Medications prescribed for treating gout include xanthine oxidase inhibitors that work by reducing the levels of urinary/serum uric acid. Allopurinol, belonging to this category of medications is also used for treating kidney stones of specific types. Additionally, the medication is also used on patients undergoing chemotherapy, where there is a need to control levels of uric acid. While the desired outcomes and the mechanism of action of the medication make it suitable for treating the above conditions, there are other undesirable outcomes. This is common to all medications, and allopurinol is no exception. Here is an in depth look at side effects of allopurinol and tips to ease and mitigate the adverse effects.
Overview and side effects of allopurinol
As mentioned above, the medication is used for controlling/reducing uric acid levels. In cancer patients, there is the possibility of an increased in uric acid levels, as the cancer cells are likely to release uric acid as the cells die. By reducing the uric acid levels in the body, allopurinol helps combat the conditions that are attributed to high levels of uric acid. Before we look at the side effects of allopurinol it is necessary to understand how certain medical conditions manifest. This will help in a better grasp of the condition and the manner in which the medication handles the condition, and the ensuing side effects.
For instance, gout is attributed to a deposit of urate in the tissues of the body, specifically around the joints. By controlling urate levels through medications including allopurinol, it is possible to manage gout. Similarly, formation of certain types of kidney stones are attributed to high levels of uric acid, and by controlling the levels, desired outcomes are achieved.
Preventing side effects of allopurinol through the right dosing
One of the most commonly attributed reasons for side effects of allopurinol is incorrect dosage and improper use of the medication. Sticking to the right dosage and recommendations, will help to significantly reduce complications. Remember, the dosage instructions mentioned here are mainly for the purpose of reference. The actual dosage will depend on the specific condition of the patient and various other parameters that can only be determined by a detailed diagnosis. Specialists recommend dosages after assessing various parameters, and this compilation is intended only to show the average doses and not the specific dosages. The strength, the frequency and the duration of the treatment regimen hinge on the condition and other factors, determined by diagnostics and evaluation.
#1 Recommended dosages for adults with gout. Adults diagnosed with gout are typically recommended an initial dose anywhere between 100 milligrams to 300 milligrams daily that could be bet either taken in a single dose or spread between multiple doses. The dosage is not to exceed 800 milligrams per day under any circumstances.
#2 Recommended dosages for adults undergoing chemotherapy. Adults undergoing chemotherapy are recommended doses anywhere between 600 milligrams to 800 milligrams per day. This is usually recommended for a period of three days.
#3 Recommended dosages for adults with kidney stones. Adults diagnosed with kidney stones are recommended a dosage anywhere between 200 milligrams to 300 milligrams daily. The medication is either taken in a singe dose or divided into multiple doses. Here again, the maximum dosage per day does not exceed 800 milligrams.
#4 Dosage for children – For children, the safe or recommended dosage reference limits are presently not available, and are guided by specific medical advice. In the case of youngsters undergoing chemotherapy, there are recommended dosages.
Compilation of undesirable or side effects of allopurinol
With the above information out of the way, it is time to look at the side effects of allopurinol. Here is a compilation of possible side effects that may be experienced when on the medication. Before we dive into the undesirable effects, it is necessary to point out a disclaimer. The compilation does not necessarily indicate that all patients will experience all of the side effects. There is every possibility that some patients may not experience any undesirable effects. There is also the possibility that some patients may experience only mild or moderate undesirable effects. The actual effects differ from person to person, in terms of the intensity, the duration and the type of intervention required.
Most commonly reported side effects of allopurinol
The most commonly reported side effects of allopurinol include pain in the joints or unusual stiffening of the joints. This may or may not be accompanied by swelling in the joints. Individuals are likely to experience pain in the ankles, or in the knees when on the medication. One of the unusual side effects of the medication includes pain in the great toe joint. Many patients have reported outbreak of rashes on the skin as a result of the medication. There is also a possibility of rashes breaking out with the formation of flat lesions that may be slightly raised when compared with surrounding skin.
Rarely reported side effects of allopurinol
While the above-mentioned side effects of allopurinol are commonly reported, there are other undesirable effects that are rare in occurrence. For instance, individuals are likely to experience some kind of agitated feeling when on the medication. This is attributed to the mechanism of action of the drug. There is a possibility among a small section of patients to pass blood in stools or in urine. Patients with this side effect are likely to observe darkened stools, or tarry stools as an indication of bleeding. Similarly, there is also the possibility of patients ending up with a bleeding nose.
Other rare side effects of allopurinol include bleeding in the gums that is not attributed to any other dental condition or bruising. The patient is also likely to frequently suffer from bruising of the skin, if the rare side effect manifests. In such instances, the skin may peel, or blisters may form on the skin, and in some instances, the skin is also likely to end up loose. Patients may experience an abnormal change in breath odor, with a distinct, ammonia like odor being experienced. The color of the skin may turn pale or bluish in complexion, with no attributable reason.
In addition to the above, there is the possibility of individuals experiencing some kind of discomfort or pain in the chest, apart from anxiety without any specific reason. The chest pain is most likely to be experienced on the left side. Other side effects of allopurinol include vigors or chilly feeling without any dip in temperature or climate. The patient may also experience bouts of constipation, while others may experience the common side effects of blood in stools or urine. While blood in stools or urine is relatively common, one of the rare side effects is the possibility of the patient coughing up blood. The patient may exhibit lesser reflexes or situational awareness when on the medication.
Other rare side effects of allopurinol include a reduction in amount of urine eliminated from the body. Contrastingly, while some patients are known to have constipation, there are other patients who experience bouts of diarrhea. The individual is likely to experience an overall discomfort or feel ill when on the medication. Other undesirable effects include a hoarse voice, or speech that appears to be less coherent, apart from the outbreak of skin conditions including rashes. Various manifestations of the side effects of the medication are experienced and this includes a lack of interest in food due to the impact of the medication on appetite. The patient may experience a distinct metallic taste in the mouth and this could sometimes be accompanied by feelings of nausea.
In certain individuals there is the possibility of episodes of seizures, while some patients are likely to experience difficulty or pain while passing urine. There is the possibility of some kind of pain or tenderness being experienced on the foot or inflammation in the leg. Pain in the stomach is one of the other possible side effects of allopurinol, where individuals experience severe pain in the upper right portion of the stomach. This may be accompanied by feelings of fullness. The skin may appear scaly, in addition to the outbreak of purple spots on the skin. Patients no the medication may experience pain as a result of swollen glands, especially in the neck, or the armpit or the groin.
Possible drug interactions
In addition to the above side effects of allopurinol there is also the possibility of certain drug interactions when the medication is taken alongside other medications. To prevent drug interactions, it is always necessary to intimate the treating specialist of any other medical condition and to list out the medications taken as part of treatment. I tis also necessary to inform the healthcare provider f any supplements or herbal formulations being consumed. This is essential, as drug interactions are also possible between herbal supplements and other OTC formulations.
For instance, individuals on certain medications for preventing blood clots, treatment for HIV, and medications for suppressing organ rejection are likely to have their doses altered or medications changed. Similarly, medications used as part of chemotherapy, treatment for hypertension and diabetic kidney disease are also likely to cause drug interactions when taken alongwith allopurinol. Either of the medications may be stopped or the dosages will end up being altered to prevent the adverse effects of the combination of the two. Similarly, various other medications are likely to cause drug interactions and hence it is necessary to inform all details of medications in use to prevent undesirable effects. It is also necessary to take the medications in the manner prescribed by the physician, and this includes abstaining from tobacco products and alcohol.