ZYLOPRIM

Using Zyloprim for Gout
Gout is one of the most painful forms of arthritis. It is partly caused by high uric acid levels (see Causes of Gout). Uric acid is a substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods. Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine, where it is eliminated from the body. If the body increases its production of uric acid, or if the kidneys do not eliminate enough from the body, increased levels of uric acid build up in the blood.

Excess uric acid can form crystals in joints or other parts of the body. These crystals can lead to inflammation, causing painful gout symptoms. This increased level of uric acid in the blood can also lead to:

• Deposits of uric acid (called tophi) that look like lumps under the skin around the joints and at the rim of the ear
• Kidney stones from uric acid crystals in the kidneys.

Zyloprim is approved for treating gout. It works well for preventing gout attacks, although it is not very effective for treating a gout attack that is already occurring (in fact, it can temporarily worsen gout, especially at first). For these reasons, Zyloprim is usually used along with other gout medications, especially when first starting Zyloprim. There is no cure for gout, and medications may be more effective when combined with additional measures, such as a gout diet.

Some medical conditions may interact with Zyloprim. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have kidney or liver disease, heart problems (eg, congestive heart failure), bone marrow problems, high blood pressure, or diabetes

Some MEDICINES MAY INTERACT with Zyloprim. Tell your health care provider if you are taking any other medicines, especially any of the following:

- Amoxicillin or ampicillin because the risk of developing a skin rash may be increased
- Chlorpropamide because the risk of low blood sugar may be increased
- Dicumarol or oral anticoagulants (eg, warfarin) because the risk of bleeding may be increased by Zyloprim
- Thiazide diuretics (eg, hydrochlorothiazide) or uricosurics (eg, probenecid) because they may increase the risk of Zyloprim's side effects
- Cyclosporine or thiopurines (eg, azathioprine, mercaptopurine) because the risk of their side effects may be increased by Zyloprim

This may not be a complete list of all interactions that may occur. Ask your health care provider if Zyloprim may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

• Zyloprim may cause drowsiness. This effect may be worse if you take it with alcohol or certain medicines. Use Zyloprim with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• You may experience an increase in gout attacks for several months after you begin taking Zyloprim. Your doctor may give you another medicine (colchicine) to help decrease these gout attacks. Contact your doctor if you experience frequent or severe gout attacks.
• It may take 2 to 6 weeks to receive the full benefit of Zyloprim.
• Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
• Zyloprim is not useful for relieving an acute gout attack.
• Follow the diet and exercise program given to you by your health care provider.
• Lab tests, including uric acid levels and kidney and liver function, may be performed while you use Zyloprim. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Zyloprim while you are pregnant. Zyloprim is found in breast milk. If you are or will be breast-feeding while you use Zyloprim, check with your doctor. Discuss any possible risks to your baby.

As with any medicine, Zyloprim® (allopurinol) can cause side effects. However, not everyone who takes the medication will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or are easily treated by you or your healthcare provider.

(This article covers many, but not all, of the possible side effects with Zyloprim. Your healthcare provider can discuss a more complete list of Zyloprim side effects with you.)

Possible Side Effects of Zyloprim
Zyloprim has been thoroughly studied in clinical trials. In these studies, the side effects that occurred in a group of people taking the drug were documented and then compared to the side effects that occurred in another group of people not taking the medicine. As a result, it was possible to see what side effects occurred, how often they appeared, and how they compared to the group not taking the medicine.

In these studies, the most common Zyloprim side effects (occurring in more than 1 percent of people) included:

• Diarrhea
• Nausea
• Gout attacks.

Less-common side effects (occurring in less than 1 percent of people) that were thought to be related to Zyloprim included:

• Fever
• Headaches
• Vomiting
• Indigestion or heartburn
• Muscle pain
• Joint pain
• Unusual sensations (such as burning, pricking, or tingling) in the hands or feet
• Drowsiness
• Nosebleeds
• Hair loss
• Taste changes or loss of taste.