Allopurinol: Adverse Effects And Indications
Allopurinol is a drug indicated for the treatment of gout and high levels of uric acid in the body. It is administered in cases where gout is due to adverse effects caused by other medications, such as those used to treat cancer or kidney stones.
It owes its action to its ability to reduce the synthesis of uric acid, responsible for triggering the clinical symptoms of gout. Thus, allopurinol belongs to the family of drugs known as xanthine oxidase inhibitors , an enzyme necessary for the synthesis of uric acid. We’ll look at this process in more detail throughout the article.
However, it is important to note that allopurinol does not cure gout attacks, but is used as a method of prevention shows the when the patient is being treated with other medications, such as those mentioned.
What is gout?
Gout is a long-known disease. It usually presents as acute joint-type inflammation, usually in the big toe. In other words, gout causes asymptomatic inflammation in a joint , which swells and causes pain for a short period of time.
This inflammation is caused by the presence of monosodium urate crystals, a substance formed by an excess of uric acid in the blood. High levels of this acid are usually related to bad lifestyle habits, such as poor diet (excessive food intake) and alcohol intake. When these levels are normalized in a sustained way, the crystals usually dissolve without problems.
When a person has high uric acid levels, they are said to have hyperuricemia. However, although this condition is common (7% of men suffer from it), only a minority of people develop the characteristic crystals of gout.
When a gout attack ceases, monosodium urate crystals remain in the joint . That way, even if the treatment ends, another gout attack can occur at any time.
Adverse reactions to allopurinol
First, it should be clarified that adverse reactions are more common in patients with renal or hepatic impairment . The reason for this is that allopurinol is metabolized in the liver and excreted by the kidneys. Therefore, due to these changes, drug concentrations in the body may increase or decrease.
On the other hand, in case it increases, the effect also increases. In this way, it is easier for the patient to suffer adverse effects. Let’s look at the most common unwanted effects this medication produces.
skin reactions
They are the most common and can appear at any time during treatment with allopurinol. Among them, we find:
- itching
- peeling
- Purpuric lesions
- Exfoliation
- Rash
If any of these effects occur, treatment with this medicine should be stopped. Soon after recovery, treatment can be restarted by increasing the dose gradually . On the other hand, if a rash occurs , the treatment must be stopped permanently.
Generalized hypersensitivity reactions
Although not very common, some hypersensitivity reactions can occur . In these cases, the patient may suffer:
- Fever
- Stevens-Johnson Syndrome or Lyell.
- Lymphadenopathy
- Vasculitis: can manifest in a variety of ways, including hepatitis, nephritis, and epilepsy.
If these reactions occur, treatment with allopurinol should be stopped immediately and forever . Also, in these cases, corticosteroids are usually given to reverse these symptoms of generalized hypersensitivity.
gastrointestinal problems
Among the changes in the digestive system , the most common reactions are nausea and vomiting . To avoid this, it is advisable not to take allopurinol after meals.
Granulomatous hepatitis
First of all, it should be mentioned that this adverse reaction has very rarely been described without the obvious evidence of a more generalized hypersensitivity. However, u ma once discontinued, it appears that this adverse effect is reversed.
Conclusion
