What does Allopurinol do?

Allopurinol inhibits the formation of uric acid in the body. It is commonly used to prevent gout and certain types of kidney stones. By reducing uric acid production, it helps prevent gout attacks and the formation of crystals in joints.

How does Allopurinol reduce uric acid levels?

Allopurinol reduces uric acid levels by inhibiting xanthine oxidase, an enzyme involved in converting hypoxanthine and xanthine into urate. By blocking this enzyme, it decreases uric acid production.

What happens to Allopurinol once it is in the body?

Once in the body, Allopurinol acts on xanthine oxidase, reducing uric acid production. This lowers the concentration of uric acid in the blood and urine, which helps prevent the formation of crystals that can lead to gout or kidney stones.

How do Allopurinol and febuxostat differ in their mechanism of action?

Allopurinol is a purine analogue that competitively inhibits xanthine oxidase, whereas febuxostat is a non-purine selective xanthine oxidase inhibitor. Febuxostat is often used for patients who cannot tolerate Allopurinol.

What should I not do while taking Allopurinol?

While taking Allopurinol, avoid alcohol as it can increase uric acid levels and trigger gout attacks. High-purine foods like red meat, organ meats, and certain seafood should also be avoided. Allopurinol may interact with other medications and supplements, so always consult your doctor about potential interactions.

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3.5 Minute

18-07-2024 Team Medicover General Medicine

Allopurinol Mechanism of Action: How It Works and Uses

Allopurinol is the standard medical therapy for treating gout (and some types of kidney stones). It functions by decreasing the production of uric acid in your body that can cause gout attacks and improving kidney function. What are the uses & dosage? Who cannot take Allopurinol? What could happen? We will also briefly discuss how a similar drug, Probenecid, works.

What is Allopurinol?

Allopurinol is a member of the xanthine oxidase inhibitor drug class. It is primarily used to treat hyperuricemia, a disorder marked by elevated blood uric acid levels. Allopurinol works to reduce the levels of uric acid, which helps lower gout attacks and prevent kidney stones made from uric acid.

How Does Allopurinol Work?

Allopurinol prevents the action of the Xanthine oxidase enzyme, which is involved in the production of uric acid. The enzyme xanthine oxidase then converts xanthine to uric acid. Allopurinol treats gout by inhibiting this enzyme; once the activity of an enzyme in charge of a step on the pathway leading to uric acid is stunted or stopped, less and subsequently lower levels can be produced.

The Role of Uric Acid

For those who did not know, uric acid is the by-product that the kidneys usually excrete. When uric acid levels rise, though, it starts to crystallize in joints and tissues, thus triggering gout. Kidney stones can also form if there are high uric acid levels. Allopurinol prevents these conditions by reducing the production of uric acid.

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Uses of Allopurinol

Uses of Allopurinol Key Takeaways

Allopurinol is commonly prescribed to prevent gout flares by lowering the levels of uric corrosive.
It is used to prevent kidney stones from uric acid.
Cancer Treatment: This treatment is used to prevent elevated blood uric acid levels and urine that may occur because of cancer treatment.

Allopurinol tablets are usually administered orally and can be used by adults and children. The dosage varies with the condition and response of the patient to the medication.

Allopurinol Dosage

The appropriate dose of Allopurinol depends on several factors, such as the patient's condition and age. A few rules of thumb:

For Gout Dose - Initial: 100mg once daily.
Maintenance Dose: It may be increased gradually (up to 300 mg/day) according to the serum urate level and patient's response.
For Kidney StonesInitial: 200 to 300 mg per day

Special Considerations

Geriatric patients: These drugs are recognized to be significantly eliminated by the kidney, and the possibility of negative effects may be greater in elderly patients with impaired renal function; the possibility of reduced clearance must also be considered.
Children: A dose for children is typically based on weight and the particular medical condition your doctor wants to treat

Allopurinol Contraindications

Allopurinol may be safe for most people; however, a few contraindications need to be considered.

Hypersensitivity: Allopurinol, like all other medications, can also cause an allergic reaction.
Acute gout attack: Once you have an acute flare-up of your painful joints, it is unsafe to start on Allopurinol as this will provoke or worsen the fit.
Renal Impairment: In severe renal impairment, dose adjustment or the use of an alternative treatment may be required.

Allopurinol Side Effects

Allopurinol has side effects, like everything else. However, these are mild and usually resolve on their own.

Gastrointestinal: Nausea, vomiting or diarrhea.
Cutaneous Reactions: Rash and pruritus may occur; rarely, hypersensitivity reactions and cases of Stevens-Johnson syndrome.
Sleepiness: Some patients notice they are tired or dizzy.

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Serious Side Effects

Liver: Abnormal liver enzyme tests and, in rare cases, more severe problems with the liver itself.
Low blood cell count: Hence increased risk of infections and bleeding due to bone marrow suppression.

Such drugs will additionally benefit those suffering from gout who have to take Probenecid. It does this in a way that is different from Allopurinol and acts by increasing the excretion of uric acid throughout your kidneys. Here's how it works:

How Probenecid Works?

Probenecid inhibits the reabsorption of uric acid in the kidneys, which increases urinary excretion. This reduces the uric acid levels in the blood and decreases gout attacks.

Uses of Probenecid

Gout: Probenecid is applied to reduce uric acid in the body when frequent gout has occurred.
Combining Antibiotics: It can be utilized to increase the effect of certain antibiotics by being given orally one to a few hours before doses for antibiotic elution (urinary excretion).

Allopurinol plus Probenecid

Occasionally, Allopurinol and Probenecid are prescribed together to control gout. For patients for whom neither medication helps nor does it help alone, this combination may be particularly effective. That said, the combination of these medications should be care-directed to avoid excessive adverse reactions.

Conclusion

Allopurinol is a medicine used to manage high levels of uric acid in certain conditions, such as gout and kidney stones. By understanding how it works, what dose to take, and the risk of side effects or toxicity, patients can use Allopurinol appropriately. In addition, understanding similar medications such as Probenecid offers greater insight into managing gout and other hyperuricemic states.

If you have any questions or concerns about Allopurinol, consult your healthcare provider for individualized information and guidance.

Frequently Asked Questions

Allopurinol inhibits the formation of uric acid in our body. The most common uses are to prevent gout and some types of kidney stones. Allopurinol also reduces uric acid production, so it helps to stop attacks of gout and the formation of crystals in your joints.

Allopurinol decreases the level of uric acid by inhibiting xanthine oxidase (which converts hypoxanthine and xanthine into urate). Allopurinol works by reducing the activity of an enzyme in your body that is involved in producing uric acid.

It acts on xanthine oxidase, an enzyme that then decreases uric acid production. This works to reduce the amount of uric acid in your blood and urine; these are substances that may form crystals when concentrated at high levels, leading to gout or kidney stones.

However, allopurinol is a purine analogue that competitively inhibits xanthine oxidase, while febuxostat is a non-purine selective XO inactivator. Febuxostat is commonly used for patients who cannot tolerate Allopurinol.

Avoid drinking alcohol as it raises uric acid and can cause gout attacks. Also, high-purine foods (red meat, organ meats and some seafood) should be avoided since they increase uric acid levels. Allopurinol can also interact with other drugs and supplements, so always ask your doctor about safety.

Disclaimer: The information provided is accurate and up-to-date to the best of our knowledge. However, it should not be considered a substitute for medical advice or consultation. We do not guarantee its completeness or accuracy. The absence of specific warnings does not mean a medicine is safe for all users. We are not responsible for any outcomes based on this information and strongly recommend consulting a doctor for any medical concerns or questions.