Complete Guide: Foods and Substances to Avoid When Taking Allopurinol

Guide to Managing Medication: Foods and Substances to Avoid When Taking Allopurinol

Allopurinol is a common medication prescribed to lower high levels of uric acid and prevent gout attacks. While effective, allopurinol can cause negative interactions if taken with certain foods and substances. Understanding what to avoid when using this medication is key to safely managing gout.

In this comprehensive guide, we’ll discuss how allopurinol works, why certain items should be avoided, and provide a detailed list of foods, beverages, supplements, and medications that can cause adverse reactions. Whether you’re starting allopurinol or have used it for awhile, this advice will help you get the most out of the medication.

How Allopurinol Works Against Gout

Allopurinol is in a class of medications called xanthine oxidase inhibitors. It blocks an enzyme called xanthine oxidase which is responsible for producing uric acid in the body. With less uric acid production, levels in the blood can be reduced.

In gout, excess uric acid forms painful crystals that accumulate in joints. Allopurinol prevents this buildup, easing inflammation and future flare-ups. It’s taken daily, often at a 100-300 mg dosage depending on uric acid levels.

While allopurinol is effective at lowering uric acid, it can cause adverse reactions if a person also takes certain substances. Being aware of these interactions is important.

Why Avoidances Are Crucial With Allopurinol

There are a few reasons why certain items should be avoided when taking allopurinol:

• Some foods and chemicals can increase uric acid, defeating the purpose of the medication.
• Allopurinol can amplify the effects of other substances, like blood thinners.
• Certain items can irritate the kidneys when combined with this medication.
• Adverse reactions can range from decreased effectiveness to serious health complications.

Being aware of any foods, beverages, supplements, or medications that fall into these categories is vital to properly managing gout with allopurinol and staying safe.

Foods High in Purines to Limit or Avoid

One of the keys with taking allopurinol is limiting purine-rich foods. Purines are natural compounds that raise uric acid levels in the body. Consuming a lot of purine-heavy foods can counteract the effectiveness of the medication.

Here are foods highest in purines that should be limited or avoided when taking allopurinol:

• Organ meats like liver, kidneys, brains
• Game meats like venison, boar, rabbit
• Anchovies, sardines, herring
• Mackerel, trout, haddock, tuna
• Scallops, mussels, crab
• Meat-based gravies and broths
• Yeast extracts like Marmite
• High-fat cuts of beef, lamb, and pork
• Bacon, sausage, veal, goose
• Meat sauces and spreads like pâté

In moderation, foods like poultry, eggs, peanut butter, asparagus, spinach, and mushrooms can be enjoyed in a gout diet while taking allopurinol.

Alcohol to Avoid on Allopurinol

All types of alcohol should be avoided when taking allopurinol. Alcohol interferes with how the medication works and can bring uric acid levels back up. However, some types of alcohol are worse for gout than others.

These alcoholic drinks contain higher purines and pose the greatest risk:

• Beer, especially darker varieties like stouts and porters
• Gin and whiskey
• Fortified wines like sherry and port

In contrast, some alcoholic drinks with lower purine content can potentially be consumed in strict moderation, like:

• Wine, especially white
• Vodka, rum, tequila
• Light beers and hard seltzers

However, abstaining completely while taking allopurinol is ideal to keep uric acid levels down.

Sugary Foods and Beverages

There is some evidence that excess sugar intake is associated with higher uric acid levels. Sugary foods and beverages provide purine precursors that can be converted into uric acid in the body.

It’s wise to limit items like:

• Soda, energy drinks, juices
• Candy, ice cream, baked goods
• Sweetened cereals, jams
• Sports drinks, sweet tea
• Flavored coffee drinks
• Honey, agave, maple syrup

Unsweetened options like water, unsweetened tea, black coffee, and fresh fruit are better choices when taking allopurinol.

Avoid Certain Supplements and Vitamins

Some vitamins and supplements can adversely interact with allopurinol, including:

• Vitamin C supplements
• Multivitamins containing vitamin C
• Calcium supplements
• Iron supplements
• Vitamin B3 (niacin)

High doses of vitamin C may increase the risk of kidney stones. Calcium can build up in soft tissues. And iron, vitamin B3, vitamin C may elevate uric acid levels.

Check with a doctor before taking any supplements with allopurinol.

Avoid Certain Medications and Drugs

Some categories of medications may cause negative interactions or increased side effects when taken with allopurinol. These include:

• Blood thinners like warfarin – allopurinol prolongs their effects
• Antihypertensives like diuretics – increased risk of toxicity
• Immunosuppressants like cyclosporine – more toxicity
• Some chemotherapy drugs – enhanced bone marrow suppression
• Oral diabetes drugs – fluctuating blood sugar levels

Allopurinol also should not be taken with probenecid or ampicillin. Illicit drugs like cocaine and amphetamines can raise uric acid.

Inform any healthcare providers about all medications and supplements being taken with allopurinol.

Other Substances to Use Cautiously

Some other items that can potentially worsen gout or interact with allopurinol include:

• Fructose-containing foods in excess
• Artificial sweeteners like aspartame
• Excess vitamin A
• Large doses of niacin
• Stinging nettle
• Dandelion leaf extract

Additionally, rapid weight loss and crushing injuries or trauma to tissue can increase uric acid and gout risk for those taking allopurinol.

Tips to Avoid Problems When Using Allopurinol

Here are some tips to get the most out of allopurinol treatment while avoiding complications:

• Take the medication consistently, as prescribed by a doctor.
• Drink plenty of water, at least 8 glasses daily.
• Follow a gout diet focused on lean proteins, complex carbs, and antioxidants.
• Limit purine-rich foods especially organ meats, seafood, gravies, etc.
• Avoid all alcohol, especially beer, gin, whiskey, and fortified wines.
• Minimize excess sugar and artificial sweeteners.
• Use caution with supplements, vitamins, and medications.
• Stay current on lab work to monitor uric acid and kidney function.

With diligence about avoidances, allopurinol can safely decrease gout flare-ups and complications.

The Bottom Line

Successfully managing gout with allopurinol involves being aware of items that can interact with the medication and raise uric acid levels. By understanding what foods, beverages, and substances to limit or avoid altogether, patients can improve allopurinol’s effectiveness and reduce adverse reactions.

Work closely with your healthcare providers and follow their guidance about utilizing allopurinol safely. Pay particular attention to guidelines around purine-rich foods, alcohol, supplements, and other medications. With smart lifestyle adjustments, allopurinol can get gout under control.