Guidelines for reducing Allopurinol dosage

[John Fred Doores]

Could you repeat the guidelines for reducing Allopurinol dosage after six? Months of around .4 Uric acid readings?

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When is the right time to reduce allopurinol?

[nobody]

Could you clarify your question?
There is a balance of risks to strike and the details matter a great deal.

Generally, .4mmol/l is too high for someone who has gout but 4 mg/dl is fine.
There are guidelines recommending 5 mg/dl or less and guidelines recommending 6mg/dl or less.
Since it often takes at least a year to get rid of acid uric crystals, the 5mg/dl guidelines seem safer to follow months into the therapy unless there is a specific reason to reduce the dosage (such as bad liver function markers).
But each case is going to be different. If there are tophi or evidence for other large uric acid deposits, you’d want to keep uric acid as low as possible for instance.

[Author]

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