PHARMACIST Fi shares the very clever way allopurinol works to reduce uric acid level for people with gout (if it is suitable for them), then shares 5 ways to try to achieve allopurinol treatment success and minimize risk of rare potentially serious side effects ('rare' meaning that less than 1 in 1000 people who take allopurinol get a serious drug reaction).

Here is the link to the playlist of PHARMACIST Fi videos about gout, and gout treatment medicines which may or may not be prescribed (depending on a person's other medical conditions, other medicines, and kidney and liver function levels): https://www.youtube.com/playli....st?list=PLwyYRbsDY3j

Please note that the next paragraphs (below this paragraph) are for doctors, so if you are a person with gout who is taking allopurinol: DON'T make any changes to your allopurinol dose unless you have been advised to do so by your doctor, because sudden increases OR decreases in allopurinol dose may trigger gout attacks (also called gout flares) in some people during the early months of allopurinol treatment when urate crystals are still being melted (but you are welcome to give the information below to your doctor, so they can discuss it with you and consider whether or not it might be relevant to your allopurinol dose schedule).

INFO FOR DOCTORS
If you are a doctor, you might find the following info interesting:
In recent years, new dose schedules for the urate-lowering medicine allopurinol are in prescribing guidelines for doctors in places like Australia.
On 18 March 2023, one of the dose schedule options in Australia's Therapeutic Guidelines is (if allopurinol is considered suitable for a particular person with gout who has no kidney problems):
*start the person with gout on allopurinol 50mg once daily for 4 weeks,
*then increase the person's daily dose by 50mg each fortnight or month (depending on their tendency to gout flares) until the person's uric acid level reaches target treatment level for their particular gout presentation (e.g. less than 0.36mmol/L (less than 6mg/dL) if the person has no tophi, or less than 0.3mmol/L (less than 5mg/dL) if the person has any tophi). Please note: this schedule is for people without kidney impairment; lower start dose and slower dose increases with close kidney monitoring are used for people with significant kidney impairment (please see Australian Medicines Handbook 2023 for details).
During this gradual allopurinol dose-increasing process, the Australian Medicines Handbook 2023 recommends serum uric acid testing every 2 to 5 weeks.
It is hoped that by starting with a lower allopurinol dose, then increasing the allopurinol dose less often and by smaller amounts (until serum uric acid target is reached), this modern allopurinol dose schedule may reduce risk of gout flares early in urate-lowering therapy with allopurinol (via smaller uric acid level changes), and also reduce risk of rare, serious potential side effects like allopurinol hypersensitivity syndrome. However, even with this modern allopurinol dose schedule, it is still currently recommended that the person with gout also take an anti-inflammatory medicine to prevent gout flares (if suitable for their medical conditions, kidney & liver function, & medicines; e.g. colchicine or NSAID, if suitable) during the early phase of allopurinol treatment when their uric acid level is changing and urate crystals have not yet been completely dissolved.

When allopurinol's dose has been gradually increased enough to enable a person with gout's serum uric acid level to decrease down to the 'target level' and stay there consistently, allopurinol is then continued at that dose (the 'maintenance dose' for that person), with blood tests once or twice per year to check whether that dose is keeping their serum uric acid level consistently at target level, or whether any dose adjustment might be needed (for example, if the person's usual drinks & foods or kidney function have changed since the last uric acid blood test, these factors might potentially change their uric acid level - especially if they have slower uric acid transporters in their kidneys or intestines [due to genetics] making them slower to get rid of uric acid than other people).
(Australian Medicines Handbook 2023, Australia's Therapeutic Guidelines 2023)

We hope you found this video helpful.
Please also see disclaimer at the end of this video.
Reference for xanthine oxidase molecule image:
RCSB ID: 8HXM Okamoto, K., Sekine, M., Ministry of Education, Culture, Sports, Science and Technology (Japan), Bovine Xanthine Oxidoreductase Crystallized with oxypurinol (2023)
https://doi.org/10.2210/pdb8HXM/pdb
Mol* Viewer: modern web app for 3D visualization and analysis of large biomolecular structures (2021) Nucleic Acids Research49:W431-W437 https://doi.org/10.1093/nar/gkab314
RCSB.org The Protein Data Bank (2000) Nucleic Acids Research 28: 235-242 https://doi.org/10.1093/nar/28.1.235.

0 Comments

Up next

Autoplay

Effexor for Anxiety—2 Month Update (Side Effects, Success Story)

1 Views . 08/29/25 Side Effects

Please note that if you are under 18, you won't be able to access this site.

Up next

Allopurinol for Gout: How Does that Work?! - Plus 5 tips for Treatment Success

Up next

Language