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Allopurinol Drug Information Allopurinol Drug information Allopurinol is used for the long-term treatment of gout. Allopurinol should effectively and you may have more attacks of treat your condition, and stop it gout during this time. This is more causing damage to your joints. likely if your urate levels are very It has been tested and has helped high or you’ve had gout for a long many people. However, as with time. It doesn’t mean the drug isn’t all drugs some people will have working. Attacks of gout usually side-effects. This leaflet sets stop within a year as long as your out what you need to know. urate level has lowered sufficiently. Usually, you’ll be offered allopurinol What is allopurinol for gout if blood tests show that and how is it used? your urate level is high and one or Allopurinol is used for the long- more of the following applies: term treatment and prevention • you’re having repeated of gout. Taken regularly, it can attacks of gout stop attacks of gout and help • your joints or kidneys have been prevent damage to the joints. damaged by attacks of gout The body naturally produces a • you have deposits of urate crystals substance called urate, which is affecting your skin (gouty tophi). normally dissolved in the blood Your doctor may be cautious until it’s passed out of the body in about prescribing allopurinol the urine. When too much urate if your kidney or liver function is produced, or if the body cannot is significantly impaired. get rid of it properly, the blood can’t dissolve all the urate and solid crystals can form in and around joints causing inflammation and pain. Allopurinol blocks an enzyme called Allopurinol starts xanthine oxidase which is involved to work within a in producing urate. By reducing the amount of urate produced allopurinol few weeks but it helps keep the level low enough to can take longer allow the crystals to dissolve and for existing urate prevent future attacks of gout. crystals to dissolve. Over a few weeks allopurinol can lower urate levels in the blood and stop new crystals forming. It can take longer to dissolve existing crystals When and how do I take allopurinol? Your doctor may advise you not to start taking allopurinol until after an acute attack of gout has Allopurinol needs completely settled. If this isn’t to be taken regularly possible it may be started while to prevent symptoms the gout is in a mild phase. returning. Allopurinol is taken in tablet form once daily, preferably after food. The tablet should be swallowed with water. Your doctor will advise you about the correct dose. Usually you’ll start with between 100 mg and 300 mg daily but your doctor will take regular blood tests and may increase Possible risks and side-effects the dose (up to 900 mg daily in severe cases) if your urate level doesn’t come Most people on allopurinol don’t down far enough for the crystals to experience side-effects. Some dissolve. You may need a lower dose possible side-effects include: if you have kidney or liver disease. • skin rashes Once your urate levels are low and • headaches steady, you’ll have further checks • drowsiness or dizziness every few months to make sure the • feeling sick (nausea) urate isn’t starting to build up again. • taste disturbance • vomiting. Allopurinol isn’t a treatment for acute attacks of gout and is generally If you develop a rash you should stop needed for life. It’s important to the allopurinol and see your doctor keep taking allopurinol (unless straight away. If you become dizzy you have severe side-effects): or drowsy while taking allopurinol, don’t drive or operate machinery, • even if it doesn’t seem to and see your doctor as soon as be working at first possible. You should also speak to • even if you have more attacks of your doctor if you develop any other gout when you first start allopurinol new symptoms that concern you. • even when you stop having attacks of gout – otherwise urate levels Even if side-effects occur, it may may start to build up again and be possible to re-start allopurinol your symptoms may come back. using a special ‘desensitisation’ course, which involves beginning allopurinol at a very low dose and increasing the dosage gradually. Sometimes when you start allopurinol If you do have it can actually trigger an attack an attack of gout of gout, as the crystals begin to after starting dissolve. You’ll probably be given allopurinol it can an additional medicine for the first few months to reduce this risk. This be treated as you will be a small dose of either a non- would normally. steroidal anti-inflammatory drug (NSAID), colchicine or steroids. If you do have an acute attack of gout while on allopurinol, don’t stop taking it. Treat the acute attack as you would normally. If you’re unable to continue taking before starting it, and you should allopurinol because of side-effects, always tell anyone else treating you you may be able to take another that you’re taking allopurinol. drug instead called febuxostat, which • Allopurinol interacts with the works in a similar way to allopurinol. immunosuppressant drugs Otherwise your doctor may suggest azathioprine and mercaptopurine a drug such as benzbromarone or and these drugs should not sulfinpyrazone which reduce urate generally be used with allopurinol. levels by increasing the amount • Allopurinol may increase the risk of of urate passed in the urine. developing a rash with the antibiotics with ampicillin or amoxicillin. Can I take other medicines • Allopurinol may increase the effect alongside allopurinol? of warfarin and other drugs that thin the blood (anticoagulants), so You’ll probably need an NSAID or you may need to have your blood colchicine to help prevent or to deal clotting tested more frequently. with attacks of gout – especially in the early stages of allopurinol treatment. Vaccinations However, some drugs interact with You can have vaccinations allopurinol, so you should discuss any while on allopurinol. new medication with your doctor Fertility, pregnancy and breastfeeding It’s rare for women to get gout before the menopause, but allopurinol As part of the general is unlikely to affect fertility. treatment for We don’t know what effect allopurinol gout, try to keep has on an unborn baby and so you alcohol consumption shouldn’t take it if you’re pregnant. If well within you’re planning a family or become recommended limits. pregnant while taking allopurinol you should discuss this with your doctor. Some allopurinol will pass into the breast milk but the risk to the baby is unknown. Therefore you shouldn’t breastfeed if you’re taking allopurinol. Alcohol There’s no known interaction between alcohol and allopurinol. You’ll have regular However, alcohol increases the level of urate in the blood. As part of the checks to begin general treatment of gout, try to with to check you’re keep well within the recommended on the right dose. limits for alcohol (maximum of 14 units per week for adults). It’s advisable to have alcohol free days, without ‘saving units up’ to drink in one go. Talk to your doctor or rheumatologist if you have any concerns. Arthritis Research UK Thank you for supporting Arthritis works to improve the Research UK. With your generosity we can keep doing our vital work. quality of life for people To donate visit with arthritis so that www.arthritisresearchuk.org/donate they can say they are in control, independent and recognised. We’re dedicated to funding research into We would like to thank the team of people the cause, treatment and cure of arthritis who contributed to the development of this so that people can live pain-free lives. booklet. It was written by Prof. Ariane Herrick and updated by Dr Kelsey Jordan. An Arthritis For more expert information visit our Research UK medical advisor, Dr Mark Lillicrap, website or if you would like to tell us is responsible for the content overall. what you think about our booklets email [email protected] Please note: we have made every effort to or write to the address below. ensure that this content is correct at time of publication, but remember that information Arthritis Research UK about drugs may change. This information sheet is for general education only and does Copeman House not list all the uses and side-effects associated St Mary’s Gate with this drug. Chesterfield S41 7TD 0300 790 0400 www.arthritisresearchuk.org @ArthritisRUK /arthritisresearchuk Date published: 2015. Registered charity in England and Wales no. 207711, Scotland no. SC041156. ©Arthritis Research UK 2015 A Company registered in England and Wales. Limited by Guarantee no. 490500. 2280/D-ALLO/15-1.
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