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

Key takeaways

Prednisone (Rayos, Prednisone Intensol) and allopurinol (Zyloprim) are both prescription medications, but they treat different conditions and belong to different drug classes. Prednisone is a corticosteroid used to manage an overactive immune system or inflammation, including autoimmune conditions and certain skin conditions. It works by calming the immune system. On the other hand, allopurinol is a xanthine oxidase inhibitor that lowers uric acid levels to treat gout, prevent kidney stones, and manage tumor lysis syndrome in cancer patients. Prednisone is available in various forms, including tablets and oral solutions, while allopurinol is only available as a tablet. Common side effects of prednisone include stomach irritation and mood changes, whereas allopurinol can cause diarrhea and nausea. Additionally, prednisone can lead to long-term issues like weight gain and weakened bones, while allopurinol may increase the risk of gout attacks when you first start taking it. Both medications require careful monitoring by your healthcare team to manage side effects and ensure they are working effectively.

Prednisone

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Allopurinol

(Zyloprim)

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Summary for Prednisone

Prescription only

Prednisone is an oral corticosteroid. It's taken by mouth by adults and children to treat health conditions related to an overactive immune system or inflammation, such as allergies and certain skin conditions. Your healthcare team will determine your dose based on what medical condition you have. Some of the common short-term side effects of prednisone include stomach irritation and mood changes. And if you take this medication for a month or longer, you're more likely to experience long-term side effects, like weight gain and weakened immune system.

Indications for Prednisone

This medication is used for many different conditions. Generally, it's used for autoimmune problems, conditions related to swelling, or cancer. Some examples include:

Allergies or allergic reactions
Skin conditions
Conditions affecting certain hormones (e.g., low adrenal hormones)
Eye conditions
Lung conditions
Gut conditions (e.g., ulcerative colitis)
Conditions related to blood cells
Certain cancers (e.g., leukemia
Nervous system conditions (e.g., multiple sclerosis)
Joint conditions (e.g., rheumatoid arthritis)
Lupus

Pros and Cons for Prednisone

Pros

Works well to treat many different conditions involving the immune system
Available as a liquid, which is a good option for people who have difficulty swallowing pills
Available as a lower-cost generic
Dose can be adjusted based on your response to the medication

Cons

Can cause side effects like upset stomach, mood changes, and sleep problems
Need to taper your dose before stopping (if you took it for more than a couple of weeks)
Might raise your risk for infections, bone weakening, and skin problems if used long term
Can slow growth in children if they take it for a long period of time

Common Side Effects for Prednisone

Swelling (e.g., puffiness in the face, hands, or feet)
Stomach bloating
Muscle weakness
Headache
Insomnia (trouble sleeping)
Changes in your mood
Larger appetite (possibly leading to weight gain)
Higher blood sugar

Warnings for Prednisone

Greater risk of infections
Mood and behavior changes
Reduced adrenal gland function
Changes in heart and kidney function
Stomach problems
Bone problems with long-term use
Eye problems with long-term use

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