Allopurinol For Gout

My allopurinol for gout guidelines explain some implications of taking allopurinol for gout.

The main reason for taking allopurinol is to lower uric acid. When it is prescribed correctly, your doctor will take regular blood tests to ensure that your uric acid stays below 6mg/dL. In most cases, the upper limit should be 5mg/dL. For the early months of allopurinol, which is often referred to as the “debulking period,” your target should be much lower than 5mg/dL.

Those are the basic facts about allopurinol for gout. I explain those facts, and others, in detail throughout these allopurinol guidelines. In this page, I look at some practical issues that show why you have to be vigilant about your uric acid level, and your allopurinol dosage.

Despite a half century of allopurinol as the first choice treatment for gout, correct prescribing remains inadequate. In recent years, professional rheumatologists throughout the world have emphasized the need to set safe uric acid levels on a personal basis. Thereafter, physicians should treat-to-target. That is, every gout patient should have a personal target uric acid level, and allopurinol dose should be adjusted to meet that target. In addition, gout patients should:

  • Be pre-screened for genetic liability to Allopurinol Hypersensitivity Syndrome in at-risk ethnic groups (Korean, Han Chinese, and Thai). See Minimize Allopurinol Side Effects
  • Know about the risks of gout flares during the debulking period.
  • Have access to pain prevention or pain treatment during the debulking period.
  • Have kidney function and liver function tests alongside uric acid tests.
  • Have adequate follow-up care for life

Continue reading Allopurinol For Gout

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Allopurinol Introduction

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 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 (XO) inhibitor.

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.

Allopurinol Dosage

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 Dose

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 5mg/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

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 topic for many recent and ongoing research programs.

Allopurinol Misspellings

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.


allo changed to ali, and nol changed to nal.


allo changed to ali.


allo changed to alli, and nol changed to nal.


nal ending changed to nol. This is the most frequent mis-spelling of allopurinol


Missing final l.


This is the correct spelling of allopurinol – the most common gout treatment for lowering uric acid.


purinol changed to purionol [extra o added before nol].


lupo changed to lopu.


lop changed to lup.


allo changed to alo, and purin changed to puren.


allo changed to alo, and nol changed to nal.


allo changed to alo.


allo changed to alu, and puri changed to pro.


Allo changed to Alu, and extra o added before nol.


allo changed to ap.


Purinol is a brand of allopurinol manufactured by Europharm

If you are aware of other alternative spellings, please share them on the gout forum.

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 understanding your doctor’s advice, or simply want to share your experiences and opinions, please visit the gout remedies forum.

Leave The Allopurinol Summary To Browse Other Gout Medications

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Allopurinol Gout Treatment

Allopurinol gout treatment is the most common form of long-term gout treatment. It works by blocking the enzyme, xanthine oxidase, that normally produces uric acid. So it is vital that you have regular uric acid tests whilst on this treatment.

Before you begin taking allopurinol, you must be aware that all uric acid lowering therapies can trigger a painful gout flare. But this will diminish as you keep taking the medication. Because it is caused by uric acid crystals that have accumulated in your body tissue dissolving. So it is vital that you get rid of these crystals to avoid crippling joint damage. Therefore you must manage this pain for the few weeks or months that it takes to dissolve them. See my explanation of allopurinol medication for more details.

See how to start your Allopurinol Gout Treatment

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