Allopurinol is the most potent and the most effective treatment for gout
Though newer ways to reduce uric acid are now available, and more are being researched, allopurinol remains the first choice.
Allopurinol 2022 Update
Please note that during 2022, I am replacing this page with a new Allopurinol index.
Allopurinol Introduction Purpose
The purpose of this allopurinol introduction is a “hub page” for allopurinol facts within the gout treatment section. Generally, these pages support the Purpose of GoutPal.com by helping you work with health professionals to improve your uric acid treatment plan. So individual pages in this section explain specifically:
- When to seek professional allopurinol advice.
- How to understand professional allopurinol advice.
- How decisions about allopurinol should be shared within the physician-patient relationship.
However, allopurinol management principles form the foundation for all uric acid treatment plans. So this introduction can also benefit GoutPal Dieters or GoutPal Herbalists. Because you should follow the same principles on all uric acid treatment plans. Substituting uric acid diet improvements or herbal gout remedies as appropriate. Also, many gout patients use allopurinol for a year or more to reverse the effects of accumulated uric acid deposits (debulking phase). Before adopting alternative uric acid treatment (maintenance phase).
If you’re unsure about the plan that suits you best, see Questions for Gout Sufferers.
Allopurinol works by inhibiting an enzyme that our bodies produce which breaks down purines into uric acid. The enzyme is called xanthine oxidase, thus allopurinol is classed as a Xanthine Oxidase Inhibitor (XOI).
Other treatments to lower uric acid are available. I explain these alternatives to allopurinol elsewhere in the Gout Treatment section.
Over the years, I have produced many articles on various aspects of allopurinol. Apart from explanations of what allopurinol is, how it works, and why it sometimes fails, most articles deal with allopurinol side effects or allopurinol dosing.
Strangely, allopurinol seems to be the most misspelled medicine I’ve ever encountered. Perhaps it is because it is used very frequently, or perhaps it is just hard to spell. It does not matter to me how you spell it. But I include these misspellings to try and avoid confusion, and to clarify that the different spellings all relate to the same medication – allopurinol.
Allopurinol: What, Why & How?
What is allopurinol, how does it help your gout, and why does it sometimes fail? Read all about how this gout treatment works, and why it is prescribed in What Is Allopurinol.
What is the correct dose of allopurinol at different phases in your gout treatment. You need to understand the differences between the dosage of allopurinol and allopurinol dosing.
Allopurinol is one of the rare medicines that does not have a standard dose. Unfortunately, most patients, and many doctors, are not aware of this, and so they look for a standard dose where none exists. Commonly, the common allopurinol dosage is seen as 300 mg per day. This is dangerous nonsense.
The only reason for taking allopurinol is to reduce uric acid to 5 mg/dL (0.30 mmol/L), or below. I will discuss this in more detail in the allopurinol dosing pages.
Why is a standard dose of allopurinol dangerous?
I have seen at first hand what happens when doctor and patient assume a standard allopurinol dose is the right treatment. The doctor is happy because he believes he has satisfied another patient. The patient is happy because he believes he has gout under control. But if uric acid is still near 7 or higher, the gout patient is not safe. Uric acid crystals continue to grow slowly, often without gout pain. After several years, the burden becomes too big. Gout attacks happen every week, and tophi grow risking fatal complications.
This is a common phenomenon, and rheumatologists currently place strong emphasis on “treat to target” That means that your uric acid is important, but your specific allopurinol dosage is not.
Allopurinol dose is only important to an individual patient as part of their treatment plan. Dose will vary over different stages of your gout treatment plan according to your personal allopurinol dosing requirements.
Allopurinol dosing is the term that describes the approach to managing gout. It is not a fixed dosage.
Allopurinol dosing covers investigation, initiation, titration, deposit removal, and maintenance. I explain these stages in the Allopurinol Dosing guidelines.
Allopurinol Side Effects
For common side effects of allopurinol, and associated information, please see the allopurinol side effects page. Adverse reactions are rare, but important. They should not prevent you from considering allopurinol, even if they eventually cause you to choose a different uric acid lowering option. See how to minimize allopurinol side effects.
Allopurinol For Gout
Allopurinol for gout is the best way to lower uric acid. But it’s dangerous to get it wrong. Most doctors get it wrong. Get safe allopurinol for your gout.
This section of the allopurinol guidelines looks at the wider issues of prescribing allopurinol for gout. It shows how you can tell if your allopurinol treatment plan is right for you. More importantly, as most allopurinol for gout is prescribed incorrectly, it shows you where to get the personal help you need to put it right.
Allopurinol And Other Treatment
Gout patients often worry about allopurinol and other treatments or diet effects. You should always discuss this with your doctor, especially if you are being treated for other health problems. You should also read labels carefully, especially the section called “contraindications.” I have included some common concerns in my Allopurinol And Other Issues pages, but you should always seek medical help if you have specific concerns, as it is impossible to cover every combination.
Allopurinol and other xanthine oxidase inhibitors are the subject of many recent and ongoing research programs. For example:
Pacher, P. A. L., Alex Nivorozhkin, and Csaba Szabó. "Therapeutic effects of xanthine oxidase inhibitors: renaissance half a century after the discovery of allopurinol." Pharmacological reviews 58, no. 1 (2006): 87-114.
Allopurinol: Next Steps
These articles about allopurinol cover a lot of ground, but they reflect just how important allopurinol is to managing gout.
You have learned how allopurinol fixes gout by lowering uric acid, and in other parts of the Gout Treatment section I explain other ways to reduce uric acid.
By now, you should be aware of how important uric acid lowering is, and how important it is to keep checking uric acid levels to ensure that your dosage is correct at different phases of your gout treatment.
Please check with your doctor if you are unsure of any part of your uric acid management plans. If you want help knowing the questions to ask about allopurinol, help to understand your doctor’s advice, or simply want to share your experiences and opinions, please visit the gout remedies forum.
Allopurinol Introduction Related Topics
Please remember: to find more related pages that are relevant to you, use the search box near the top of every page.
Other posts that include these terms:
- High Alkaline Foods for Gout Diet Menu
- Gout Foods Table for Vegetables
- Gout Food List for GoutPal Foodies
- Foods High in Uric Acid Chart
- Purine Rich Foods
- Does Alcohol Affect Gout?
- Colchicine For Gout
Allopurinol Introduction Spelling
Like many medicines, allopurinol is often misspelled. Though spelling is often overrated, it pays to take extra care with medicines, as a misunderstanding might cause treatment problems in the unlikely event of a similar sounding drug being taken mistakenly.
Additionally, bad spelling or using brand names can make searching for information difficult.
I have now moved spelling tips to the allopurinol facts page. So see Allopurinol facts for allopurinal, alupronol, alupurionol, appurinol, puranol, purinal, and purinol.