Medical Questions & Answers

Question: Eight years ago, a blood test showed an excess of uric acid, and although I had no problems with gout or arthritis, my doctor put me on Zyloprim each day, saying failure to take the tablet could result in gout. A health shop proprietor said Zyloprim could actually cause problems if taken long term. Can you advise me?
High levels of uric acid in the blood stream can cause recurrent attacks of gout. Because of the severe pain associated with gout, these attacks are very obvious to the sufferer. Uric acid has another more sinister effect on the kidneys. These can be slowly damaged, and unless kidney stones form, the presence of excessive levels of uric acid may not show up until the kidney starts to fail, and the patient presents with a totally different set of symptoms.
Zyloprim (also known as Progout and allopurinol) is a drug that lowers the amount of uric acid in the blood stream. It has been available for over 40 years, so a great deal is known about its side effects and complications. A very small number of patients do have long-term problems with its use, but the risks of using Zyloprim are far less than the risks of high uric acid levels.
Regular blood tests should be performed every year while you are taking the medication to check the level of uric acid, and the liver and kidney function. Some patients require only a low dose of Zyloprim to reduce their uric acid levels, and this can be judged by the blood test results. The drug is available in both 100 and 300 milligram sizes, so reduction of dosage in those patients who can be controlled more readily can be easily achieved. Follow the advice of your doctor rather than a ‘health’ shop proprietor, whose advice may be biased by a desire to sell you his products.

Question: Can you tell me about a drug called Capoten that my doctor has prescribed for me?
Capoten (also known as captopril) is a quite modern drug that is widely and successfully used to treat high blood pressure and heart failure. Its only absolute contraindication is pregnancy, but it should be used with caution in patients with poor kidney function, and care must be used if the patient has a general anaesthetic.
It has few side effects, the most common ones a being a cough and lightheadedness because the blood pressure has dropped too far. Anyone on treatment with blood pressure medication should be checked regularly by a doctor, and provided no problems are found, this medication can be used confidently for many years.

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