A young female visitor asked about allopurinol as she feared Steven-Johnson Syndrome.
Any Alternatives To Allopurinol?
Why do people seek allopurinol alternatives?
Are medical alternatives safe?
Are natural alternatives effective?
Before we look at these questions, it helps to know what Steven-Johnson syndrome is.
Steven-Johnson Syndrome
Steven-Johnson syndrome (SJS) is an immune system reaction varying from mild irritation of the skin and mucous membranes to fatal rashes and inflammation involving the entire body. The reaction appears, from several studies, to be associated with certain genes. Pictures are horrific, so they generate fear in potential allopurinol takers. There is an associated condition called Toxic Epidermal Necrolysis (TEN), and any reaction to allopurinol, or any other gout treatment must be taken seriously.
However, you must realize that this allopurinol side effect is rare, and fatalities are one or two cases per million. If allopurinol is started with a 100mg dose for 4 weeks, this will allow you to see if you are at risk. Arrange for blood tests towards the end of this trial period. Kidney and liver function tests will confirm that you have no reaction, and uric acid levels will give an indication of how much dosage will need to change to get uric acid to 5mg/dL (0.30mmol/L) or below.
Remember, that despite the horrific nature of rare SJS and TEN, untreated gout will always result in horrific, disfiguring tophi, and crippled joints. Therefore, doing nothing is not an alternative. If you have gout, you must quickly find an alternative for lowering uric acid if you do not take allopurinol.
Medical Allopurinol Alternatives
There are other gout medications to avoid gout by lowering uric acid. Those pages include febuxostat (Uloric/Adenuric) which works in a similar way to allopurinol by lowering uric acid production from inhibiting xanthine oxidase.
Uricosurics such as probenecid lower uric acid levels by encouraging excretion. Many people are reporting effective uric acid lowering from combinations, and there is also a new medication that breaks down uric acid. Pegloticase (Krystexxa) is for extreme cases, but there are also other new drugs being developed as alternatives to allopurinol.
Natural Allopurinol Alternatives
Recent guest writer articles have reported on a herbal combination therapy for lowering uric acid. I have noted that there are many investigations into plant-based treatments, and I will continue to report on these as more discoveries are made. Many of these have looked at plants used in traditional medicines in several countries.
Testing is just as important with natural gout treatments as it is with gout medications. Whether you take allopurinol, or one of it’s alternatives, you must take regular blood tests to ensure uric acid remains safe at 5mg/dL (0.30mmol/L) or below.
You can ask about allopurinol alternatives in the gout support forum, and I would especially like to see your suggestions for alternatives to allopurinol. Please note, I have nothing against allopurinol, it works marvelously well for me, but other gout patients show reluctance. Most important to me, is getting proper uric acid lowering treatment to keep you at safe levels. I hope that, with more choices, more people will be committed to controlling their uric acid.
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