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Safety as assessed by the number of study participant withdrawal due to AEs or SAEs were not reported, but AEs were reported.

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Allopurinol may be required before its full effects are manifested; likewise, uric acid may return to pretreatment levels slowly (usually after a period of 7 to 10 days following cessation of therapy).

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Our review did not identify any RCTs or CCTs that used allopurinol in doses as high as 800 mg daily, although one trial titrated the dose to 600 mg daily, which enabled achievement of the target serum urate target level ().

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The use of Allopurinol to block the formation of urates avoids the hazard of increased renal excretion of uric acid posed by uricosuric drugs.

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In contrast to our review, included two trials with mixed populations of people with hyperuricaemia and chronic gout ( (S13-18); (S44-S49); and excluded from their review due to methodological limitations.

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The duration of gout affecting the participants was reported in all 11 studies, and ranged from a few days to 25 years.

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All other comparisons (allopurinol versus colchicine, allopurinol versus probenecid, continuous versus intermittent allopurinol and different doses of allopurinol) were supported by small, single studies only, limiting conclusions.

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Allopurinol belongs to a class of drugs known as xanthine oxidase inhibitors.

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Two independent reviewers (RS and AK) will extract relevant information from the included trials including study design, characteristics of study population, treatment regimen and duration, outcomes and timing of outcome assessment, using predetermined forms.

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Incorrect population: in an open-controlled, randomised trial over 24 weeks, the serum uric acid lowering effect of a daily dose of allopurinol 100 mg in combination with benzbromarone 20 mg compared with allopurinol 300 mg alone was investigated on 60 participants with hyperuricaemia.

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Two review authors (RS and AK) will independently assess the risk of bias of all included studies.

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We considered trials that included adults (aged greater than 18 years) with a diagnosis of chronic gout.

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One trial that included 37 participants, judged to be at high risk of bias, compared allopurinol (100-150 mg daily initially, titrated to 100, 200 or 300 mg daily according to creatinine clearance) with benzbromarone (100 mg daily titrated with increments of 50 mg daily to 200 mg daily) ().

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Whereas Allopurinol is cleared essentially by glomerular filtration, oxipurinol is reabsorbed in the kidney tubules in a manner similar to the reabsorption of uric acid.

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We clarified that we excluded mixed populations in the review; included search of registries for serious adverse effects and specified the other sources of bias we looked for: whether there was a carry-over effect from previous therapies, whether appropriate co-intervention (e.

The dose of oral mercaptopurine (Purinethol) and azathioprine (Imuran) should be reduced as Allopurinol increases their blood levels.


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In people with chronic gout, compared with febuxostat (80 mg daily), low-quality evidence indicated that allopurinol (100 to 300 mg daily) may not reduce the number of acute gout attacks, and may be less effective in achieving target serum urate levels, without increasing withdrawals due to AEs, or serious adverse event rates.

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