Allopurinol: What It Is and Why You Might Need It

Allopurinol is a pill that reduces uric acid in your blood. High uric acid can cause painful gout attacks and kidney stones, so doctors often prescribe this drug to keep levels in check.

If you’ve been told you have gout, chronic kidney disease, or a condition that produces too much uric acid, chances are your doctor will start you on allopurinol.

How to Take Allopurinol the Right Way

Start with a low dose—usually 100 mg once a day—and increase slowly. The goal is to find the smallest amount that keeps uric acid below 6 mg/dL. Most people end up on 300 mg daily, but some need up to 600 mg split into two doses.

Take the tablet with food to avoid stomach upset. If you miss a dose, just take it as soon as you remember unless it’s almost time for the next one; don’t double up.

Regular blood tests are a must. Your doctor will check uric acid levels after a few weeks and then every few months to make sure the dose is right.

Common Side Effects and When to Call the Doctor

Most people feel fine, but a few experience rash, nausea, or mild headache. A rash that spreads quickly or feels like a sunburn could mean a serious allergic reaction—stop the drug and seek medical help right away.

Allopurinol can also affect the liver and kidneys. If you notice dark urine, yellowing skin, or sudden swelling in your legs, call your doctor immediately.

Watch out for interactions. Common culprits are azathioprine, mercaptopurine, and certain antibiotics like ampicillin. Tell your pharmacist about every medicine you’re taking.

Pregnant or breastfeeding women should only use allopurinol if the benefits clearly outweigh the risks. Discuss options with your healthcare provider.

In everyday life, the best way to avoid problems is to stay hydrated, limit alcohol and purine‑rich foods (like red meat and seafood), and keep up with follow‑up appointments.

Remember, allopurinol doesn’t stop an acute gout flare; it works over weeks to months to prevent future attacks. If you’re in the middle of a flare, your doctor may add colchicine or NSAIDs on top of the allopurinol regimen.

Bottom line: start low, go slow, monitor labs, and report any odd symptoms. With those steps, allopurinol can be a safe, reliable tool to keep gout and kidney stones at bay.