It is for a certain that gout has a handful of devastating effects. For this very reason, a lot of medications were invented too. All of which are applying different mechanisms in approaching gout from different sides and angles. The allopurinol, febuxostat, and colchicine are just none but few.
Due to the differences in the medications, a lot of questions arise. All of these questions may be inquiries about the effectiveness, dosage, time of intake, mechanisms, as well as the side effects of the medications.
One common question that’s being raised is, “Why does allopurinol worsen acute gout?” this article wishes to explain the irony of allopurinol being a medication for gout. As well as a medication that may worsen the gout attacks.
The Irony of Allopurinol
Allopurinol is an acclaimed very effective medication in the reduction of uric acid. Coming along with this is febuxostat, these two are the most common of all the medications that help in lowering the uric acid.
In spite of being recommended as a medication for gout, the allopurinol may worsen the gout attacks. The pain may become more severe and more intense. This has something to do with the mechanism of the allopurinol.
The allopurinol, as we know, is a xanthine oxidase inhibitor. Meaning, it prevents the xanthine oxidase enzyme from responding with purine. If the purine doesn’t react with the xanthine oxidase, it isn’t broken down into uric acid.
Simply speaking, the allopurinol ensures the binding with the xanthine oxidase rather than having purine bind with the enzyme. It just distracts the xanthine oxidase.
Now, to answer the question “why does allopurinol worsen acute gout?” we need to understand the mechanism of gout attacks first.
Gout Mechanism
Gout is a type of condition that’s caused by an excessive level of uric acid. Usually, the presence of the uric acid will not cause any pain. The agony starts when the uric acid goes amiss and transpire in the wrong place.
The excretory system may only process a limited amount of uric acid. It isn’t a machine that may do an instant job to get rid of all the toxic materials. The unprocessed uric acid may temporarily be stored in the interstitial fluids ‘til there’s a space for them to be processed. If there’s no more space for them even in the interstitial fluids, they’ll be obliged to various areas that are all supposed to be hygienic, just like in the synovial fluids.
The synovial fluids are located in the synovial joints or what we commonly call as the ball-and-socket joints. When they form crystals, they‘ll be thought as foreign objects and will be triggering some autoimmune pain since the body will try resisting the existence of the uric acid in the joints. Over the period of time, the crystal will be settled and the pain will dwindle.
Furthermore, the pain may start again when the crystal that’s settled is troubled. It’ll garner the attention of the autoimmune system and cause pain one more time. In the event that the uric acid stays settled for a very long period of time and starts to deteriorate, it may also cause pain.
Why Does The Allopurinol Worsen Acute Gout?
As mentioned earlier, if it is left undisturbed, the uric acid crystal may deteriorate on the assumption that there will be no uric acid. If it so happens to deteriorate, the uric acid crystal bits being disconnected from it may trigger some autoimmune responses.
Bear in mind that we don’t endorse the use of allopurinol. The uric acid crystals may worsen, however, the purine that isn’t broken down stays in the bloodstream. This will now then be a long term problem for the liver. With the proviso that the liver perceives the purine, it’ll keep on pumping more and more xanthine oxidase enzyme.
We actually have lots of other articles which may discuss the side effects of the allopurinol, as well as the natural alternative treatments, which may help in easing the pain and treat gout without depending on a drug that may risk the life.
