Allopurinol itching and skin rash

[Gout Patient]

I don’t know if its coincidence or not. I started on the colgout tablet then the allopurinol tablet. 100 mg for a week 200 mg for a week and 300 mg. Then dropped off the colgout. I developed a small rash below my belly button. I used caneston cream as I can get a heat rash in this warm weather and with been a cleaner am prone to heat rashes. I have been off the tablets now for 5 days. Went to doctor yesterday I am back on colgout for 2 weeks then will start the allopurinol again to see if that is causing the rash. Any ideas?

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[Keith Taylor]

John, it’s a shame about the rash. I think the best way to tell if it’s due to allopurinol is what you are doing. Stop allopurinol for a time, to see if there is a correlation between taking allopurinol, and getting the rash.

The only thing I’d say is, I don’t think 2 weeks without allopurinol is long enough. The main action of allopurinol comes from it’s by-product: oxypurinol. This takes up to two weeks to clear from your system. You then need a period of time for any rash to recover. For that, I’d suggest asking your doctor.

When the rash has cleared completely, you can try allopurinol again. If allopurinol does prove to be the cause, you should ask about febuxostat. A better alternative to that, is to take a 24-hour urine test to see if you are a uric acid under-excreter. If you are, you have more treatment options available. Because of the effects of allopurinol, you have to stop it for at least 2 weeks to get accurate results from a 24-hour urine test.

[Gout Patient]

thanks for your reply. my skin rash is only in a little area about half way between my belly button and pubic hair. i feel it is more of a heat rash. it had completely cleared then the weather warmed up again and it started again. caneston cream helps a lot. i do physical work as i am a cleaner. i go back to the doctors on tuesday then i will have been of allopurinol 2 1/2 weeks. thanks john

[Sully]

How long will allopurinol stay in body after I stop taking

White crusty crystal on face and on and in ears

[Keith Taylor]

Allopurinol doesn’t last very long in the body. It gets converted to oxypurinol. That stays in the body for around 2 weeks.

The symptoms you describe are most likely to be uric acid deposits. But, you should get this checked by a doctor.

[Gout Patient]

I am a 65 yr old “gouty” woman(6.9 uric acid level). For the past 2 weeks, I have been on allopurinol(100 mg twice a day) and colchicine(once a day for next 3 months). The past 4 days I have experienced tiny, slightly itchy bumps breaking out on my back(I never have skin breakouts), which began on my lower back, and now have moved to include upper back. It isn’t severe, but annoying, and somewhat uncomfortable. Could it be a reaction to allopurinol, and should I stop taking it and call my doctor?
Thanks for this site, Keith!😁
Lee

[Keith Taylor]

Hi Lee,

I can’t see a need to stop allopurinol immediately, as you don’t know if your itchy bumps are due to allopurinol, colchicine, or something else. And, as you say, it’s annoying, but not severe. But, I think it’s wise to call your doctor, for a blood test. You can get:
A) Liver and kidney function tests that will help your doctor take a view on itchy bumps. Important for checking the severity of your skin reaction.
B) Uric acid test to see if your allopurinol dose should be increased.
c) A proper medical opinion, and hopefully peace of mind, about the skin breakout.

[Gout Patient]

Thanks, Keith! Appreciate your response. I did have bloodwork done when I went for initial diagnosis a couple of weeks ago. At that time, the Dr. said uric acid level was 6.9, kidney function slightly elevated and to drink more water(I already drink 8-10 glasses a day). Anyway, I called her last Tuesday about the rash, and she advised me to stop taking the Allopurinol for a week, but to continue the Colchicine. I am into the 5th day without the Allopurinol, still have the rash, but, it is not quite as itchy and is not spreading any further. Will contact her again in coming week, and go from there. I do wish there was a good natural way to get rid of uric acid. O well, maybe one day. 🙂
Best Regards!

[Keith Taylor]

6.9 is too high. So, if the rash does prove to be allopurinol, you need to try Uloric. Best way to tell is to restart allopurinol when the rash finally clears.

I think the most natural way of lowering uric acid is getting rid of blood.

Search blood donation in the search box at the top of the page.

I haven’t met anyone yet who has used this method to control gout. But, the theory seems logical to me.

[Keith Taylor]

I’ve reviewed information about allopurinol causing itching skin. I think the main worry might be that it’s associated with the dreaded allopurinol hypersensitivity rash. But that should now be a thing of the past, given the screening process that is now available for at-risk groups. So for more information, see the screening article linked to Allopurinol Side Effects.

In addition, I’m reminded of an old discussion about allopurinol and itching. In it, I identified a few procedural aspects of allopurinol therapy that might reduce itching and other side-effects. So, from the archive:

• Before taking allopurinol, it is important to have kidney function tests. Any kidney deficiency can render allopurinol unsuitable.
• You should be advised that allopurinol treatment can cause gout flares at first and discuss your choice of preventative anti-inflammatory treatment, or pain killers as you need them.
• You should be advised to drink plenty of fluids when you take allopurinol, though as a gout patient you should be doing this anyway.
• You should be advised about allopurinol side effects, distinguishing from those that are harmless, and those that should prompt immediate consultation with your doctor.
• You should be asked to return every few weeks for uric acid tests and dosage review.

Of course, this is just my view from my ivory tower of gout research. I suspect that frontline custom and practice differ. So, I’d love to hear about the procedures and advice experienced by gout patients when they are first prescribed allopurinol.

In any case, isn’t this type of itching simply a common symptom of a low-level gout flare?

[David Rieter]

Continue treatment with a slight allopurinol rash?

Hi Keith. Just a quick question or two of you don’t mind. I’m a fellow gout sufferer in MI. 32 yrs old and I have atypical gout as the rheumatologist calls it. I’ve had the disease for 5 yrs. 3 attacks over the 5 yrs all lasting around a month. I seem to get it pretty bad and persistent when I do get it. My most recent attack started nearly 6 months ago. Both feet, almost entirely. My heels are fine. Anyhow this attack did some real damage. I have some hammer toes now etc. I took your advice and started allopurinol 2 months ago (300mg) my number has gone from a 9 to a 4.9, so it is working. Unfortunately, I have the smallest rash on the bottom of my foot since starting the Med, I almost didn’t even notice it. It does not bother me in any way. I noticed it a few weeks into the medication, it does not seem to be spreading or getting worse or anything. I know you are not a doctor but have you heard of anybody just getting a tiny rash and still continuing their allopurinol regimen safely? I’m a little worried. Let me know your thoughts. Thanks for your time and dedication.

Also, I haven’t had meat/alcohol since my first attack 5yrs ago. In the last 6 months I’ve cut out sugar and I’ve lost 50 pounds. All while pretty much bed ridden. I believe mine is caused by stress/possibly some dehydration.
I’ve done acv/ baking soda/cherries for the last few yrs daily.

[Keith Taylor]

Hi David,

It’s probably nothing, but you ought to point it out to your doctor. Because at this stage in your allopurinol treatment, you should be getting a follow-up check. So, that means testing uric acid, kidney function, and liver function. Then those function test results will tell your doctor if you need to worry about the rash. Also, the uric acid result suggests you should have a higher dose of allopurinol for a few months to speed your recovery.

As for food, all you need to concern yourself with is general healthy eating. The most freedom is found in the DASH diet. But, Mediterranean style eating plans are even better. Mostly, you need to get sufficient exercise and maintain a healthy weight. Then eating is simply EFSEP – Eat Food, Sufficient, Especially Plants.

EFSEP means eating real food, not manufactured food-like products. Sufficient means enough calories to fuel your daily activities. Also, most of your calorie intake should be plant based. Occasional meat or fish is good. But if you reject all flesh, you should consult a nutritionist to ensure you get essential vitamin and mineral supplements.

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Slight allopurinol rash?

PS David, I used an old photo as an example of a rash. If you have a photo of your allopurinol rash, please can you send it on the feedback form below.

[C Noonan]

Allergic to Allopurinol

I was diagnosed 4 months ago with gout, one attack and my Doctor put me on Allopurinol and Colchicine. I broke out in hives and was immediately taken off Allopurinol. I will not use febuxostat due to the recent “black box heart warning”. What is left for me to take? I am an older female and do not fall into the usual category of gout sufferers. Does anyone have any advice?

[nobody]

I’m going to answer both your posts here.
I’ve been aware of the issue with cardiovascular deaths linked to febuxostat long before this hoopla. I don’t know exactly what’s going on but I don’t think you should rule out febuxostat simply because it’s got a black box. Your risk factors would need to be considered in light of the available data.
One thing I do know is that febuxostat is often used incorrectly, even by doctors who are suffering from gout themselves. Unfortunately, finding a doctor who understands gout and related issues can be very difficult. Should you manage to find a doctor you trust and who knows what they’re doing, simply ask them what (if anything) you should take.
If on the other hand you want to become your own doctor, the first questions you need to ask are:
-what did you hope to achieve with allopurinol or febuxostat? The main effect of these drugs is to lower the amount of uric acid in your blood. And no one can give you sensible advice about how to achieve that without knowing how much there is in your blood in the first place (or what you’d like that number to be).
-did you get hives because of allopurinol or was that a coincidence? Did you try to take colchicine on its own after these hives went away for instance?

[C Noonan]

When I was diagnosed in April, my ua was 7.6. I was placed on both allopurinol and colchicine and my ua went to 6.0. then I developed hives and was told to stop the allopurinol but not the colchicine. Now my ua is 7 8 but no hives I have a history of ventricular tach, kidney stones, GERD and am boarder line anemic. Reading the warnings for uliric and probenecid scare me.

[nobody]

How long were you on how much allopurinol per day before that 6.0 result?
And are these three measurements are the only ones you’ve got?

I assume you have since then stopped taking colchicine. Side effects can become serious over time.

There are no official warnings for not taking drugs but obviously it doesn’t mean failing to treat a disease is necessarily safe.
In particular, I’m concerned about these kidney stones. I’m not knowledgeable about kidney problems but I know some people take allopurinol or febuxostat for kidney stones because uric acid is one of the things which can form stones. Taking too much of these drugs can in principle also result in kidney stones (composed of xanthine). Young people would normally not get kidney stones from uric acid when it tests under 8 but even though your values aren’t very high, possibly the condition of your kidneys might make values as low as yours dangerous. So a diet designed to lower uric acid and help with its excretion could contribute to protecting your kidneys. You would probably also benefit from taking some drug but the simple drug-only approach may not best in your situation. You may also benefit from taking smaller drug doses than most people.
Have you ever seen a doctor knowledgeable about kidney issues and did you discuss uric acid with them? Or have you read the medical reports about your kidneys and the composition of your kidney stones and researched these issues yourself? Obviously there’s a lot more to kidney function than whether or not you have a history of kidney stones…

There are a few other drugs than the ones you’re listed as well as other compounds sold as medicine in some countries or simply found in foods which could help with your uric acid problem but you’d have to be careful about their effect on your kidneys in particular.
Sometimes serious drugs are best in spite of their side effects if one uses them carefully because one may only need a very small amount in comparison to less specific or less effective medicines.

About febuxostat and your history of tachycardia, there’d be another balance to strike regarding the risks but I think your kidneys ought to be considered first and I lack the knowledge or experience to help you with that. If it turns out your kidneys would benefit from a drug and/or diet which happens to alleviate your uric acid problem as a side effect, there might be no need for you to try febuxostat or allopurinol desensitization.

[C Noonan]

Just saw Rheumatologist. Since I am allergic to Allopurinol and have a heart problem, he will not put me on Febuxostat. Probenecid causes Kidney Stones so he rulled that out. I am now on my own!! Do you know of an effective otc supplement that gets rid of ua (along with diet)? I don’t know what else to do.

[nobody]

Finding a good doctor would be the ideal course of action.
A rheuma isn’t a kindey specialist and no responsible doctor would use bullshit excuses to get rid of problem patients and let them fend for themselves.
I must have seen about a dozen doctors over the years. Most were useless and some were dangerous quacks. And I still had to do some of the work myself or I might have ended up without a solution. So don’t give up after the first couple of doctors.

Supplements can be even more dangerous than drugs. People promote many quick fixes to the desperate online. The best of these are useless but harmless.
I wouldn’t even dare to recommend a diet based on the very limited information you have shared so far. I have no idea what your current diet looks like or if it changed since the UA tests you shared. Worse, I don’t know if you have health problems requiring a special diet. What if you have a cholesterol problem affecting your tachycardia instance? A diet which would be fine for someone else could easily be more dangerous than febuxostat for you.
If you can’t find a decent doctor, you’ll have to research the issues slowly and methodically. Question everything. Gout isn’t going to kill you anytime soon so you can afford to take your sweet time. Preventing worse kidney problems might be more urgent which is one more reason I’d start by looking into these kidney stones and your kidney function more generally.

There’s one bit of advice I think I can give right now because so far as I know it is pretty safe: make sure you drink the generally recommended amount of water and avoid any diuretics (including alcohol) unless a doctor told you it was important you take a diuretic drug (in that case, ask the doctor if there is an alternative).

[Ben]

I have terrible itching on my back.
Been on allopurinol for quite a while and the itching is getting worse. Do you think it is allopurinol?

[nobody]

Hi Ben!
Best see a doctor in person. I don’t think anyone here can guess what is causing this itching on your back.

[Author]

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