Can You Take Uric Acid and Liver Health Medications Together?

Q: Can You Take Uric Acid and Liver Health Medications Together?

Dear Mr. Wang： **Allopurinol Tablets® (Allopurinol; 100 mg)：** 1. Allopurinol is a purine derivative that reduces uric acid synthesis by competitively inhibiting the last two steps of uric acid biosynthesis, which are catalyzed by xanthine oxidase. Uric acid is

Can medications for lowering uric acid be taken simultaneously with liver-protective medications?

Recently, I have been experiencing frequent foot pain, so I visited a general clinic for medical attention.
Following the doctor's recommendations, I underwent blood tests and discovered that my uric acid levels and liver enzymes were elevated.
The doctor prescribed me a uric acid-lowering medication, Yongxin - Allopurinol, and a liver-protecting medication, Guojia - Sijian Capsules.
Can I take Yongxin - Allopurinol and Guojia - Sijian Capsules together? Also, I have heard that the uric acid-lowering medication Allopurinol can harm liver and kidney function.
Is this true? Can I safely use the uric acid-lowering medication Allopurinol?

Wang Tongxue, 30~39 year old female. Ask Date: 2019/02/16

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Wang:
Allopurinol Tablets® (Allopurinol; 100 mg):
1.
Allopurinol is a purine derivative that reduces uric acid synthesis by competitively inhibiting the last two steps of uric acid biosynthesis, which are catalyzed by xanthine oxidase.
Uric acid is less soluble than its precursors; therefore, when xanthine oxidase is inhibited, the solubility of purine derivatives (xanthine and hypoxanthine) in the blood increases, reducing the likelihood of precipitation.
2.
Allopurinol is effective in treating primary hyperuricemia associated with gout, as well as secondary hyperuricemia caused by other conditions, such as certain malignancies (which produce large amounts of purines, especially after chemotherapy) or kidney diseases.
This medication is the first choice for patients with a history of kidney stones and a creatinine clearance rate of less than 50 mL per day.
3.
Allopurinol is completely absorbed after oral administration, and its main metabolite is alloxanthine (oxypurinol), which is also a xanthine oxidase inhibitor with a half-life of 15 to 18 hours; the half-life of allopurinol itself is 2 hours.
Therefore, effective inhibition of xanthine oxidase can be maintained with once-daily dosing.
Both the drug and its metabolites are excreted in feces and urine.
4.
Most patients tolerate allopurinol well, with the most common side effect being allergic reactions, particularly skin rashes, occurring in nearly 3% of patients.
Such reactions may develop after long-term use over months or years, at which point allopurinol treatment should be discontinued.
Silymarin Capsules 150 mg (Silimin):
1.
According to the manufacturer's insert, silymarin is a natural plant extract.
Silymarin has a strong affinity for liver cells, binding to the cell membrane and protecting its integrity.
It can penetrate liver cells to enhance their metabolic functions and promote the regeneration of damaged liver cells.
It also enhances the secretory function of liver cells and helps to halt disease progression, facilitating the repair of inflammatory cells.
2.
This medication has antioxidant properties that prevent damage to liver cell membranes caused by free radicals and peroxides generated from drugs, toxins, or metabolic processes, thereby maintaining normal liver function and ensuring overall health.
3.
If any allergic or adverse reactions (such as rash, itching, etc.) occur after taking this medication, please discontinue use immediately and consult a physician or pharmacist.
This medication is generally well tolerated, and gastrointestinal discomfort (such as nausea, vomiting, or abdominal bloating) is extremely rare.
However, mild diarrhea or diuresis may occur with high doses or prolonged use.
In summary, there is no pharmacological or clinical reason to contraindicate the simultaneous use of these two medications.
However, if you experience any discomfort after taking them, please inform your attending physician immediately to clarify any issues.

Reply Date: 2019/02/16

More Info

When it comes to the concurrent use of medications for high uric acid levels, such as Allopurinol (known as 永信-安樂普利諾 in your case), and liver health medications like the liver protective capsule (國嘉-賜得健膠囊), it is essential to consider both the potential interactions and the individual health conditions involved.

Can You Take Allopurinol and Liver Health Medications Together?
In general, Allopurinol is a commonly prescribed medication for managing hyperuricemia (high uric acid levels) and preventing gout attacks. It works by inhibiting the enzyme xanthine oxidase, which is involved in the production of uric acid. On the other hand, liver health medications often contain ingredients aimed at improving liver function, detoxifying the liver, or protecting liver cells from damage.

Based on current medical knowledge, there are no direct contraindications for taking Allopurinol and liver health medications together. However, it is crucial to monitor liver function regularly, especially if you have pre-existing liver conditions or elevated liver enzymes. Both medications should ideally be prescribed and monitored by a healthcare professional who understands your complete medical history.

Concerns About Allopurinol and Liver/Kidney Function
Regarding your concern about Allopurinol potentially harming liver or kidney function, it is important to note that while Allopurinol is generally safe for most patients, it can have side effects, particularly in individuals with pre-existing liver or kidney issues. Some of the potential side effects include:
1. Liver Function: Allopurinol can cause mild elevations in liver enzymes, which usually resolve upon discontinuation of the medication. However, in patients with existing liver disease, careful monitoring is necessary.

2. Kidney Function: Allopurinol is primarily excreted through the kidneys, and in patients with renal impairment, the dosage may need to be adjusted to prevent accumulation and potential toxicity. It is essential to have your kidney function assessed before starting Allopurinol.

3. Allergic Reactions: Some patients may experience hypersensitivity reactions to Allopurinol, which can manifest as skin rashes, fever, or more severe conditions like Stevens-Johnson syndrome. If you notice any unusual symptoms after starting the medication, you should contact your healthcare provider immediately.

Recommendations
1. Consult Your Doctor: Before starting or continuing any medication regimen, especially with your history of elevated liver enzymes and uric acid levels, it is crucial to have a thorough discussion with your healthcare provider. They can provide personalized advice based on your specific health status.

2. Regular Monitoring: If you are prescribed Allopurinol, regular blood tests to monitor liver and kidney function, as well as uric acid levels, are essential. This will help ensure that the medications are working effectively without causing harm.

3. Lifestyle Modifications: In addition to medication, consider lifestyle changes that can help manage uric acid levels and support liver health. This includes maintaining a healthy diet low in purines (found in red meats, certain seafood, and alcohol), staying hydrated, and avoiding excessive alcohol consumption.

4. Report Side Effects: Be vigilant about any side effects you may experience while on these medications. If you notice symptoms such as jaundice (yellowing of the skin or eyes), dark urine, severe abdominal pain, or any other concerning signs, seek medical attention promptly.

In conclusion, while Allopurinol and liver health medications can generally be taken together, it is vital to approach this combination with caution, especially given your elevated liver enzymes. Regular monitoring and open communication with your healthcare provider will be key to safely managing your conditions.

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