Does allopurinol worsen acute gout?
The most common adverse effect of allopurinol is the precipitation of an acute flare of gout. This is due to urate lowering resulting in urate crystals being shed from articular cartilage into the joint space, resulting in acute inflammation.
Can allopurinol flare up gout?
Allopurinol is prescribed to help prevent gout attacks. It does not have any effect during a gout attack, although you should continue to take it regularly every day, even if this happens. A painkilling medicine will be prescribed for you to take alongside it should you get a gout attack.
Why allopurinol was not prescribed to this patient during acute attack?
Medical teaching suggests that allopurinol should not be initiated in the setting of an acute gout attack, because rapid lowering of serum urate may exacerbate the attack.
Which drug is contraindicated in acute gout?
Nonsteroidal anti-inflammatory drugs are contraindicated with the concomitant use of angiotensin-converting enzyme (ACE) inhibitors and/or diuretics. Prostaglandin production is decreased while using NSAIDs, resulting in increased constriction of afferent renal arterioles and decreased glomerular filtration pressure.
What are the primary side effects of allopurinol?
Allopurinol side effects
- skin rash.
- diarrhea.
- nausea.
- changes in your liver function test results.
- gout flare-up (if you have gout)
How do you treat an acute gout flare up?
Oral corticosteroids, intravenous corticosteroids, NSAIDs, and colchicine are equally effective in treating acute flares of gout. 20 NSAIDs are the first-line treatment. Indomethacin (Indocin) has historically been the preferred choice; however, there is no evidence it is more effective than any other NSAID.
When should I start allopurinol after gout attack?
Prophylactic colchicine or NSAID is recommended, starting 2 weeks before allopurinol whenever possible, and continuing for 3–6 months to prevent such attacks. An alternative is to start allopurinol at 50–100 mg/day and increase by similar increments weekly until the target serum urate is reached.
What medications should be avoided with gout?
In addition to diet, exercise, and weight loss, avoid these medications that can trigger gout, if you can:
- Diuretics (used to treat high blood pressure or heart disease)
- Salicylate-containing drugs (such as aspirin)
- Niacin (vitamin B3 and nicotinic acid)
- Cyclosporine (an immune-suppressing drug)
How allopurinol acts on gout?
Allopurinol is in a class of medications called xanthine oxidase inhibitors. It works by reducing the production of uric acid in the body. High levels of uric acid may cause gout attacks or kidney stones. Allopurinol is used to prevent gout attacks, not to treat them once they occur.