From the Research
The best time to take allopurinol is in the morning after breakfast, as this helps reduce stomach upset and ensures consistent blood levels throughout the day. Taking allopurinol with food is generally recommended because it helps reduce gastrointestinal side effects, which are common with this medication 1. Morning dosing is preferred because it coincides with the body's natural metabolic activities, including the breakdown of purines from food. Allopurinol works by reducing uric acid production, and taking it at a consistent time each day helps maintain steady blood levels of the medication.
The typical starting dose is 100 mg daily, which may be gradually increased to 300-600 mg daily depending on uric acid levels and response to treatment 2. It's essential to drink plenty of water throughout the day while taking allopurinol to help flush uric acid from the system and reduce the risk of kidney stones. If any rash or severe side effects occur after taking allopurinol, it's crucial to contact a healthcare provider immediately, as this could indicate a serious allergic reaction. Consistency in timing is more important than the specific hour the medication is taken, so choosing a time that can be reliably remembered every day is key.
Some studies have investigated the safety and efficacy of allopurinol in various populations, including those with chronic kidney disease 3 and those at risk of allopurinol hypersensitivity syndrome 1. However, these studies do not provide specific guidance on the optimal timing of allopurinol administration. The most recent and highest-quality study on gout pharmacotherapy suggests that allopurinol is an effective and commonly used urate-lowering therapy, but it does not address the timing of administration 1.
In terms of potential side effects, a recent study found that colchicine and NSAID prophylaxis when initiating allopurinol for gout may be associated with an increased risk of adverse events, including diarrhea, myocardial infarction, and acute kidney injury 4. However, this study does not provide information on the optimal timing of allopurinol administration.
Overall, the available evidence suggests that taking allopurinol in the morning after breakfast is a reasonable approach, as it helps reduce stomach upset and ensures consistent blood levels throughout the day. However, the specific timing of administration may need to be individualized based on patient factors and preferences.