.
Allopurinol is a xanthine oxidase inhibitor used to prevent gout and to lower blood levels of uric acid in certain people taking drugs for cancer.
Interactions with Dietary Supplements
Vitamin D
Individuals with gout have low blood concentration of the
active form of vitamin D (1,25 dihydroxycholecalciferol), and allopurinol corrects this
problem.1
L-Carnitine
People who have Duchenne muscular dystrophy have low levels of L-carnitine in their muscles.
Allopurinol restores L-carnitine to normal levels, resulting in improved muscle
strength.2 Whether L-carnitine supplementation might improve this effect of
allopurinol has not been investigated.
L-tryptophan
In a preliminary study, seven of eight individuals with severe mental depression showed improvement when they took L-tryptophan and
allopurinol;3 of these seven, five experienced full remission. Controlled research
is necessary to determine whether this combination might be more effective for severe
depression than standard treatment.
Interactions with Foods and Other Compounds
Food
Allopurinol may be taken with food to prevent stomach upset.4
Protein
Compared with people on high-protein diets, people on low-protein diets excrete less
allopurinol, resulting in a threefold increase in the time it takes for the drug to be removed
from the body.5 Vegetarians and those who eat low-protein diets (20 grams of
protein a day or less) should discuss this possible interaction with their healthcare
practitioner before taking allopurinol.
Alcohol
According to animal research, alcohol reduces the activity of antioxidant systems involving
vitamin E, vitamin C, and selenium, leading to tissue damage in the cerebellum; however,
allopurinol reverses this effect.6 Drinking alcoholic beverages also increases the
removal of allopurinol from the body, thereby reducing the effectiveness of the
drug.7 Therefore, people taking allopurinol should avoid alcohol.
Summary of Interactions for Allopurinol
| Depletion or interference | None known |
|---|---|
| Adverse interaction | None known |
| Side effect reduction/prevention | None known |
| Supportive interaction | L-tryptophan |
| Reduced drug absorption/bioavailability | None known |
| Other (see text) | L-carnitine Vitamin D |
For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
References:
1. Takahashi S, Yamamoto T, Moriwaki Y, et al. Decreased serum concentrations of 1, 25 (OH)2-vitamin D3 in patients with gout. Metabolism 1998;47:336–8.
2. Camina F, Novo-Rodriguez MI, Rodriguez-Segade S, Castro-Gago M. Purine and carnitine metabolism in muscle of patients with Duchenne muscular dystrophy. Clin Chim Acta 1995;243:151–64.
3. Stern SL, Mendels J. Drug combinations in the treatment of refractory depression: a review. J Clin Psychiatry 1981;42:368–73.
4. Threlkeld DS, ed. Central Nervous System Drugs, Antiemetic/Antivertigo Agents, Miscellaneous, Agents For Gout. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparison, 1999, 1523–7.
5. Murrell GA, Rapeport WG. Clinical pharmacokinetics of allopurinol. Clin Pharmacokinet 1986;11:343–53.
6. Nordmann R, Ribiere C, Rouach H. Ethanol-induced lipid peroxidation and oxidative stress in extrahepatic tissues. Alcohol Alcohol 1990;25:231–7.
7. Kaneko K, Fujimori S, Ishizuka I, Akaoka I. Effects of ethanol on metabolism of the hypourecemic agents allopurinol and benzbromarone. Clin Chim Acta 1990;193:181–6.
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The information presented in VitaminLore is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.