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Started taking allopurinol back in Nov '08, first at 100mg then ramping up to 300mg this spring. Ended up with flares of gout in June and here in July. But I also noticed recently I started to get a rash in my groin area. I read about allopurinol and possible rash side effect but it's never clear to me whether there is anything characteristic about the rash that may be caused. I don't know if my rash is just coincidence or not? For all I know it could just as easily be a consequence of the extreme heat around here (Texas) this summer.
in addition to the red spots in the groin area, a red spot on my upper lip. Neither of these is particularly itchy. Though I am experiencing a general itchiness kind of all over. (Scalp, then neck, then back, then arm, then foot, then leg, … you get the idea.)
What worries me more than the rash and itching, is a nagging doubt that you might not be getting proper monitoring of your uric acid levels.
The best procedure for allopurinol, is to start with 50 or 100 mg, then gradually increase this dose until uric acid levels are consistently below 6mg/dL. Anyone with a long history of gout, really needs to aim lower, say 5mg/dL to get rid of the build-up of uric acid crystals more quickly. Obviously, this involves blood testing for uric acid quite frequently until a stable dose is established.
Your sudden jump from 100 to 300mg appears to have promoted old crystals to dissolve, which is what you want, but this is hard to assess properly without a good history of uric acid test results.
I would consider reviewing this with your doctor to see if a more gradual increase of allopurinol is appropriate. If your doctor does not understand the need for testing and dose adjustment, then you will have to persuade him, or seek a gout specialist – usually a rheumatologist.
It is important to maintain good hydration with allopurinol, as it is for all gout sufferers. All soft drinks count towards your fluid intake. If you take alcohol, try to increase water consumption afterwards.
goutboy,
I have, of course also heard about that allopurinol rash after taking it for years or decades and I like you cannot find anything specific, or a picture.
But take it from me, a groin rash in Texas in July is almost certainly jock rash…a tinea infection sometimes compounded with a yeast infection.
Buy a tube of LAMISIL (or generic terbinafine) and apply it after every shower wherever you see any part of the rash, even down the inner thigh…a one inch strip should take care of both groin joints. It makes short work of tinea, use at least 7 days, and once cured, using it every few days will be prophylactic. It's over-the-counter (check Target…I see 4 around Austin
)If that doesn't work, then you'll need to exclude allopurinol for a couple weeks and see what happens. And then re-introduce it and by then you'll know if you are allergic. If so you have no choice but to stop.
All over itchiness is a tell-tale sign of hepatitis/jaundice. Look for any yellowing of your eye whites. If you see it head for the doctor and a liver function test.
But sometimes itchiness can be from something so simple as a new soap.
Thanks for notes in reply…
For the 'Admin', uric acid has been tested in the last month. Was at 5. Med increase since last year was gradual. 100, then 200, then 300.
For zip2play, not that I won't take you up on your suggestion if I see it again – though have lived in TX for 20 yrs and this would be a first – but under doctors recommendation, eliminated the allopurinol. 3 days later: groin rash gone. redness on lip, gone. itchiness: gone.
He prescribed Uloric as replacement.
It’s good to see that your doctor is taking your uric acid level seriously, and getting the level down to something that is going to help you.
It’s a pity about the allopurinol side-effects, but encouraging that you are getting an alternative.
One alternative, particularly useful when allopurinol was the only real answer, is to increase the allopurinol dosage very, very, slowly. This is quite an awkward process involving tiny adjustments with a mixture of tablets and increasing strength allopurinol liquids.
Uloric, from the data released as part of its approval process, seems like a good alternative. Just like allopurinol, it might trigger the odd gout flare until you get all existing uric acid crystals out of your body. If your Uloric dose is right, these will become less severe, and less frequent, as time goes by.
Please keep us posted with how you get on with the Uloric.
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