Allopurinol (Zyloprim®) Tablets for Gout and High Uric Acid

What Allopurinol Is and How It Works

Allopurinol is a xanthine oxidase inhibitor used for chronic gout, hyperuricemia, and prevention of uric acid kidney stones. It reduces production of uric acid, which helps prevent gout flares, dissolve tophi, and lower stone risk. Tablets are commonly available in 100 mg and 300 mg strengths. Many people search for allopurinol price to manage ongoing therapy costs, and generic options can help.

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Allopurinol is used long term and is not for acute gout pain. It is often paired with an anti-inflammatory medicine during the first months, when flares can increase as serum urate falls. Indications include gout, tumor lysis syndrome–related hyperuricemia, and recurrent uric acid stones. The drug is taken by mouth once daily for most patients, or in divided doses at higher totals.

Dosage and Usage

• Start at 100 mg once daily; in renal impairment, start at 50–100 mg on alternate days or once daily, based on prescriber judgment.
• Titrate every 2–5 weeks to reach target serum urate (often <6 mg/dL). Typical maintenance is 200–300 mg daily; some patients require 400–600 mg daily.
• Maximum total daily dose is generally up to 800 mg, given in divided doses when total exceeds 300 mg.
• Tablets are taken after meals with water to reduce stomach upset.
• Use prophylaxis against flares during initiation, such as low-dose colchicine or an NSAID, for at least 3–6 months.
• Do not use allopurinol to treat a sudden gout attack; continue established therapy during a flare unless directed otherwise by the prescriber.
• Missed dose: take when remembered unless near the next dose; do not double doses.
• Higher risk of severe cutaneous reactions exists in carriers of HLA-B*58:01; testing is often considered in certain Asian and African ancestry groups.
• Major interaction: azathioprine and 6-mercaptopurine require substantial dose reduction and close monitoring if used together.

• Store tablets at 15–30°C (59–86°F) in a dry place, away from moisture and heat.
• Keep the bottle tightly closed and in the original packaging to protect from humidity.
• When traveling, carry medicine in your hand luggage with a copy of your prescription.
• Use a pill organizer for longer trips, and keep a small reserve in a separate bag.
• Avoid leaving tablets in a parked car. Do not freeze. Keep out of reach of children and pets.

Benefits and Savings

Allopurinol helps prevent painful gout attacks by lowering serum urate. It supports gradual tophi reduction and can reduce the formation of uric acid stones. Once-daily dosing improves adherence for many patients. For those managing lifelong therapy, generic allopurinol tablets offer dependable results at an accessible allopurinol cost.

Buying through a Canadian pharmacy can yield 60–80% savings versus typical US prices. Multi-month supplies may reduce the per-month cost, and simple reorder reminders can make refills easier. Patients using allopurinol for gout or for high uric acid often appreciate predictable pricing over the long term.

Side Effects and Safety

• Common: rash, itching, nausea, vomiting, diarrhea, stomach pain, loss of appetite.
• Other reported: drowsiness, headache, changes in taste, elevated liver enzymes, edema.
• Lab-related: changes in liver function tests or blood counts may occur.
• Drug interactions: azathioprine/6-mercaptopurine (dose reduction required), warfarin (monitor INR), thiazide diuretics (higher rash risk), ampicillin/amoxicillin (rash risk).

Serious but rare reactions include allopurinol hypersensitivity syndrome (fever, rash, liver/kidney injury, eosinophilia), DRESS, and severe skin reactions such as Stevens–Johnson syndrome/toxic epidermal necrolysis. Risk is higher in renal impairment, HLA-B*58:01 carriers, and with thiazides. New rash, fever, mouth sores, eye irritation, or systemic symptoms require urgent evaluation.

Onset Time

Serum uric acid usually begins to fall within days of starting therapy, with meaningful reductions seen as titration proceeds over 2–6 weeks. Flare prevention benefits grow as target urate is maintained over time. Flares can transiently increase in the first months; prophylaxis helps reduce this risk.

Tophi reduction is gradual and may take several months to years depending on baseline burden. For uric acid stone prevention, reduced urinary uric acid and improved urine chemistry may be seen over weeks to months, with fewer stone events as therapy continues.

Compare With Alternatives

Febuxostat is another xanthine oxidase inhibitor used for chronic gout and hyperuricemia. It can be an option for those not reaching urate targets or intolerant to allopurinol. Cardiovascular risk has been a consideration in some studies, so prescribers weigh individual profiles when choosing.

Probenecid is a uricosuric that increases uric acid excretion. It is useful when kidney function is adequate and urine volume is maintained, but it may not suit patients with a history of uric acid stones. It can be combined with low-dose allopurinol in select cases.

Anti-inflammatory options manage pain during flares. Colchicine is often used for flare prevention during allopurinol initiation, and Naproxen is a common NSAID for acute pain relief. Explore gout-related care under Gout, and learn more in our article Arthritis What Are The Most Common Forms Of Arthritis.

Combination Therapy

• Allopurinol with low-dose colchicine or an NSAID for 3–6 months to reduce flare risk during initiation.
• Allopurinol with a uricosuric (for example, probenecid) when monotherapy does not reach target serum urate.
• Dose adjustments are required when combined with azathioprine or 6-mercaptopurine to avoid toxicity.
• Review diuretics and other medicines that may raise uric acid; alternative options may help urate control.

Patient Suitability and Cost-Saving Tips

Allopurinol is used to treat chronic gout, asymptomatic hyperuricemia with specific risks, tumor lysis–related hyperuricemia, and recurrent uric acid kidney stones. Candidates include those with frequent flares, tophi, urate nephrolithiasis, or high serum urate despite lifestyle changes. It is not designed to stop a current gout attack.

Those with prior severe cutaneous reactions to allopurinol should avoid re-exposure. HLA-B*58:01 positivity raises risk of severe skin reactions; prescribers often consider testing in higher-risk ancestry groups. Renal and hepatic impairment may require lower starting doses and careful titration. Significant interactions exist with azathioprine and 6-mercaptopurine.

To manage ongoing therapy costs, consider larger fills where appropriate, since multi-month supplies may lower the monthly price. Set reorder reminders so you never run short. Generic options, including allopurinol 100 mg tablet and allopurinol 300 mg tablet, help keep the allopurinol cost predictable over time.

Authoritative Sources

FDA Prescribing Information for Allopurinol Tablets

Health Canada Product Monograph: Allopurinol

Merck Manual: Drugs Used in Gout

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This content is educational and does not replace professional medical advice. Discuss diagnosis, dosing, and risks with a qualified healthcare provider.