Indocin vs. Allopurinol for Gout: Important Differences and Potential Risks.

Key takeaways

Indocin (indomethacin) and Zyloprim (allopurinol) are both prescription medications, but they treat different conditions and belong to different drug classes. Indocin is an NSAID used to treat various types of arthritis, shoulder pain, and gouty arthritis by reducing inflammation and pain. It is available as a tablet, supsension, and rectal suppository, which can be beneficial for those who have trouble swallowing pills. On the other hand, Zyloprim is a xanthine oxidase inhibitor that lowers uric acid levels to treat gout, prevent kidney stones, and manage tumor lysis syndrome in cancer patients. Zyloprim is taken orally daily and can be split into smaller doses if needed. While Indocin can cause serious side effects like stomach bleeding and heart issues, Zyloprim may lead to severe skin reactions and liver problems. Both medications have generic forms available, making them more affordable options.

Indomethacin

(Indocin)

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Allopurinol

(Zyloprim)

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Summary for Indocin

Prescription only

Indomethacin (Indocin) suppository is an NSAID that's used to treat different types of arthritis and conditions that cause pain in the shoulder. It helps lower inflammation and relieve pain. As a suppository, it's inserted into the rectum, typically 2 to 4 times a day depending on what condition the medication is being used to treat. Side effects might include headache and stomach upset. Unlike other NSAIDs, indomethacin (Indocin) suppository isn't available over-the-counter and requires a prescription from your healthcare provider.

Indications for Indocin

Moderate-to-severe rheumatoid arthritis, including flare-ups
Moderate-to-severe ankylosing spondylitis
Moderate-to-severe osteoarthritis
Shoulder pain caused by bursitis or tendonitis
Gouty arthritis

Pros and Cons for Indocin

Pros

Good option for people who have trouble swallowing pills
Can treat many different types of arthritis
Available as a lower-cost generic

Cons

Only available in one strength (50 mg), so you might need to use several suppositories if you're taking a high dose
Might need to take multiple times per day
Not available over-the-counter

Common Side Effects for Indocin

Note: The side effects listed here are for indomethacin capsules. Side effects for the suppositories might differ.

Headache
Dizziness
Nausea
Stomach upset

Warnings for Indocin

Stomach bleeding and ulcers
Heart attack and stroke
High blood pressure and heart failure
Liver problems
Kidney damage and high potassium levels
Severe allergic reactions
Severe asthma attack
Worsening of nervous system and mental health problems
Harm to unborn babies

Summary for Allopurinol

Prescription only

Allopurinol (Zyloprim) is a xanthine oxidase inhibitor that lowers uric acid levels in the body. It's used to treat gout in adults. This prescription medication can also prevent recurrent calcium oxalate kidney stones in adults. In addition, allopurinol (Zyloprim) helps prevent tumor lysis syndrome in people with cancer who are taking certain chemotherapy (cancer medications). Allopurinol (Zyloprim) is a lower-cost generic tablet that's taken by mouth. Side effects are generally mild but can include diarrhea and nausea.

Indications for Allopurinol

Gout in adults
Prevention of tumor lysis syndrome from certain chemotherapy medications in adults and children with cancer
Recurrent calcium oxalate kidney stones in adults

Pros and Cons for Allopurinol

Pros

First-choice option for treating gout
Can take with or without food
Available as a lower-cost generic

Cons

Might raise the risk for gout attacks in the first few weeks (since your uric acid levels are rapidly changing during this time)
Can cause kidney stones, especially in people who don't drink a lot of fluids
Possible risk for low blood cell levels and liver damage