Instructions for using Allopurinol to treat gout

The article was professionally consulted by Pharmacist Nguyen Thi Linh - Faculty of Pharmacy - Vinmec Danang International General Hospital.

Allopurinol is a drug that works to reduce uric acid levels in the blood, thereby helping to treat gout, especially chronic gout and related diseases caused by hyperuricemia.

Allopurinol has the main ingredient Allopurinol, which works to reduce the production of uric acid (both in the blood and in the urine). It is this effect that Allopurinol helps prevent or reduce the deposition of urate in the joints and in the kidneys, thereby preventing the occurrence or progression of arthritis in gout and urate nephropathy. In addition, the drug Allopurinol also reduces blood uric acid levels for patients during chemotherapy to treat cancer with increased uric acid.
Allopurinol can be used for a long time to maintain uric acid levels at a stable level to prevent the risk of recurrence of acute gouty arthritis as well as dangerous complications of gout affecting the kidneys.

Allopurinol is used when uric acid levels in the body are higher than normal. In 24 hours, the uric acid level in the urine was measured at 800mg/L in men and 750mg/L in women; Blood levels in men reached 773 mg/L and in women it was 595 mg/L.
In addition, Allopurinol is also used for the purpose of preventing new acute gout attacks. Specifically, for patients who have had an acute gout attack before, after about 3 months of treatment, uric acid levels are likely to increase again and this time it is necessary to use Allopurinol for timely treatment. In such cases, Allopurinol is often used in conjunction with Colchicine or non-steroidal anti-inflammatory drugs to bring uric acid levels back to normal in the most optimal way.

The dose of Allopurinol drug should be paid attention to avoid unwanted side effects, namely:
Use Allopurinol with a low starting dose of 100mg/day, then it can be gradually increased to ensure the return of blood uric acid. to the normal level. Usually increasing to a dose of 200-300mg/day is sufficient, but in some cases it is necessary to increase to a higher dose.
During the treatment with Allopurinol, if there is an acute gout attack, continue to maintain the current dose, in addition to using drugs to treat acute gout.

When using Allopurinol, it should be noted that unwanted effects may occur, including:
Nausea, vomiting Skin rash, itching Causes acute gout attacks Abdominal pain, diarrhea Headache Drowsiness

The drug should be stopped immediately and consult a doctor if any skin reactions such as maculopapular or pruritus, purpura or other signs of hypersensitivity worsening including exfoliative rash, Stevens syndrome - Johnson and toxic epidermal necrolysis (TEN)...
Flu-like symptoms, high fever, skin peeling, widespread erythema, appearance of bullae, purpura, mucosal necrosis, ulcers and ulceration of natural niches, this is a manifestation of Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). It is recorded with a lower rate of 1% but the risk of death is up to 39% because damage can also occur simultaneously on other organs such as liver, kidney ... SJS and TEN due to allopurinol.
SJS and TEN can occur soon after initiation of treatment, with an average duration of about 3-4 weeks and more than 90% occurring within the first 3 months. The risk factor for the onset of SJS and TEN with allopurinol use is a carrier of the HLA-B*58:01 gene. Women are at greater risk than men. Several other factors increase the risk: high dose, impaired renal function, and drug interactions. Allopurinol is one of the effective drugs used in the treatment of chronic gout today. However, the use of the drug needs to be consulted and prescribed by a doctor. This not only makes the treatment effective, but also ensures the safety of the drug.
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