{"id":53425,"date":"2022-09-07T09:19:53","date_gmt":"2022-09-07T13:19:53","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=53425"},"modified":"2022-09-07T09:19:53","modified_gmt":"2022-09-07T13:19:53","slug":"allopurinol-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/allopurinol-side-effects\/","title":{"rendered":"Allopurinol side effects and how to avoid them"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"#common-allopurinol-side-effects\">Common allopurinol side effects<\/a>\u00a0| <a href=\"#serious-side-effects\">Serious side effects<\/a> |\u00a0 <a href=\"#rash\">Rash<\/a> | <a href=\"#diarrhea\">Diarrhea<\/a> | <a href=\"#gout-flare-up\">Gout flare-up<\/a> | <a href=\"#drowsiness\">Drowsiness<\/a> | <a href=\"#liver-problems\">Liver problems<\/a> | <a href=\"#kidney-problems\">Kidney problems<\/a> | <a href=\"#bone-marrow-suppression\">Bone marrow suppression<\/a> | <a href=\"#side-effects-timeline\">Side effects timeline<\/a> | <a href=\"#contraindications\">Contraindications<\/a> | <a href=\"#warnings\">Warnings<\/a> | <a href=\"#interactions\">Interactions<\/a> | <a href=\"#how-to-avoid-side-effects\">How to avoid side effects<\/a> | <a href=\"#how-to-treat-side-effects\">How to treat side effects<\/a><\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/allopurinol\"><span style=\"font-weight: 400;\">Allopurinol<\/span><\/a><span style=\"font-weight: 400;\"> is a generic prescription drug that is classified as a <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/xanthine-oxidase-inhibitors\"><span style=\"font-weight: 400;\">xanthine oxidase inhibitor<\/span><\/a><span style=\"font-weight: 400;\">. It works by reducing the body\u2019s production of uric acid, a normal body waste product. Reducing uric acid helps people with <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/gout-treatment-and-medications\"><span style=\"font-weight: 400;\">gout<\/span><\/a><span style=\"font-weight: 400;\">, a type of <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/arthritis-treatment-and-medications\"><span style=\"font-weight: 400;\">arthritis<\/span><\/a><span style=\"font-weight: 400;\"> caused by a buildup of uric acid. Left untreated, uric acid crystals can form in the joints, causing pain and inflammation.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In addition to treating <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK546606\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">gout<\/span><\/a><span style=\"font-weight: 400;\">, allopurinol is FDA-approved to treat high uric acid levels caused by the treatment of certain blood cancers, such as leukemia. Allopurinol can also treat recurring <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/kidney-stone-treatment-and-medications\"><span style=\"font-weight: 400;\">kidney stones<\/span><\/a><span style=\"font-weight: 400;\"> in people with high levels of uric acid in their urine. Allopurinol can be prescribed as an oral tablet under different brand names, including <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/zyloprim\"><span style=\"font-weight: 400;\">Zyloprim<\/span><span style=\"font-weight: 400;\"> and<\/span><\/a> <span style=\"font-weight: 400;\">Lopurin. It can also be administered as an injection, which may be prescribed under the brand name Aloprim.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Allopurinol is considered an effective, long-term treatment for managing gout. Although it\u2019s generally a safe drug, allopurinol may cause some side effects. Side effects are usually mild when the drug is taken as prescribed. Continue reading to learn more about the side effects of allopurinol.\u00a0<\/span><\/p>\n<h2 id=\"common-allopurinol-side-effects\"><span style=\"font-weight: 400;\">Common side effects of allopurinol<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Most people who take allopurinol as prescribed don\u2019t experience side effects. However, allopurinol can cause side effects that range in severity from mild to serious. You should seek medical attention if side effects persist or worsen. The most common side effects of allopurinol include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Skin rash<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diarrhea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gout flare-ups<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drowsiness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vomiting<\/span><\/li>\n<\/ul>\n<h2 id=\"serious-side-effects\"><span style=\"font-weight: 400;\">Serious side effects of allopurinol<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In rare cases, allopurinol may cause serious side effects. You should consult a healthcare provider if you experience any of the following serious side effects of allopurinol:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe skin rash<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Allergic reaction with signs or symptoms such as rash, trouble breathing, and swelling of the face or throat<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kidney problems, such as kidney failure, damage, or impairment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver problems, such as liver failure, damage, or impairment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low white blood cell counts (leukopenia)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bone marrow suppression<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gastrointestinal problems, such as gastrointestinal bleeding, <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/pancreatitis-treatment-and-medications\"><span style=\"font-weight: 400;\">inflammation of the pancreas<\/span><\/a><span style=\"font-weight: 400;\"> (pancreatitis), and swelling of the tongue or salivary glands<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Respiratory problems, including <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/asthma-treatment-and-medications\"><span style=\"font-weight: 400;\">asthma<\/span><\/a><span style=\"font-weight: 400;\"> and bronchospasm<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Seizures<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Inflammation of the nerves in the arms, feet, hands, and eyes<\/span><\/li>\n<\/ul>\n<h3 id=\"rash\"><span style=\"font-weight: 400;\">Rash<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Skin rash is one of the most common side effects of allopurinol reported. However, it develops in less than 1% of people taking allopurinol and is more likely to occur in people with decreased kidney function or who are also taking certain drugs, such as ampicillin or amoxicillin. Skin rash can indicate a potentially serious or even life-threatening problem. For this reason, always contact a healthcare professional and stop taking allopurinol even if you experience a mild skin rash. Other serious side effects, such as fever, chills, and joint pain, can accompany a skin rash and indicate a serious problem.\u00a0<\/span><\/p>\n<h3 id=\"diarrhea\"><span style=\"font-weight: 400;\">Diarrhea<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Diarrhea is an uncommon side effect of allopurinol, experienced by 1% or less of patients taking the drug. It is not typically life-threatening unless it persists or is watery or bloody. In severe cases, contact a healthcare professional for medical advice.<\/span><\/p>\n<h3 id=\"gout-flare-up\"><span style=\"font-weight: 400;\">Gout flare-up<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Allopurinol may cause acute gout attacks when the drug is first started due to the rapid lowering of uric acid levels. To avoid gout flare-ups, healthcare professionals usually recommend starting allopurinol at <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/allopurinol\/dosage\"><span style=\"font-weight: 400;\">low doses<\/span><\/a><span style=\"font-weight: 400;\">. A healthcare provider may also prescribe <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/colchicine\"><span style=\"font-weight: 400;\">colchicine<\/span><\/a><span style=\"font-weight: 400;\"> or a nonsteroidal anti-inflammatory drug (<\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/nsaids\"><span style=\"font-weight: 400;\">NSAID<\/span><\/a><span style=\"font-weight: 400;\">) at the start of therapy to prevent gout attacks. Flare-ups are temporary and not life-threatening. You should continue taking allopurinol if you experience a gout attack at the start of treatment.\u00a0<\/span><\/p>\n<h3 id=\"drowsiness\"><span style=\"font-weight: 400;\">Drowsiness<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Drowsiness is not commonly experienced by people taking allopurinol. However, driving or operating machinery should be avoided while taking allopurinol until you\u2019re aware of how allopurinol affects you. Talk to a healthcare provider if you experience drowsiness that interferes with your daily activities.<\/span><\/p>\n<h3 id=\"liver-problems\"><span style=\"font-weight: 400;\">Liver problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In rare cases, severe liver problems, such as liver toxicity, have been reported in people taking allopurinol. Liver toxicity, or hepatotoxicity, is usually reversible. Liver enzyme levels may need to be monitored, especially in people with liver disease, as allopurinol may cause elevations in liver enzyme levels.<\/span><\/p>\n<h3 id=\"kidney-problems\"><span style=\"font-weight: 400;\">Kidney problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Kidney failure, although rare, has been reported in people taking allopurinol, especially those with pre-existing kidney problems. People with kidney problems may need to be started on lower doses than normal and monitored throughout treatment with allopurinol. Elevated blood urea nitrogen (BUN) levels have been reported in people with kidney disease who take allopurinol.\u00a0<\/span><\/p>\n<h3 id=\"bone-marrow-suppression\"><span style=\"font-weight: 400;\">Bone marrow suppression<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">People taking other drugs along with allopurinol have experienced bone marrow suppression as early as 6 weeks to as long as 6 years after starting allopurinol. Bone marrow suppression is a decrease in the production of blood cells in the bone marrow.\u00a0<\/span><\/p>\n<h2 id=\"side-effects-timeline\"><span style=\"font-weight: 400;\">How soon do allopurinol side effects start?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The side effects of allopurinol can develop early during treatment. For example, gout flare-ups typically occur at the start of treatment as uric acid levels rapidly drop. Allergic reactions, such as rash, itching, and trouble breathing, can develop right after the first dose. However, other serious side effects, such as liver problems, could take weeks to months to appear with symptoms.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">How long do allopurinol side effects last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Most side effects of allopurinol, such as nausea and drowsiness, are mild and go away after treatment is discontinued. Severe side effects, such as severe allergic reactions, liver or kidney problems, and blood cell problems, may take weeks, months, or sometimes years to recover from. If mild side effects don\u2019t resolve within one to two weeks, consult a healthcare provider for medical advice.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What are the long-term side effects of allopurinol?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Allopurinol is considered a safe, long-term treatment for gout. Studies evaluating the long-term use of allopurinol have found that the <\/span><a href=\"https:\/\/ard.bmj.com\/content\/annrheumdis\/29\/1\/89.full.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">risk of toxicity<\/span><\/a><span style=\"font-weight: 400;\"> with allopurinol is low. The drug also remains effective for long-term use, with studies showing that long-term allopurinol treatment reliably helps <\/span><a href=\"https:\/\/www.jrheum.org\/content\/early\/2022\/06\/24\/jrheum.220270\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">reduce gout flare-ups<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h2 id=\"contraindications\"><span style=\"font-weight: 400;\">Allopurinol contraindications<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Allopurinol is contraindicated in people who have had a hypersensitivity reaction to the drug.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Pregnancy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Allopurinol is prescribed cautiously and only as needed to pregnant women. There are no adequate studies that conclude whether allopurinol is safe in pregnant women. However, animal studies and limited human studies indicate that allopurinol may cause harmful effects in an unborn baby. Consult a healthcare provider before taking allopurinol while pregnant.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Breastfeeding<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Allopurinol has been shown to pass through breast milk in mothers taking allopurinol. However, the exact effects of allopurinol in nursing infants is not known. Although allopurinol does not necessarily have to be discontinued while breastfeeding, healthcare providers may suggest <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501198\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">monitoring the nursing infant for potential problems<\/span><\/a><span style=\"font-weight: 400;\">, particularly allergic reactions such as skin rash.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Children<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Allopurinol is rarely used in children. However, it may be used to treat high uric acid levels in children with certain cancers who are receiving chemotherapy or children with purine metabolism problems. <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=9ae58f3c-dbf9-4c10-9b79-233b10e0e9f1\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Allopurinol IV injections<\/span><\/a><span style=\"font-weight: 400;\"> have been studied in children and found to be safe and effective.<\/span><\/p>\n<h2 id=\"warnings\"><span style=\"font-weight: 400;\">Allopurinol warnings<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Even though allopurinol side effects are uncommon, allopurinol may cause problems in people with pre-existing medical conditions or who are taking certain types of drugs.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Cautions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Allopurinol can build up in the body in people with liver disease or kidney disease, so dose adjustments or extra monitoring may be required.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In rare cases, some people may experience a potentially fatal adverse effect of allopurinol called allopurinol hypersensitivity syndrome, or AHS. Some people carry a gene variant called HLA-B*5801 that puts them at an increased risk for AHS. People who are positive for the HLA-B*5801 gene may be recommended to avoid the use of allopurinol. Some groups of people are more likely to carry this gene than others, including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Africans and African-Americans<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Asians (Han Chinese, Korean, Thai, etc.)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Native Hawaiians and Pacific Islanders<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Extra monitoring may be recommended for people who are at an increased risk of allergic reactions to allopurinol.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Abuse and dependence<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Allopurinol does not carry a risk for abuse, physical dependence, or withdrawal.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Overdose<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Contact a poison control center or get emergency medical care if an overdose of allopurinol is suspected. An overdose of allopurinol can be fatal and require immediate medical attention. The maximum dosage of allopurinol is 800 mg per day.\u00a0<\/span><\/p>\n<h2 id=\"interactions\"><span style=\"font-weight: 400;\">Allopurinol interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Like many other prescription drugs, allopurinol can interact with certain medications and substances. In some cases, drug interactions can decrease the effectiveness of allopurinol. In other cases, drug interactions can increase the risk of adverse effects.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Problems can occur when allopurinol is combined with:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/anticoagulants\"><span style=\"font-weight: 400;\">Anticoagulants<\/span><\/a><span style=\"font-weight: 400;\">: Allopurinol may increase levels of anticoagulants, such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/warfarin-sodium\"><span style=\"font-weight: 400;\">warfarin<\/span><\/a><span style=\"font-weight: 400;\">, which can increase the risk of bleeding problems.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Certain antibiotics: There is an increased risk of skin rash when allopurinol is combined with drugs like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ampicillin\"><span style=\"font-weight: 400;\">ampicillin<\/span><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/amoxicillin\"><span style=\"font-weight: 400;\">amoxicillin<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Certain immunosuppressants: Some immune suppressants, particularly <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/azathioprine\"><span style=\"font-weight: 400;\">azathioprine<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/mercaptopurine\"><span style=\"font-weight: 400;\">mercaptopurine<\/span><\/a><span style=\"font-weight: 400;\">, and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/cyclosporine\"><span style=\"font-weight: 400;\">cyclosporine<\/span><\/a><span style=\"font-weight: 400;\">, may require a lower dose to prevent toxicity and serious side effects when combined with allopurinol.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/thiazide-diuretics\"><span style=\"font-weight: 400;\">Thiazide diuretics<\/span><\/a><span style=\"font-weight: 400;\">: Thiazide diuretics, such as hydrochlorothiazide, may increase <\/span><a href=\"https:\/\/www.jaad.org\/article\/S0190-9622(79)70031-4\/pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">the risk<\/span><\/a><span style=\"font-weight: 400;\"> of severe hypersensitivity reactions with allopurinol.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Antacids: Aluminum hydroxide, found in antacid products like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/maalox\"><span style=\"font-weight: 400;\">Maalox<\/span><\/a><span style=\"font-weight: 400;\">, may decrease the body\u2019s absorption of an oral dose of allopurinol. Allopurinol should be taken at least three hours before or after taking an antacid.\u00a0<\/span><\/li>\n<\/ul>\n<h2 id=\"how-to-avoid-side-effects\"><span style=\"font-weight: 400;\">How to avoid allopurinol side effects<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Fortunately, serious side effects of allopurinol are rare and often reversible. Some of the side effects, however, can be worrisome for some people. Taking allopurinol as prescribed and following a few good medication practices may help lower the risk of serious side effects.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1. Discuss your medical history with your prescriber<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">For a drug like allopurinol, one of the surest ways to avoid side effects is to discuss your complete medical history with the prescribing healthcare provider. Some medical conditions, such as liver or kidney disease, may increase the risk of side effects with allopurinol. Make sure the prescriber knows about any of the following problems you may have:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Allergic reactions to allopurinol<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kidney disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heart failure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">An active gout attack<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">2. Tell the prescriber about any medications you take<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Another way to avoid problems with allopurinol is to give the prescriber a complete list of prescription drugs, over-the-counter drugs, and dietary supplements you take.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To prevent certain side effects, your healthcare provider may recommend adjusting doses, avoiding certain medications, or adjusting the timing of your medications. Tell your doctor if you take any of the following medications:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chemotherapy drugs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Immunosuppressants<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blood thinners<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Antibiotics<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Antacids<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Thiazide diuretics<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">3. Take allopurinol as instructed<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Follow the instructions given by your prescriber or printed on the prescription label. If you miss a dose, take the dose as soon as you remember. If it\u2019s almost time for the next dose, skip the missed dose and take the next dose as scheduled. Never take two doses to make up for a missed dose.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">4. Avoid driving or other risky activities<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Although uncommon, allopurinol may cause drowsiness. When first taking this medicine, ease off on driving, operating machinery, or engaging in potentially hazardous activities that require alertness and focus.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">5. Take allopurinol with a meal<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Allopurinol may be better tolerated when taken with a meal. Taking allopurinol with food may help prevent certain gastrointestinal side effects, such as nausea.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">6. Drink plenty of fluids<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">It\u2019s important to drink plenty of fluids with allopurinol to prevent potential kidney problems and ensure the drug remains effective. It is recommended to drink at least 2 liters (68 ounces) of fluids each day while taking allopurinol.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">7. Avoid heavy alcohol consumption<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Alcohol is known to cause <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3991555\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">increased uric acid levels<\/span><\/a><span style=\"font-weight: 400;\"> that may lead to a gout flare-up. The risk of a gout attack can increase with higher consumption of alcohol. Try to limit your alcohol intake while taking allopurinol, especially if you\u2019re just starting treatment.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">8. Avoid certain antacids<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Check the active ingredients of over-the-counter antacids. Any antacids that contain aluminum hydroxide may decrease your body\u2019s ability to absorb allopurinol. If you need to take an antacid, don\u2019t take a dose of allopurinol three hours before or three hours after taking the antacid.<\/span><\/p>\n<h2 id=\"how-to-treat-side-effects\"><span style=\"font-weight: 400;\">How to treat side effects of allopurinol<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Fortunately, most people don\u2019t experience side effects when using allopurinol. In general, the side effects of allopurinol are mild. However, you should contact a healthcare provider or seek immediate medical attention if you experience side effects that are serious or particularly unusual.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Gout flare-up<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Contact your healthcare provider for guidance if you experience a gout flare-up while taking allopurinol. Your healthcare provider will typically recommend continuing treatment with allopurinol. They may also recommend an NSAID or colchicine to prevent a gout flare-up when first starting treatment with allopurinol.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Skin rash<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Stop taking allopurinol and contact your healthcare provider. A skin rash may be an early sign of a severe hypersensitivity reaction. If you experience fever, chills, joint pain, trouble breathing, or swelling of the face or throat, seek medical attention immediately.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Liver problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Stop taking allopurinol and contact a healthcare professional if you experience signs of a serious decline in liver function including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Yellowing of the skin or eyes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Smelly or dark urine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pale or clay-colored stools<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight loss<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loss of appetite<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pain in the upper right area of the stomach region<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe tiredness<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Kidney problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Stop taking allopurinol and contact a healthcare professional if you experience signs of a serious kidney problem including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Decreased urination<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Painful urination<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blood in the urine<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Allergic reactions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The most serious side effects of allopurinol include allergic reactions. Stop taking allopurinol and contact your healthcare provider if you experience signs or symptoms of an allergic reaction including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Skin rash (even a mild skin rash)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fever<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling of the face<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Enlarged lymph nodes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blisters<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Trouble breathing<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">Sources<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501198\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Allopurinol<\/span><\/a><span style=\"font-weight: 400;\">, Drugs and Lactation Database<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/online.epocrates.com\/drugs\/12901\/allopurinol\/Adult-Dosing\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Allopurinol<\/span><\/a><span style=\"font-weight: 400;\">, Epocrates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK499942\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Allopurinol<\/span><\/a><span style=\"font-weight: 400;\">, StatPearls<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.pdr.net\/drug-summary\/Zyloprim-allopurinol-816.988\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Allopurinol drug summary<\/span><\/a><span style=\"font-weight: 400;\">, Prescriber\u2019s Digital Reference<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=19a138b8-d225-03e6-f762-abe71560204b\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Allopurinol tablet prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=9ae58f3c-dbf9-4c10-9b79-233b10e0e9f1\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Allopurinol sodium injection prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1767024\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Effect of allopurinol on mortality and hospitalisations in chronic heart failure: a retrospective cohort study<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Heart<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK546606\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Gout<\/span><\/a><span style=\"font-weight: 400;\">, StatPearls<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/ard.bmj.com\/content\/annrheumdis\/29\/1\/89.full.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Long-term use of allopurinol in the treatment of gout<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Annals of Rheumatic Diseases<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.jaad.org\/article\/S0190-9622(79)70031-4\/pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">The allopurinol hypersensitivity syndrome<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Journal of the American Academy of Dermatology<\/span><\/i><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Common allopurinol side effects\u00a0| Serious side effects |\u00a0 Rash | Diarrhea | Gout flare-up | Drowsiness | Liver problems | Kidney problems | Bone marrow suppression | Side effects timeline | Contraindications | Warnings | Interactions | How to avoid side effects | How to treat side effects Allopurinol is a generic prescription drug that [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":53435,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[790,12752],"coauthors":[8861],"class_list":["post-53425","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-chronic-disease","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Allopurinol side effects and how to avoid them | SingleCare<\/title>\n<meta name=\"description\" content=\"Rash, diarrhea, and gout flare-up are common allopurinol side effects. 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