What is Lesinurad and Allopurinol: Uses, Dosage, Side Effects and More

Lesinurad and allopurinol is a combination medication that helps people with gout manage their condition more effectively. This dual-action treatment works by both reducing uric acid production and helping your kidneys remove excess uric acid from your body.

If you've been struggling with gout flares despite taking allopurinol alone, this combination might be exactly what your doctor recommends. The pairing of these two medications can provide better uric acid control than either drug used by itself.

What is Lesinurad and Allopurinol?

This medication combines two different drugs that work together to lower uric acid levels in your blood. Allopurinol reduces how much uric acid your body makes, while lesinurad helps your kidneys get rid of the uric acid that's already there.

You'll find this combination sold under the brand name Duzallo. It comes as a single tablet that contains both medications, making it easier to take your gout treatment without juggling multiple pills.

The combination was specifically designed for people whose gout isn't well-controlled with allopurinol alone. Think of it as adding a helper to make your existing treatment more effective.

What is Lesinurad and Allopurinol Used For?

This medication treats gout in adults whose uric acid levels remain too high despite taking allopurinol by itself. Gout happens when uric acid crystals build up in your joints, causing sudden, severe pain and swelling.

Your doctor will typically prescribe this combination if you've been taking allopurinol for at least six weeks but your uric acid levels are still above the target range. The goal is to get your uric acid below 6 mg/dL, which helps prevent future gout attacks.

This isn't a medication for treating active gout flares. Instead, it works as a long-term prevention strategy to reduce the frequency and severity of future attacks.

How Does Lesinurad and Allopurinol Work?

This combination medication is considered a moderately strong treatment that tackles uric acid from two different angles. Allopurinol blocks an enzyme called xanthine oxidase, which your body uses to make uric acid from purines in food.

Lesinurad works differently by blocking proteins in your kidneys that normally reabsorb uric acid back into your bloodstream. This means more uric acid gets flushed out through your urine instead of staying in your body.

Together, these medications create a powerful one-two punch against excess uric acid. You're both making less of it and getting rid of more of what you do produce.

How Should I Take Lesinurad and Allopurinol?

Take this medication exactly as your doctor prescribes, usually once daily in the morning with food. Taking it with food helps reduce stomach upset and improves how well your body absorbs the medication.

Drink plenty of water throughout the day while taking this medication. Staying well-hydrated helps your kidneys work properly and reduces the risk of kidney stones, which can be a concern with this treatment.

Don't crush, chew, or split the tablets. Swallow them whole with a full glass of water. If you have trouble swallowing pills, talk to your doctor about other options.

Your doctor will likely start you on a lower dose and gradually increase it based on how well you respond. This careful approach helps minimize side effects while finding the right dose for you.

How Long Should I Take Lesinurad and Allopurinol For?

This is typically a long-term medication that you'll take for months or years to keep your gout under control. Most people need to stay on uric acid-lowering therapy indefinitely to prevent future gout attacks.

Your doctor will monitor your uric acid levels regularly, usually every few months at first. Once your levels stabilize in the target range, you might have blood tests less frequently.

Don't stop taking this medication suddenly, even if you feel better. Gout is a chronic condition, and stopping treatment often leads to uric acid levels rising again and gout flares returning.

What Are the Side Effects of Lesinurad and Allopurinol?

Like all medications, this combination can cause side effects, though not everyone experiences them. Understanding what to watch for helps you know when to contact your healthcare provider.

The most common side effects you might notice include headaches, flu-like symptoms, and increased blood pressure. These usually occur in the first few weeks of treatment and often improve as your body adjusts.

Here are the side effects you're most likely to experience:

• Headache
• Flu-like symptoms (fever, chills, body aches)
• Increased blood pressure
• Nausea or stomach discomfort
• Fatigue
• Gastroesophageal reflux (heartburn)

These common side effects are usually mild and manageable. Your doctor can help you find ways to minimize any discomfort you experience.

Some people may experience more serious side effects that require immediate medical attention. While these are less common, it's important to know the warning signs.

Contact your doctor right away if you experience any of these rare but serious side effects:

• Signs of kidney problems (changes in urination, swelling in legs or feet)
• Severe skin reactions (rash, blistering, peeling)
• Signs of liver problems (yellowing of skin or eyes, dark urine, severe fatigue)
• Severe allergic reactions (difficulty breathing, swelling of face or throat)
• Unusual bleeding or bruising
• Severe stomach pain

These serious side effects are uncommon, but recognizing them early can help prevent complications. Your healthcare team is there to support you through any concerns.

Who Should Not Take Lesinurad and Allopurinol?

This medication isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you. Certain health conditions and medications can make this combination unsafe or less effective.

You should not take this medication if you have severe kidney disease or are on dialysis. The lesinurad component can worsen kidney function in people with advanced kidney problems.

People with certain genetic conditions that affect how their bodies process medications may also need to avoid this combination. Your doctor might order genetic testing if they suspect you have one of these conditions.

Here are the main situations where this medication is typically not recommended:

• Severe kidney disease (creatinine clearance less than 30 mL/min)
• Dialysis treatment
• Known allergy to allopurinol or lesinurad
• Severe liver disease
• Pregnancy or breastfeeding
• Taking certain medications that interact dangerously

Your doctor will review your complete medical history and current medications before prescribing this combination. Being honest about all your health conditions helps ensure your safety.

Lesinurad and Allopurinol Brand Names

The combination of lesinurad and allopurinol is available under the brand name Duzallo. This is currently the only brand name available for this specific combination in the United States.

Duzallo comes in tablet form with different strengths to allow for proper dosing. Your doctor will prescribe the specific strength that's right for your situation.

While generic versions of allopurinol alone are widely available, the combination with lesinurad is only available as the brand-name Duzallo. This can affect insurance coverage and out-of-pocket costs.

Lesinurad and Allopurinol Alternatives

If this combination isn't right for you, several other options exist for managing gout and high uric acid levels. Your doctor can help you explore these alternatives based on your specific needs.

Allopurinol alone remains the most commonly prescribed uric acid-lowering medication. Many people do well with allopurinol by itself, especially when the dose is optimized properly.

Here are the main alternatives your doctor might consider:

• Febuxostat (Uloric) - another xanthine oxidase inhibitor
• Probenecid - helps kidneys remove uric acid
• Pegloticase (Krystexxa) - for severe, treatment-resistant gout
• Colchicine - for preventing gout flares during treatment
• Lifestyle modifications and dietary changes

The choice of alternative depends on factors like your kidney function, other health conditions, and how well you've responded to previous treatments. Your doctor will work with you to find the best approach.

Is Lesinurad and Allopurinol Better Than Allopurinol Alone?

For people who haven't reached their uric acid targets with allopurinol alone, adding lesinurad can provide significant benefits. Studies show that the combination is more effective at lowering uric acid levels than allopurinol by itself.

However, this doesn't mean the combination is automatically better for everyone. If you're doing well on allopurinol alone and your uric acid levels are at target, there's no need to add another medication.

The combination makes most sense when allopurinol alone isn't getting your uric acid below 6 mg/dL despite adequate dosing. In these cases, adding lesinurad can help you reach your target levels more effectively.

Your doctor will consider your individual response to allopurinol, your uric acid levels, and your overall health when deciding whether the combination is worth trying. The goal is always to find the most effective treatment with the fewest side effects.