From the Guidelines
When taking allopurinol, it is recommended to maintain a balanced diet with moderate portions of high-purine foods, reduce alcohol consumption, and stay well-hydrated to support overall uric acid management and reduce the risk of gout flares. While allopurinol effectively lowers uric acid levels by inhibiting xanthine oxidase, some dietary modifications are still beneficial. Limit high-purine foods like organ meats, shellfish, and red meat to moderate portions, as they can raise uric acid levels 1. Reduce alcohol consumption, especially beer, as it can interfere with allopurinol's effectiveness and raise uric acid levels 1. Stay well-hydrated by drinking 8-10 glasses of water daily to help flush uric acid from your system. Maintain a healthy weight through balanced nutrition and regular exercise, as excess weight contributes to higher uric acid levels 1. Consider reducing intake of sugary beverages and foods with high-fructose corn syrup, which can worsen gout 1. Low-fat dairy products should be encouraged, and regular exercise should be advised, as they have been shown to have a positive effect on uric acid levels and gout management 1. These dietary adjustments complement allopurinol therapy by supporting overall uric acid management and reducing the risk of gout flares during treatment. It is essential to note that the most recent and highest quality study, published in 2017, provides the most up-to-date guidance on dietary modifications for patients taking allopurinol 1.
From the FDA Drug Label
A fluid intake sufficient to yield a daily urinary output of at least 2 liters and the maintenance of a neutral or, preferably, slightly alkaline urine are desirable to (1) avoid the theoretical possibility of formation of xanthine calculi under the influence of therapy with allopurinol tablets and (2) help prevent renal precipitation of urates in patients receiving concomitant uricosuric agents
- The patient should increase fluid intake to at least 2 liters per day to help prevent renal stones and urate precipitation.
- It is also recommended to maintain a neutral or slightly alkaline urine.
- Patients should be encouraged to increase fluid intake during therapy to prevent renal stones 2.
From the Research
Dietary Modifications on Allopurinol
To manage conditions like gout while on allopurinol, certain dietary modifications can be beneficial:
- Reduce intake of purine-rich foods such as meat and seafood, as they can increase uric acid levels 3
- Limit consumption of fructose-rich foods and beverages, as they are associated with hyperuricemia and renal dysfunction 4
- Maintain a healthy weight, as obesity is a risk factor for gout 3
- Stay hydrated to help flush out uric acid from the body
- Consider increasing intake of foods that can help lower uric acid levels, such as those high in antioxidants like rutin and quercetin 4
Foods to Avoid
Foods that can trigger gout attacks or increase uric acid levels should be avoided or consumed in moderation:
- Organ meats like liver and kidney
- Seafood like anchovies and sardines
- Red meat
- Foods high in sugar and refined carbohydrates
- Alcohol, especially beer and liquor
Importance of Dietary Changes
Dietary modifications are crucial in managing gout and reducing the risk of complications: