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Is zyloric advisable for high uric acid?

Friday, 06 June 2003
Answered by: Chandra M. Gulhati
Editor,
MIMS,
New Delhi
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Q. Recently, I had a blood test done and my uric acid level was 7.2 mg/dl; My LDL cholesterol was 155, HDL 24, VLDL 56 and triglycerides 278. My doctor asked me whether I had pain in my joints, as I have pain when I press the joints in my toes and fingers. The doctor said something about gout and prescribed Zyloric 100 mg morning and evening and Simvastatin 20 mg at night. My question is whether the value 7.2 mg/dl for uric acid accompanied by the said pain, warrants the prescription of Zyloric. Your advice would be greatly appreciated.

A.  Uric acid levels of up to 7 mg/dl are within the normal range and hence do not need treatment. Beyond this level, it should be treated. Hence the prescription of allopurinol (Zyloric) 100 mg is appropriate in your case. I would suggest that you get your uric acid checked again, at a different laboratory, to ensure that there is no mistake in the determination of uric acid level. Also you need to avoid certain foods about which your doctor must have told you. With regard to your lipid levels, the problem appears to be more with triglycerides and much less with cholesterol. I should think that you should be on one of the fibrates such as bezafibrate (Bezalip Retard) 400 mg daily after food at night. This will lower your triglycerides by 30 to 40% and increase HDL by 10 to 20%. Fibrates should not be taken with any statin (such as simvastatin) due to the possibility of serious side effects.

A.  Uric acid levels of up to 7 mg/dl are within the normal range and hence do not need treatment. Beyond this level, it should be treated. Hence the prescription of allopurinol (Zyloric) 100 mg is appropriate in your case. I would suggest that you get your uric acid checked again, at a different laboratory, to ensure that there is no mistake in the determination of uric acid level. Also you need to avoid certain foods about which your doctor must have told you. With regard to your lipid levels, the problem appears to be more with triglycerides and much less with cholesterol. I should think that you should be on one of the fibrates such as bezafibrate (Bezalip Retard) 400 mg daily after food at night. This will lower your triglycerides by 30 to 40% and increase HDL by 10 to 20%. Fibrates should not be taken with any statin (such as simvastatin) due to the possibility of serious side effects.

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