical process that produces uric acid in the body. Buildups of excess uric acid can lead to gout and kidney stones.
Allopurinol belongs to a class of medications called xanthine oxidase inhibitors.
Allopurinol is available in 100 and 300 mg oral tablets. The usual dose for Allopurinol is between 50 to 800 mg every day, depending on a doctor’s prescription.
It takes time for this medicine to work, and patients may have flares of gout when they start. It is important for people starting Allopurinol to be patient and continue taking the medication as prescribed by their doctor.
If gout flares while taking Allopurinol, patients should see their doctor so that the flare can be treated with a different medicine.
Important Tests and Risks
Patients taking Allopurinol should have their blood tested occasionally, as advised by their doctor. It is important to keep track of the gout, and make sure blood counts, liver, and kidneys are ok.
Patients taking Allopurinol should not take azathioprine as the medications may interact.
Patients should make sure their doctor and pharmacist knows all of the medications and any supplements that they are taking.
Drinking alcohol is known to cause flares of gout. Patients taking Allopurinol are advised to avoid alcohol completely.
Allopurinol works by inhibiting an enzyme called Xanthine oxidase. Xanthine Oxidase is a crucial part of a chemical reaction that produces uric acid in the body. By inhibiting this enzyme, Allopurinol’s effect on the body is that it starts producing less uric acid.
Gout, the most common type of inflammatory arthritis, occurs when excess uric acid in the body builds up and starts to form into crystals in the joints, tendons, and surrounding tissues. The crystals can trigger a response by the immune system, and its attack results in the painful symptoms seen in a flare of gout.
Allopurinol helps prevent flares (attacks) of gout by reducing the amount of uric acid in the body. The accumulation of crystals is reduced, and in turn, the body’s immune response is reduced. A person’s gout will usually become less severe and really should disappear over time as they continue to take this medication.
When Allopurinol is first started, it can increase gout flares. It is important for patients to keep taking this medicine because in time it will help prevent and eventually stop flares. New flares that happen after starting Allopurinol can be treated with a different medicine.
Patients taking Allopurinol should have their blood tested occasionally so their doctor can make sure that it isn’t irritating their blood counts, liver, or kidneys.
Other possible side-effects of Allopurinol include:
- Diarrhea and Nausea – Allopurinol can cause diarrhea, abdominal pain, nausea, and vomiting.
- Skin rash – Allopurinol very rarely causes severe skin rashes. Patients who develop a skin rash should stop taking Allopurinol immediately and tell their doctor.
- Allergic reaction – Allopurinol can sometimes cause an allergic reaction. Symptoms include fever, chills, nausea, vomiting, joint pain, and skin rash. This is rare. Patients who have an allergic reaction should stop taking Allopurinol immediately and tell their doctor
- Drug interactions – Allopurinol should not be taken with azathioprine
Patients should talk to their doctor if they are concerned about any side effects.
Allopurinol can safely be stopped without needing to be weaned off. Patients should tell their doctor if they stop taking this medicine.
Allopurinol has not been studied for safety in pregnancy. Patients should let their doctor know if they are planning to get pregnant or if they are breastfeeding.
Patients who should NOT be taking Allopurinol include:
- Patients who have had a previous reaction to Allopurinol
- Patients taking azathioprine, or other medications with possible interactions
Patients who become pregnant while taking Allopurinol should notify their doctor immediately.
Patients should call their doctor if they feel sick and want to stop, or they you are concerned about any side effects.
Other reasons to call a doctor while taking Allopurinol include:
- Flare of gout
- Allergic reaction
- Becoming pregnant or planning pregnancy
Watch Canadian rheumatologist Dr. Andy Thompson introduce Allopurinol in this short video: