Allopurinol lowers uric acid and is used long term to prevent gout attacks and kidney stones. The right dose varies by your symptoms, kidney function, and other medicines. Here’s a simple, practical dosing guide so you know what to expect before you talk to your doctor.
Most adults start at 100 mg once daily. If you tolerate it and your uric acid is still high, your doctor will slowly raise the dose every 2–4 weeks. Common maintenance doses are 100–300 mg daily. For stubborn high uric acid or frequent gout flares many people end up on 300–600 mg daily. In selected, closely monitored cases some clinicians use up to 800 mg daily, but that’s not routine and needs medical oversight.
The treatment goal is a serum uric acid under 6 mg/dL for most patients. For people with tophi or very frequent attacks, doctors often aim for under 5 mg/dL. Don’t increase dose faster than recommended — slow changes cut the chance of severe side effects and let you spot problems early.
Kidney function matters. If you have reduced kidney function, doctors usually start lower (for example 50–100 mg daily or alternate-day dosing) and increase very slowly. Another option is keeping the usual mg dose but giving it less often. Your prescriber will use your eGFR or creatinine clearance to adjust the plan. Regular blood tests are needed to check kidney function and uric acid while you’re on treatment.
Important safety notes: don’t start or raise allopurinol during an acute gout attack unless your doctor says otherwise — starting can sometimes worsen the attack briefly. If you have a serious rash or signs of a hypersensitivity reaction (fever, rash, liver or kidney problems), stop the drug and seek medical care immediately.
Also test for HLA-B*5801 if you are of Han Chinese, Korean, Thai ancestry, or certain other high-risk groups — that gene raises the risk of severe skin reactions on allopurinol. Your doctor will advise testing where appropriate.
Watch drug interactions. Allopurinol boosts levels of azathioprine and mercaptopurine — those doses must be reduced or avoided. Tell your doctor about all medicines and supplements you take, including OTC drugs.
Practical tips: take allopurinol after a meal to reduce stomach upset, drink water to help kidney clearance, and get a baseline blood test (renal panel, liver tests, uric acid) before starting. Expect your dose to change: many people need adjustments to reach the target uric acid safely.
If you’re unsure what dose is right, bring recent bloodwork and a list of medicines to your appointment. Proper dosing is a balance between lowering uric acid enough to prevent flares and avoiding side effects — your doctor will guide the right pace for you.
Confused about allopurinol dosage? This detailed guide breaks down how to find the right dose for treating gout and high uric acid. It covers starting amounts, dose adjustments, real-life examples, and safety tips, making it easy to understand and follow. Learn about what affects dosing, why it matters, and how to keep side effects at bay. Whether you're new to allopurinol or trying to fine-tune your treatment, you’ll find real, actionable advice here. Let’s make managing gout less of a headache.