Are allopurinol side effects dangerous?
In rare cases, they can be, but you have to balance the risks of allopurinol side effects against the benefits of uric acid reduction.
High uric acid is a dangerous health risk, as gout will progressively destroy joints and cause kidney disease, heart disease, and other organ failure.
Let’s look at how to plan allopurinol properly to avoid bad reactions and manage uric acid lowering safely.
Allopurinol Side Effects
In addition to ‘official’ reported allopurinol side-effects, several contributors have noted other issues in the gout cures forum. There are major problems with identifying true side-effects, and simply associating random changes with a new gout medication.
The nature of all urate lowering treatments is a tendency to induce gout flares in the first few months. This happens as old uric acid crystals start to dissolve, and your immune system reacts to the partially dissolved crystals. The associated feverishness, and anxiety because of the changes in your body, are natural reactions to lowering uric acid. They should pass in a few days or weeks, but you should discuss all side effects with your doctor.
It is natural human behavior to try and associate events, therefore there is a tendency to attribute coincidental feelings of ill health with your new medication. Again, this should soon pass, but if any problems persist, you must report them to your doctor.
In normal circumstances, you should not stop taking allopurinol once started, but if you cannot tolerate it, then speak to your doctor about other urate lowering gout medications.
Serious Side Effects Of Allopurinol
Serious side-effects of allopurinol are rash or other sign of an allergic reaction such as difficulty in breathing, hives, or swollen face, lips, tongue or throat. If you experience any of these when you start allopurinol, then stop the treatment immediately and seek urgent medical advice. The risk of serious side effects is reduced if allopurinol is managed properly from the start.
Minimize Allopurinol Side Effects
The expert recommendations for allopurinol have been revised recently, and more investigations of allopurinol safety are in progress, so guidelines may change again. The essence of all recent recommendations is to start with a low dose, then increase until target uric acid levels are met, as described elsewhere in these allopurinol pages. More importantly, certain ethnic groups have been identified as carrying a higher risk of Allopurinol Hypersensitivity Syndrome. Your doctor can now arrange genetic screening if you are in a high-risk group, before prescribing allopurinol. If your genetic profile suggests you are at risk from serious side effects, then alternatives, such as Uloric, can be prescribed.
See Minimize Allopurinol Side Effects for more details.
Other Allopurinol Side Effects
There are many reported side effects, some of which are believed to be caused by allopurinol, and some where a link cannot be found. As with any medicine, you should consult your doctor as soon as you notice any possible bad reaction.
For less serious reactions such as: vomiting, diarrhea; drowsiness, headache; changes in your sense of taste; or muscle pain, you have to weigh the inconvenience of the side effect against the benefits of safe uric acid levels.
For more serious allopurinol side effects, you must stop treatment and consult your doctor. These include:
- fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
- the first sign of any skin rash, no matter how mild;
- pain or bleeding when you urinate;
- nausea, upper stomach pain, itching, loss of appetite, weight loss, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- urinating less than usual or not at all;
- joint pain, flu symptoms;
- severe tingling, numbness, pain, muscle weakness;
- easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin
There are more details of possible allopurinol side effects related to the following parts of the body:
- Whole body
- Heart and blood vessels
- Stomach and intestines
- Blood and lymph
- Muscles and skeleton
- Skin and extremities
- Urine and genitals
There is also more general information about medicines for gout, and how to manage them, in the rest of this Gout Treatment section.