This is how allopurinol works against gout

Allopurinol is used to treat chronic gout disorders. The active ingredient ensures that the uric acid concentration in the blood is reduced. As a result, the remedy can prevent an acute gout attack. Allopurinol is considered to be well tolerated, but side effects can occur while taking it. The most common complaints include gastrointestinal problems and allergic skin reactions. Find out details about the effects, side effects and dosage of allopurinol here.

Effect of allopurinol in gout

Uric acid  plays   a crucial role in the development of  gout . It is formed when purines are broken down. On the one hand, purines are produced by the body itself, on the other hand, they enter the body through  purine -rich  foods such as meat, certain types of fish and legumes. If there is too much uric acid in the body (hyperuricemia), uric acid crystals form. These are insoluble in water and can therefore be deposited in the tissue. This can lead to the typical gout symptoms such as painful thickening and inflammation in the joints.

Allopurinol is one of the so-called  uricostatics that inhibit the breakdown of purines into uric acid. It does this by blocking a specific enzyme (xanthine oxidase) that is needed for its breakdown. If the purines can no longer be broken down into uric acid, the uric acid level in the blood drops. In addition, existing deposits in the tissue can be broken down. Instead of uric acid, taking the active ingredient produces more xanthine – a precursor of uric acid that can be excreted from the body much more quickly via the kidneys.

In the case of gout, allopurinol is recommended from a uric acid concentration of 8.5 milligrams/100 milliliters of blood. In addition to gout, the active ingredient is also used to  treat other diseases  . It is used, for example, in the case of kidney damage caused by uric acid or secondary hyperuricemia. It is also used to treat certain enzyme deficiency diseases that are associated with increased uric acid levels.

Allopurinol side effects

The active ingredient is generally considered to be well tolerated, but side effects can occur while taking allopurinol. At the beginning of the therapy, an acute gout attack can be triggered by the drug. It can also cause  nausea , vomiting and  diarrhea  . Allergic skin reactions such as  itching , redness and swelling are also possible.

If you  notice any skin reactions  , please contact your doctor immediately and discuss with him whether you should continue taking the medicine. In individual cases, the active ingredient can cause severe skin reactions that are accompanied by flaking and peeling of the skin. These can be symptoms of a life-threatening skin reaction such as that seen in Stevens-Johnson syndrome or epidermal necrolysis.

In rare cases, other side effects may occur while taking allopurinol. These include headaches,  feverjoint pain , seizures, and kidney infections. Since dizziness, drowsiness and movement disorders are also among the possible side effects, you should not drive a car or work on an electrical machine after taking the active ingredient. Also avoid activities where you do not have a firm grip.

Correct dosage of allopurinol

Allopurinol is taken in pill form. The tablets contain either 100 or 300 milligrams of allopurinol. It usually starts with 100 milligrams and then slowly increases the dose if necessary. In individual cases, the daily dose can be increased to 600 to 800 milligrams.

The tablets should be swallowed whole with plenty of liquid after a meal. If you take more than 300 milligrams or if you experience gastrointestinal problems, you should take the dose spread over the day. It is important that the uric acid level is checked regularly during treatment and that the dose is adjusted if necessary.

For children, the maximum daily dose is 400 milligrams. In general, children should not take more than 10 milligrams of allopurinol per kilogram of body weight per day. The total dose is divided into three individual doses, which are taken in the morning, at noon and in the evening.

Contraindications: Not for pregnant women

Although allopurinol is well tolerated, you may not use the active ingredient under certain circumstances. This is the case, for example, if there is hypersensitivity to the active substance. Pregnant women should also refrain from taking it, as there is not enough experience for them so far. The active ingredient is also contraindicated during breastfeeding, as it passes into breast milk.

If you have certain diseases, special precautions must be taken: If you have a blood formation disorder, your blood count must be checked  regularly  . In the case of kidney disease, on the other hand, the dose taken must be reduced. This is because allopurinol is excreted through the kidneys and the time it stays in the body increases with kidney disease. The dose may also need to be adjusted if the liver function is impaired.

Attention:  Please note that allopurinol is only suitable for the prevention of a gout attack, but not for its acute treatment! If allopurinol is taken during a gout attack, more uric acid crystals may form. This can prolong or worsen the seizure.

interactions

Interactions can occur when allopurinol is taken with certain other medications. The effect of the gout remedy is reduced by active ingredients such as benzbromarone, etacrynic acid, probenecid, sulfinpyrazone and thiazines. On the other hand, chlorpropamide, ciclosporin, phenytoin and theophylline as well as coumarin-type anticoagulants enhance the effect of allopurinol.

Allopurinol itself also affects other medications. It strengthens or prolongs the effect of drugs containing chlorpropamide, phenprocoumon, salicylic acid, theophylline and vidarabine. The effect of anticoagulants can also be increased. In contrast, allopurinol slows the elimination of probenecid.

The active ingredient should also not be taken together with  antibiotics  such as ampicillin or  amoxicillin  . Otherwise, skin rashes may appear.  The gout remedy should also not be combined with  cytostatics , as this can lead to changes in the blood picture. If cytostatics have to be taken, a significant reduction in the dose is usually necessary.

A detailed list of all side effects, contraindications and interactions of and with allopurinol can be found in the package insert of your medication.

Instructions for taking Allopurinol

The following behaviors can support therapy with allopurinol:

  • Eat a balanced and healthy diet. Avoid purine-rich foods such as offal, legumes, fish or alcohol.
  • Drink a lot, preferably water or  herbal teas
  • If you are overweight, try to lose a little weight.

 

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