Allopurinol And Other Medications
Below are examples of medications that can interact with allopurinol oral tablets. This section does not contain all drugs that may interact with allopurinol.
Before taking allopurinol oral tablets, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Drugs that can affect how allopurinol oral tablets work include:
- Salicylates, which can cause the opposite effect of allopurinol and prevent it from lowering uric acid levels. Examples of these drugs include:
- bismuth subsalicylate
Allopurinol oral tablets can affect how other drugs work. If you take one of the following drugs, you may need a lower dose than usual if you also take allopurinol:
- azathioprine
- cyclosporine
Some medications can increase your risk for certain side effects.* These drugs include:
- Amoxicillin , which has been reported to increase the risk of skin rash when used in combination with allopurinol.
- Thiazide diuretics, which can increase the risk of kidney problems, especially in people with kidney disease. Examples of thiazide diuretics include:
* For more information about side effects, see the Allopurinol oral tablet side effects section above.
Uloric Has More Side Effects Than Allopurinol
Allopurinol has been used for over 50 years, and its side effects and efficacy are very well established. Uloric is much newer, having received FDA approval only ten years ago. Even so, the types and number of side effects known for Uloric significantly outnumber those of allopurinol. You can explore those differences in the table below.
Please note: the table below is not a comprehensive listing of Uloric and allopurinol side effects.
Frequently Asked Questions About Allopurinol
How fast does allopurinol work?
For gout, allopurinol lowers uric acid to prevent gout flares. It won’t work to lower pain and discomfort during a gout attack. It can take weeks to months to get to the correct dose of allopurinol and some people experience more gout attacks/flares during this time.
Does allopurinol cure gout?
No, there is currently no cure for gout. Allopurinol and other medications can only prevent gout attacks and treat the symptoms.
Do I have to take allopurinol forever?
If you have high uric acid levels, it’s likely that your provider will have you continue allopurinol or a similar medication to lower your levels. If you stop taking
Is allopurinol hard on the kidneys?
Taking allopurinol is not known to cause kidney problems. The medication leaves your body through the kidneys, so if your kidneys are not working at a certain level, your provider may lower your dose. Some people taking allopurinol have had kidney stones. Drinking a lot of fluids with the medication can help prevent this.
Should I take allopurinol in the morning or night?
Allopurinol can be taken at anytime of the day. If it makes you sleepy, you should take it closer to bedtime. If it hurts your stomach, try taking it with a meal. If you are taking it multiple times a day, try to separate the doses as evenly as possible throughout the day.
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What If I Forget To Take It
If you take allopurinol:
- once a day take the missed dose as soon as you remember. If you do not remember until the following day, skip the missed dose.
- twice or more a day – if you do not remember until your next dose is due, skip the missed dose and take the dose that is due.
Never take a double dose to make up for a missed dose.
If you often forget to take your medicines, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on ways to help you remember to take your medicines.
Allopurinol Oral Tablets And Alcohol
There are no known interactions between allopurinol and alcohol.
But your doctor may suggest that you avoid certain alcoholic beverages as part of a low-purine diet. This diet is often recommended for people with gout or kidney stones because it can lower the level of uric acid in your bloodstream.
Beer and whiskey are especially high in purines. But its possible that all forms of alcohol can increase uric acid levels.
Also, drinking alcohol can cause dehydration. Staying well hydrated is important for helping prevent kidney stones.
If you drink alcohol, ask your doctor how much alcohol, if any, is safe for you to have while taking allopurinol oral tablets.
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How To Take It
Swallow the allopurinol tablets with water, ideally after food. You’ll usually take it once a day, but if you’re on a high dose, your doctor may advise you to split the dose and take it twice a day.
If your doctor has recommended you take allopurinol with lots of fluid, try to drink 2 to 3 litres of fluids every day.
You can take allopurinol at any time of the day, however, try to take your doses at the same time of day each day.
Allopurinol Oral Tablet Cost
As with all medications, the cost of allopurinol oral tablets can vary. To find current prices in your area, check out GoodRx.com.
The cost you find on GoodRx.com is what you may pay without insurance. The actual price youll pay depends on your insurance plan, your location, and the pharmacy you use.
Keep in mind that you may be able to get a 90-day supply of allopurinol oral tablets. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If youre interested in this option, check with your doctor or your insurance company.
Before approving coverage for allopurinol oral tablets, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.
If youre not sure if youll need to get prior authorization for allopurinol oral tablets, contact your insurance company.
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What Medications Are Similar
Other medications are sometimes prescribed instead of allopurinol to help lower uric acid levels in people with gout, such as Uloric and Benemid . These medications are given instead of allopurinol, not in addition to it.
Like allopurinol, febuxostat is a xanthine oxidase type of drug that lowers the amount of uric acid in your body. However, healthcare providers usually prefer to prescribe allopurinol. Although the science on this is evolving, research suggests that febuxostat might not be as safe as allopurinol, especially for people with existing heart problems. Additionally, allopurinol is less expensive.
Probenecid is another potential option. Some data suggest that it may be even safer than allopurinol in terms of heart attack and stroke risk. But it may not be a good choice if you have kidney disease.
Other drugs may be used in gout as well. For example, anti-inflammatory drugs, such as colchicine, can help prevent flares . They also reduce pain from any flares that do happen. These should be used in addition to a drug that lowers uric acid levels .
Allopurinol Oral Tablets And Children
Allopurinol oral tablets may be used in some children. Dosing for allopurinol in children is based on factors such as the childs age and the condition being treated. Talk with your doctor if you have questions about your childs dose.
Allopurinol is used to reduce uric acid levels in children who are born with or develop some cancers or genetic disorders. These can include leukemia, lymphoma, and Lesch-Nyhan syndrome.
The allopurinol oral tablet dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of the condition youre using allopurinol to treat
- other medical conditions you may have, such as kidney problems
- age
Typically, your doctor will start you on a low dosage. Then theyll adjust it over time to reach the amount thats right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
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Uloric Is Deadlier Than Allopurinol
A 2018 study with an average of 2.6 years follow-up investigated the safety of febuxostat and allopurinol in gout patients with existing cardiovascular disease. Researchers found that Uloric was “non-inferior to allopurinol” when examining the time to first occurrence of a major adverse cardiovascular event . They included:
- cardiovascular death
- nonfatal myocardial infarction
- nonfatal stroke
- unstable angina with urgent coronary revascularization
Despite this seeming similarity, the two drugs differed sharply in terms of how many patients died during the study. Patients in the febuxostat group were more likely to suffer either cardiovascular death or all-cause death than those in the allopurinol group. In total, 243 out of 3098 febuxostat patients and 199 out of 3092 allopurinol patients died during the course of the study. As a result, Uloric is only recommended for patients for whom allopurinol is ineffective.
What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
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What Other Medications Interact With Zyloprim
Be sure to tell your healthcare provider about all the medications you take, including over-the-counter products and herbal treatments. In some cases, these medications might interfere with how well and how safely Zyloprim works. You might need to adjust your dose or avoid Zyloprim altogether if you are taking certain medications.
It is not recommended to use Zyloprim with Videx , a medication used to treat HIV.
Other medications that interact with Zyloprim include:
- Anticoagulants, such as warfarin
- Diuretic drugs, like Diuril
- Medications that suppress the immune system, like Imuran
Who Can And Cannot Take Allopurinol
Allopurinol can be taken by adults and sometimes children.
Allopurinol is not suitable for certain people.
Talk to a doctor or pharmacist if you:
- have ever had an allergic reaction to allopurinol or any other medicine
- are of Han Chinese, Thai or Korean origin
- have problems with your liver or kidneys
- currently have an attack of gout
- have thyroid problems
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Allopurinol Oral Tablet Precautions
Before taking allopurinol oral tablets, talk with your doctor about your health history. The drug may not be right for you if you have certain medical conditions or other factors affecting your health.
Allopurinol oral tablets have one contraindication. You should not take allopurinol oral tablets if youve had the following:
- Past severe reaction to allopurinol. If youve taken allopurinol in the past and developed a severe reaction to the drug, you should not take it again. Examples of severe reactions include skin rash and liver damage. Be sure to tell your doctor and pharmacist about any severe reactions youve had to allopurinol.
Allopurinol oral tablets come with several other precautions. With precautions, the drug may not be safe for you to take. Your doctor can help you decide if the drugs benefits of treatment outweigh its other risks. If your doctor prescribes allopurinol oral tablets for you, theyll monitor you carefully after you start treatment.
Precautions with allopurinol include:
Note: For more information about the potential negative effects of allopurinol, see the Allopurinol oral tablet side effects section above.
You should take allopurinol according to the instructions your doctor or healthcare professional gives you.
Youll likely take this medication once or twice a day, after a meal.
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Uloric Shortcomings And Legal Troubles
Uloric was initially celebrated as an advancement in gout treatment, but that sentiment shifted when the drug gained a black box warning in early 2018. Uloric has since been relegated to second-line treatment status, only prescribed to patients for whom allopurinol has failed. This forces such patients to choose between living with the higher risks of Uloric or the debilitating symptoms of unmanaged gout.
In addition to depriving gout patients of a much-needed treatment option, Uloric’s lack of cardiovascular safety has given its manufacturer a plethora of legal troubles. Law firms nationwide have filed lawsuits against Takeda Pharmaceuticals claiming they failed to warn patients of Uloric’s increased risk of death.
The Side Effects Of Allopurinol In The Liver
Allopurinol, basically adds to the burden of the liver and the kidneys. However, this is just a minor effect. The allopurinol is a xanthine oxidase inhibitor. This just means that it is capable of bonding with the xanthine oxidase, the enzyme that bonds with the purine. It actually competes with the purine so the purine will not be broken down into uric acid. The allopurinol is actually an attention seeker that reacts with the purine xanthine oxidase so itll not react with the purine.
You might as, where does purine go? Well, itll return to the blood stream. The purine is significant as a building block of the body so it isnt considered as a trash by the liver. The concentration of the purine isnt reduced, however, the concentration of the xanthine oxidase is being reduced. Since purine is still available, the liver will keep on pumping xanthine oxidase in order to break it down. The liver may not produce loads of xanthine oxidase instantly, thats the reason why the allopurinol overpowers the purine temporarily and lowers the production of uric acid.
In simple terms, the allopurinol cheats the system and overloads the liver. This is just the start of the side effects of allopurinol. The liver damage may arise here. Furthermore, more damage will start too, just as the homeostatic turbulences in the regulation of the pH level balance of the blood. The liver condition will also cause morose diseases such as TEN.
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What Are The Uses Of Allopurinol
- It is indicated for reducing uric acid formation in gouty arthritis and nephrolithiasis.
- It is given for diseases such as uric acid lithiasis and uric acid nephropathy that cause an increase in levels of uric acid.
- It is indicated for the management of recurrent calcium calculi.
- It is used in patients whose serum or urine uric acid levels are elevated due to cancer medications.
- Allopurinol is useful in the treatment of seizures and certain infections.
- It is effective in reducing ulcer relapses.
- The medicine helps prevent the rejection of kidney transplants.
Getting The Most From Your Treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor will want you to have a blood test to check that the level of uric acid has come down. This is often done a month or so after starting allopurinol.
- Remember, allopurinol should be taken every day to prevent a gout attack. It can take 2-3 months to become fully effective. It does not have any effect during a gout attack, although you should continue to take it regularly every day even if this happens.
- During the first few weeks of taking allopurinol, your blood levels of uric acid may rise for a short while before they fall. This can cause a gout attack. Your doctor will prescribe an anti-inflammatory treatment or colchicine tablets for you to take alongside allopurinol during this time.
- Treatment with allopurinol is usually long-term unless you experience an adverse effect. Continue to take the tablets unless you are advised otherwise by a doctor.
- There are a number of lifestyle changes that you can make to help reduce the risk of having a gout attack. These include losing weight , eating a healthy diet and not drinking much alcohol or sugar-sweetened soft drinks. Your doctor will advise you about the changes which could benefit you.
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Are There Any Side Effects
Most people do not experience side effects from allopurinol. Tell your doctor if you are concerned about any possible side effects.
If you do experience side effects, a reduction in dose may minimise these so that you can continue to take the medicine. Your doctor will advise on any dose changes that are necessary.
Most common possible side effects
- The most common side effects are nausea or vomiting. These can be reduced if you eat little and often. If you are sick, drink plenty of liquid.
Less common or rare possible side effects
There are some rare but potentially serious side effects with allopurinol.
- Skin problems: Allopurinol can cause a rash or flaking skin. Very rarely, severe skin rash and mouth ulceration can occur. If any of these occur contact your doctor straight away.
- Tiredness: Drowsiness can occur. If it makes you feel sleepy, avoid driving or operating machinery.
- Liver: Allopurinol can inflame the liver. Blood tests can pick this up if it occurs. The dose of allopurinol may need to be reduced or it may need to be stopped if problems occur. Contact your doctor immediately if you notice yellowing of the skin and/or whites of the eyes.
- Other: Headache, dizziness, taste disturbances, high blood pressure, feeling generally unwell, and hair loss can occur.
Long term side effects
Allopurinol can be taken for long periods to manage gout. There seems to be no long-term side effects.