How does Zyloprim work?

Zyloprim is a brand name drug for allopurinol. Allopurinol has been the mainstay of most gout treatments since it was approved by the U.S. Food and Drug Administration in 1966. Gout occurs when a person can no longer eliminate excess uric acid from the bloodstream. What does this mean, and how does Zyloprim help?

Gout comes about when high levels of uric acid build up in the bloodstream. Uric acid is naturally present in the bloodstream as the body breaks down purines, chemical compounds produced during the natural process of cell death. Purines are also present in large quantities in specific foods, including liver, bacon, kidney, mussels, anchovies, sardines, and veal, as well as in alcohol. Those purines must also be turned into uric acid.

Most people are able to excrete uric acid just by using the bathroom; kidneys sift uric acid out of the bloodstream and into urine. If this process doesn't work, either because your body is making too much uric acid or because your kidneys can't eliminate it fast enough, then the extra uric acid will accumulate in the bloodstream and crystallize. As the uric acid forms spiky crystals, resembling needles, white blood cells assault the area, which produces a world of pain, inflammation and tenderness in the area. Doctors don't know precisely why the big toe is particularly susceptible to these excruciating attacks of pain; it could be because the toe and the rest of the foot already bear a good deal of physical stress just by walking.

Zyloprim doesn't act to cure that pain, which can last for several days or even a few weeks. Instead, it works to prevent the creation of uric acid, so that it's never formed and there's less of it in your bloodstream. Zyloprim inhibits the formation of xanthine oxidase, a chemical created just before purines are transformed into uric acid.

As purines are worn down, chemicals known as hypoxanthine and xanthine are produced. Add in a little xanthine oxidase, and you'll change those chemicals to uric acid. By impeding xanthine oxidase, Zyloprim still lets the body break down those purines, but rather than turning into uric acid, the xanthine and hypoxanthine stay in a form that is essentially recyclable and not damaging to the body.

According to some studies, blocking xanthine oxidase may have added benefits. Xanthine oxide may also contribute to ischemia, inflammatory disease and heart failure.

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