Q: I have a high uric acid level of 9, which I confirmed from three labs. Though the high uric levels have not manifested with gout yet, but I used to have joint pains, stiffness and inflammation. My internist put me on Zyloric 100 twice and after three months the uric acid level came to 4. During the treatment, my joint pain disappeared. Zyloric was discontinued and again uric acid level rose to 7/8 and again the same problem of joint pain started. Again my doctor said that I will have to take zyloric 100 twice that too possibly for lifelong. I feel better and my joint problems etc. have also vanished. But I was told by my family doctor that prolonged use of zyloric is not desirable because of serious side effects. Can you guide me whether prolonged use of zyloric is not desirable. What should I do?

A:Zyloric (allopurinol) prevents the excess formation of uric acid and hence you should continue to take it for as long as necessary. It is much better to prevent the formation of uric acid than to get rid of it once it is formed. While there are many causes of high uric acid levels, one of them is obesity. Hence patients who are over weight must reduce. Similarly there are many reasons for reduced clearance of uric acid from the body such as high blood pressure and use of certain medicines such as diuretics, salicylates, alcohol etc. Hence these should be taken care of. Like all medicines, allopurinol has side effects but its benefit is more than risks in patients who are prone to high uric acid levels.