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Below is a professional and clear summary of critical safety information and warnings associated with the use of allopurinol (Zyloprim). Please read this carefully and consult your healthcare provider with any questions or concerns.

• Severe Skin Reactions: Rare but potentially life-threatening skin reactions may occur, such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and DRESS syndrome. The risk is heightened during the initial months of treatment, especially if you have the HLA-B 58:01 gene, are of African or Asian descent, have kidney issues, or are taking thiazide diuretics, bendamustine, ampicillin, or amoxicillin.

• Increased Gout Attacks: During the first few months of treatment, you may experience more frequent gout flares. This happens as the medication lowers uric acid levels rapidly, potentially causing joint irritation and inflammation.

• Kidney Stones and Injury: There is a possibility of developing kidney stones, which could lead to kidney injury. This risk is higher in individuals with a history of kidney problems or stones, as well as those who are dehydrated.

• Liver Damage: Allopurinol (Zyloprim) can cause liver damage, which is often reversible upon discontinuation of the medication. Though usually mild, it can be severe in rare cases. Regular monitoring of liver enzymes is advised, particularly if you have pre-existing liver conditions. Be alert for symptoms such as appetite loss, weight loss, itching, or yellowing of the skin or eyes, and contact your healthcare provider if these occur.

• Low Blood Cell Counts: Although rare, this medication can lead to decreased levels of red blood cells, white blood cells, or platelets, increasing the risk of anemia, infections, and easy bleeding or bruising. This condition can develop from one month to several years after beginning treatment.

• Sleepiness and Dizziness: Allopurinol (Zyloprim) may cause dizziness or sleepiness, affecting cognitive functions and reaction times. The risk increases if you are also using medications that induce drowsiness, such as benzodiazepines, muscle relaxants, or sleep aids, or if you are taking high doses of allopurinol.

Please ensure you adhere to these guidelines and promptly communicate with your healthcare provider if you experience any adverse effects or have concerns regarding your treatment.

When taking this medication, you may experience common side effects that are generally mild and temporary. These include stomach upset, nausea, diarrhea, drowsiness, and elevated liver enzymes. If these symptoms persist or worsen, it's advisable to consult with your healthcare provider for guidance. Other side effects that may occur include rashes, headaches, and changes in taste, as well as joint or muscle pain. It's important to monitor these symptoms and seek advice if necessary.

Serious side effects, although rare, demand immediate medical attention. These include severe skin reactions such as painful blisters, skin peeling, or hives, which can be life-threatening. Certain ethnic groups may have a higher risk of these severe skin reactions. Additionally, watch for signs of severe allergic reactions like facial swelling, difficulty breathing, or anaphylaxis, which require urgent care. Liver issues may also arise, indicated by symptoms such as persistent nausea, vomiting, abdominal pain, or yellowing of the skin and eyes. Low blood cell counts may present with fever, unusual bruising, or blood in urine or stool, necessitating prompt medical evaluation.

Always be vigilant for any unusual symptoms and seek immediate medical assistance for severe reactions to ensure your safety. If you notice any other effects not listed here, contacting your healthcare provider is recommended.

When taking Allopurinol (Zyloprim), it is important to inform your doctor and pharmacist about all the medications and supplements you are using, including prescription, over-the-counter, vitamins, and herbal products. This medication can interact with several other drugs, potentially affecting their efficacy or increasing side effects.

Some interactions with Allopurinol include:

1. Not Recommended:

   • Didanosine: Using Allopurinol with Didanosine is not advised due to potential severe interactions. Your healthcare provider may choose an alternative treatment or adjust your existing medications.

2. Usually Not Recommended but May Be Necessary:

   • Blood Thinners (e.g., Warfarin, Acenocoumarol, Phenprocoumon): These may require dose adjustments if used together with Allopurinol.
   • Capecitabine, Azathioprine, Fluorouracil, Mercaptopurine, Pegloticase: Caution is advised as these combinations might necessitate dosage changes or increased monitoring.
   • ACE Inhibitors (e.g., Captopril, Enalapril, Enalaprilat): May require special attention if prescribed together with Allopurinol.
   • Tegafur: Similar precautions as above may be necessary.

3. Increased Risk of Side Effects:

   • Aluminum Hydroxide, Cyclosporine, Vidarabine: These combinations may enhance side effects, but may also be necessary, requiring careful dose management and monitoring.

Always consult your doctor before making any changes to your medication regimen to ensure safe and effective treatment.