Antigout
Generic and Trade Names:
| Colchicine | Colchicine | |
| Allopurinol | Zyloprim, Lopurin, Zurinol | |
| Sulfinpyrazone | Anturane, Aprazone | |
| Probenecid | Benemid, Probalan |
Description:
There are various agents used to treat the symptoms of gout E.g. Allopurinol (Zyloprim), Probenecid or Colchicine. Colchicine reduces and decreases inflammation and the deposition of uric acid in joints. Sulfinpyrazone increases uric acid secretion, thus lowering levels of uric acid in the body. Probenecid is used to treat chronic gout and increase blood levels of the penicillins and cephalosporins. Probenecid increases the excretion of uric acid and reduces penicillin excretion. Allopurinol is a prescription drug classified for use in gout, and other conditions in which uric acid levels are high(see gout), kidney stones. This drug acts to inhibit the enzyme xanthine oxidase, thus slowing the formation of uric acid. (Drug Facts and Comparisons 1999)
Nutritional Considerations:
Monitor purine foods, or a low purine diet may be prescribed.(Saji, 1996)
Avoid aspirin. (Facts 1999)
Avoid alcohol. (Facts 1999)
Avoid excess vitamin C because it could increase chances of kidney stones. (Pronsky 1998)
Drink adequate amounts of fluids(2.5-3L) per day to produce 2L of urine per day. (Pronsky 1999)
For stomach upset take with food. (Pronsky 1999)
Maintain alkaline urine (Pronsky 1999)
Limit coffee and tea, as these substances can contribute to uric acid stones, and also quicken the excretion of Allopurinol. (Balch 1996) (Grant, 1986)
Monitor blood counts and liver and kidney function during treatment with these medications. (Drug Facts and Comparisons 1999)
The absorption of a number of nutrients may be impaired and require supplementation because of mucosal injury:
Vitamins: Vitamin A Riboflavin, B12. (McKevoy 1998)(Brinker 1998)
Minerals: Calcium, Iron, Potassium and Sodium;(Brinker 1998)
Herbal Considerations:
Avoid Autumn Crocus together with colchicine because it can increase side effects. (Blumenthal 1998)
Plants containing salicylate such as, Black cohosh, Meadowsweet flower, Poplar bark, Sweet birch bark, Willow bark and Wintergreen leaves may interfere with colchicine or probenecid. (Brinker 1998)
Tannin containing plants: Atropa belladonna, Lobelia inflata can also interfere with colchicine. (Brinker 1998)
References
Angel, J.E. 1983. Physicians Desk Reference. Medical Economics Company, Inc. Oradell, New Jersey.
Balch, J.F. & Balch, P.A.: Prescription for Nutritional Healing. Second Edition. Avery, New York. 1996.
Blumenthal M, et al. ed. The Complete German Commission E Monographs:
Therapeutic Guide to Herbal Medicines. Trans. S.Klein.
Boston, MA: American Botanical Council, 1998.
Brinker, Francis N.D. Herb Contraindications and Drug Interactions. 1998
Calin A: Allopurinol toxicity masquerading as malignancy. JAMA 1978; 239:497.
Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 1999.
Grant DM, Tang BK, Campbell ME, Kalow W: Effect of allopurinol on caffeine disposition in man, Br J Clin Pharmacol, 1986 Apr; 21(4):454-8
Griffin JP: Drug-induced disorders of taste. Adv Drug React Toxicol Rev 1992; 11:229-239.
Griffith, H. W. 1983. Complete Guide to Prescription and Non-Prescription. Fisher Publishing, Inc., Tucson.
McKevoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Osol, Arthur. 1980. Remington's Pharmaceutical Sciences. Mack Publishing Company, Pennsylvania.
Pronsky, Zaneta, MS, RD, FADA. Food Medication Interactions. 11th edition.
Saji M: [A study of serum oxipurinol concentration and renal function in patients administered allopurinol], Nippon Jinzo Gakkai Shi 1996 Dec;38(12):640-50
United States Pharmacopeia Dispensing Information. 15th edition, 1995.
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