This is how Allopurinol works against gout

Allopurinol is used to treat chronic gout diseases. The active ingredient ensures that the uric acid concentration in the blood is lowered. As a result, the remedy can prevent an acute gout attack. Allopurinol is considered to be well-tolerated, but side effects may occur while taking it. Common complaints include gastrointestinal problems and allergic skin reactions. Learn more about the effects, side effects and dosage of Allopurinol.

Effect of allopurinol in gout

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

Allopurinol belongs to the so-called Urikostatika, which inhibit the degradation of purines to uric acid. This happens because the drug blocks a specific enzyme (xanthine oxidase) that is needed for its breakdown. If the purines can no longer be broken down to uric acid, the uric acid level in the blood drops. In addition, existing deposits in the tissue can be reduced. Instead of uric acid, more xanthine is produced by ingesting the active ingredient - a precursor of uric acid, which can be cleared from the organism much faster via the kidney.

For gout, allopurinol is recommended from a uric acid concentration of 8.5 milligrams / 100 milliliters of blood. In addition to gout, the drug is also used to treat other diseases. It is used, among other things, for kidney damage caused by uric acid or secondary hyperuricemia. It is also used to treat certain enzyme deficiency disorders associated with elevated uric acid levels.

Side effects of Allopurinol

The drug is generally considered to be well-tolerated, although side effects may occur while taking allopurinol. Thus, at the beginning of therapy by the drug an acute attack of gout can be triggered. It can also cause nausea, nausea and diarrhea. Likewise, allergic skin reactions such as itching, redness and swelling are possible.

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

In rare cases, additional side effects may occur while taking Allopurinol. These include headache, fever, joint pain, seizures and kidney inflammation. Since dizziness, drowsiness and movement disorders are also possible side effects, you should not drive or use an electrical machine after taking the drug. Also avoid activities where you do not have a firm grip.

Dose allopurinol correctly

Allopurinol is taken in the form of tablets. The tablets contain either 100 or 300 milligrams of allopurinol. Usually started with 100 milligrams and the dose is then slowly increased if necessary. In some 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 you have gastrointestinal problems, you should take the dose throughout the day. It is important that the level of uric acid is checked regularly during treatment and that the dose may be adjusted.

In 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: Nothing for pregnant women

Although allopurinol is well tolerated, you should not use the active ingredient under certain circumstances. This is the case, for example, when there is hypersensitivity to the active ingredient. Likewise, pregnant women should refrain from taking it, since there is not enough experience for them so far. Even during lactation, the drug is contraindicated as it passes into breast milk.

If you have certain illnesses, you must take special precautions: if you have a blood disorder, check the blood count regularly. In kidney disease, however, the dose taken must be reduced. This is because Allopurinol is excreted by the kidneys and the length of stay in the body is prolonged in a kidney disease. Even with limited liver function, the dose may need to be adjusted.

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, it may happen that even more uric acid crystals are formed. This can prolong or aggravate the seizure.


When allopurinol is taken with certain other medicines, interactions may occur. Thus, the effect of the gout agent is reduced by drugs such as benzbromarone, etacrynic acid, probenecid, sulfinpyrazone and thiazines. On the other hand, chloropropamide, cyclosporin, phenytoin and theophylline, as well as coumarin-type anticoagulants, potentiate the action of allopurinol.

Allopurinol itself also affects other medicines. It strengthens or extends the effects of drugs containing chlorpropamide, phenprocoumon, salicylic acid, theophylline and vidarabine. Also anticoagulants can be strengthened in their effect. In contrast, allopurinol slows down the excretion of probenecid.

The active substance should also not be taken together with antibiotics such as ampicillin or amoxicillin. Otherwise, rashes can occur. Even with cytostatics, the gout should not be combined, otherwise it can lead to changes in the blood picture. If cytostatic drugs have to be taken, a significant dose reduction is usually necessary.

For a full list of all side effects, contraindications and interactions of and with allopurinol, see the package leaflet that came with your medicine.

Instructions for taking Allopurinol

The following behaviors can help you with allopurinol therapy:

  • Eat well and healthy. Avoid purine-rich foods such as offal, legumes, fish or alcohol.
  • Drink a lot, preferably water or herbal teas
  • Try to reduce your weight slightly if you are overweight.
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