Precautions and Warnings With Allopurinol

To help ensure a safe and effective treatment process, make sure you are aware of the precautions and warnings with allopurinol. Before taking this medication, let your healthcare provider know of any other medical conditions you have, such as liver or kidney disease. You should not take allopurinol if you are allergic to any components of the medication.

What Should I Tell My Healthcare Provider Before Taking Allopurinol?

You should talk with your healthcare provider prior to taking allopurinol (Zyloprim®) if you have:
  • Liver disease, such as liver failure, cirrhosis, or hepatitis
  • Kidney disease, such as kidney failure (renal failure)
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about any other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Allopurinol

Some warnings and precautions to be aware of prior to taking allopurinol include the following:
  • You should stop taking allopurinol immediately and contact your healthcare provider if you develop a rash. Sometimes, a rash is the first sign of dangerous reactions to allopurinol, such as Stevens-Johnson syndrome (a life-threatening skin condition), liver damage, or even death.
  • Allopurinol can cause liver problems that are usually reversible after the medication is stopped. Let your healthcare provider know if you develop any signs of such problems, such as weight loss, appetite loss, itching, and increased liver enzymes. If you already have liver problems, your healthcare provider should periodically test your liver function (using a simple blood test) while you take allopurinol.
  • Allopurinol can cause drowsiness. Make sure to see how allopurinol affects you before driving or operating heavy machinery.
  • If you have kidney disease, you may need to be monitored more closely, and you may need a lower allopurinol dosage.
  • Allopurinol works to prevent gout attacks; it does not help to treat attacks that are already occurring. In fact, it can temporarily worsen gout, especially at first. For these reasons, allopurinol is usually used along with other gout medications, especially for the first few months.
  • It is important to drink plenty of fluids while taking allopurinol, in order to help prevent kidney stones from forming.
  • Some people have developed kidney failure while taking allopurinol. This is more likely to occur in people with cancer or who already have kidney problems.
  • It has been reported that allopurinol may decrease the bone marrow's ability to produce certain cells. This could possibly lead to anemia (due to decreased red blood cells) or frequent infections (due to decreased white blood cells).
  • Allopurinol may interact with other medications (see Drug Interactions With Allopurinol).
  • Allopurinol is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not currently known (see Allopurinol and Pregnancy).
  • Allopurinol passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Allopurinol and Breastfeeding).
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