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allopurinol

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Brand names: Zyloprim

Xanthine Oxidase Inhibitor Rx

Allopurinol is a medicine that lowers uric acid levels in your body. It helps prevent gout attacks and other problems caused by high uric acid.

Drug Shortage Alert

allopurinol is currently listed as to be discontinued by the FDA. Affected manufacturer: Teva Pharmaceuticals USA, Inc..

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Drug Pricing (NADAC)

Generic Price

$0.04/unit

Generic Available

Yes (15 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

This medicine is used to manage gout in adults.

Common side effects

Diarrhea, Nausea, Increased liver enzyme levels

Key warnings

Allopurinol can cause serious skin reactions that can be deadly.

How It Works

Allopurinol works by blocking an enzyme called xanthine oxidase. This enzyme helps your body make uric acid. By blocking it, allopurinol reduces the amount of uric acid in your blood and urine.

How to Take It

Take this medicine by mouth, exactly as your doctor tells you. For gout, the starting dose is usually 100 mg each day. Your doctor may increase the dose by 100 mg each week until your uric acid level is below 6 mg/dL. You can take this medicine with or without food.

Pregnancy & Breastfeeding

Allopurinol may harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is not recommended to breastfeed while taking this medicine because it can pass into breast milk.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store at room temperature, away from moisture and heat.

Side Effects (from patient reports)

Based on 67,596 FDA adverse event reports.

Diarrhea
8,423
Tiredness
7,965
Difficulty breathing
7,659
Feeling sick to your stomach
7,061
Death
6,664
Sudden kidney damage
6,554
Using the medicine for a purpose it was not approved for
6,272
Fever
5,946
Lung infection
5,568
Weakness
5,484

FDA Adverse Event Report Analysis

Detailed analysis of 150,998 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 1997–2025.

Total Reports

150,998

Death-Related Reports

21,323

Hospitalization Reports

74,277

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 49,076 (35%)
Male 89,858 (64%)

Age Distribution

0–17 1,406
18–44 5,760
45–64 28,914
65–74 33,834
75+ 38,718

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DIARRHOEA 8,423
2 FATIGUE 7,965
3 DYSPNOEA 7,658
4 NAUSEA 7,063
5 DEATH 6,665
6 ACUTE KIDNEY INJURY 6,554
7 OFF LABEL USE 6,272
8 PYREXIA 5,943
9 PNEUMONIA 5,568
10 ASTHENIA 5,486
11 ANAEMIA 5,285
12 DRUG INEFFECTIVE 4,943
13 DIZZINESS 4,936
14 RENAL FAILURE 4,688
15 FALL 4,544

Reactions in Death Reports

DEATH 6,649
PNEUMONIA 1,639
SEPSIS 1,505
DYSPNOEA 1,204
RENAL FAILURE 1,204
OFF LABEL USE 1,060
PYREXIA 1,042
ACUTE KIDNEY INJURY 1,029
ANAEMIA 1,002
GENERAL PHYSICAL HEALTH DETERIORATION 976

Reactions in Hospitalization Reports

DYSPNOEA 4,959
PNEUMONIA 4,591
ACUTE KIDNEY INJURY 4,575
PYREXIA 4,538
DIARRHOEA 4,154
ANAEMIA 3,921
NAUSEA 3,461
FATIGUE 3,365
ASTHENIA 3,265
FALL 3,173

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Allopurinol can cause serious skin reactions that can be deadly. Stop taking this medicine and get medical help right away if you get a skin rash or any other signs of an allergic reaction.

Known Drug Interactions

( 7.2 ) Pegloticase: Discontinue and refrain from initiating treatment with allopurinol tablets. Pegloticase Clinical Impact Concomitant use of allopurinol tablets and pegloticase may potentially blunt the rise of serum uric acid levels and increase the risk of pegloticase related anaphylaxis in patients whose uric acid level increase to above 6 mg/dL. Intervention Discontinue and do not institute allopurinol tablets therapy during treatment with pegloticase.

Mechanism: Allopurinol can hide changes in your blood levels that warn doctors of a possible severe allergic reaction to pegloticase.

What to do: Stop taking allopurinol before starting pegloticase and do not take it again while you are on treatment.

Cyclosporine Clinical Impact Concomitant use of allopurinol increases cyclosporine concentrations, which may increase the risk of adverse reactions. Intervention Increase frequency of monitoring cyclosporine concentrations as reflected in its prescribing information and modify the dosage of cyclosporine as appropriate when used concomitantly with allopurinol tablets.

Mechanism: Allopurinol slows down how your body gets rid of cyclosporine, leading to higher levels of the drug in your system.

What to do: Your doctor should check your blood levels more often and may need to adjust your dose.

moderate amoxicillin

( 7.1 ) Concomitant use of Amoxicillin and Clavulanate Potassium and oral anticoagulants may increase the prolongation of prothrombin time.( 7.2 ) Co-administration with allopurinol increases the risk of rash. 7.3 Allopurinol The concurrent administration of allopurinol and amoxicillin increases the incidence of rashes in patients receiving both drugs as compared to patients receiving amoxicillin alone. It is not known whether this potentiation of amoxicillin rashes is due to allopurinol or the hyperuricemia present in these patients.

Mechanism: Taking these two medicines at the same time increases the chance that you will develop a skin rash. It is not fully known if the drugs themselves or the high uric acid levels in the body cause this reaction.

What to do: Watch for any signs of a skin rash and contact your healthcare provider immediately if one appears.

( 7.1 ) Concomitant use of AUGMENTIN and oral anticoagulants may increase the prolongation of prothrombin time.( 7.2 ) Co-administration with allopurinol increases the risk of rash. 7.3 Allopurinol The concurrent administration of allopurinol and amoxicillin increases the incidence of rashes in patients receiving both drugs as compared to patients receiving amoxicillin alone. It is not known whether this potentiation of amoxicillin rashes is due to allopurinol or the hyperuricemia present in these patients.

Mechanism: Taking these two drugs together increases the chance of developing a skin rash. It is not fully known if the rash is caused by the drugs themselves or the medical condition being treated.

What to do: Watch your skin closely for any new rashes and tell your doctor immediately if one appears. Your doctor may need to monitor your reaction to these medications.

Warfarin Clinical Impact Allopurinol may inhibit the metabolism of warfarin, possibly enhancing its anticoagulant effect. Assess INR frequently and adjust warfarin dosage accordingly when allopurinol is added to warfarin therapy.

Mechanism: Allopurinol slows down the body's ability to break down warfarin. This can cause warfarin to stay in the body longer and increase the risk of bleeding.

What to do: Your doctor should check your blood clotting levels (INR) frequently and adjust your warfarin dose if necessary.

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Common Questions

Can I stop taking allopurinol when my gout pain is gone?
No, keep taking allopurinol even when you feel better, unless your doctor tells you to stop.
How long does it take for allopurinol to work?
It may take several weeks to months for allopurinol to fully lower your uric acid levels and prevent gout attacks.
Can I take allopurinol during a gout attack?
Yes, you can continue taking allopurinol during a gout attack. Your doctor may also prescribe other medicines to treat the attack.
Will allopurinol cure my gout?
Allopurinol does not cure gout, but it can help manage the condition and prevent future attacks.
Are there any foods I should avoid while taking allopurinol?
Your doctor may recommend limiting foods high in purines, such as red meat and seafood.
Can allopurinol affect my kidneys?
Yes, allopurinol can affect your kidneys, especially if you already have kidney problems. Your doctor will monitor your kidney function.
Can allopurinol affect my liver?
Yes, allopurinol can affect your liver. Your doctor will monitor your liver function.
Can I drink alcohol while taking allopurinol?
Talk to your doctor about drinking alcohol while taking allopurinol, as it may worsen your gout.
What should I do if I get a rash while taking allopurinol?
Stop taking allopurinol and contact your doctor immediately if you develop a rash.
Does allopurinol interact with other medications?
Yes, allopurinol can interact with other medications. Tell your doctor about all the medicines you take.
What are the common side effects of allopurinol?
The most commonly reported side effects of allopurinol include Diarrhea, Nausea, Increased liver enzyme levels, Gout attacks, Skin rash. Based on 67,596 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does allopurinol interact with other medications?
Yes, allopurinol has 10 known drug interactions. Notable interactions include pegloticase, cyclosporine, amoxicillin. Always inform your doctor about all medications you are taking.
What drug class is allopurinol?
allopurinol belongs to the Xanthine Oxidase Inhibitor drug class. It requires a prescription (Rx). This medicine is used to manage gout in adults.
Is allopurinol safe during pregnancy?
Allopurinol may harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Is allopurinol currently in shortage?
Yes, allopurinol is currently listed as to be discontinued by the FDA. Affected manufacturer: Teva Pharmaceuticals USA, Inc.. Visit the FDA Drug Shortages database for the latest updates.

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What the FDA Data Shows for allopurinol

The FDA label for allopurinol (sold under brand names such as Zyloprim) classifies it as a prescription-only medication in the Xanthine Oxidase Inhibitor class. This medicine is used to manage gout in adults. Official labeling lists 5 commonly reported side effects, including Diarrhea, Nausea, Increased liver enzyme levels.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 67,596 voluntary reports. The database also lists 10 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.04.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: July 8, 2024

All federal data sources used on this page