For allopurinol and alcohol, the FDA label lists only one interaction: both can make you drowsy or dizzy. The bigger problem is your gout. Alcohol pushes uric acid up and makes attacks more likely within about a day, which works against what allopurinol is doing.
The 2020 American College of Rheumatology gout guideline makes a conditional (weaker) recommendation to limit alcohol, not ban it, and rates the evidence behind that advice as low. It gives no safe number of drinks. So the real question is how much each drink raises your odds of a flare.
This article provides general information about medication management and is not a substitute for professional medical advice. Always consult your doctor or pharmacist before making changes to your medication schedule.
Can You Drink Alcohol While Taking Allopurinol?
The label does not forbid it, but it is a question for your own doctor. MedlinePlus puts it simply: "ask your doctor about the safe use of alcoholic beverages while you are taking allopurinol."
Here is what the FDA prescribing information for allopurinol does and does not say:
- It does say that drowsiness, sleepiness, and dizziness have been reported, and that these effects "may be additive to those of alcohol and other CNS depressants."
- It does not say that alcohol changes how allopurinol is absorbed or cleared. The label's drug-interaction studies list other medicines, not alcohol. Allopurinol is turned into a related compound called oxypurinol, and both are cleared by the kidneys.
Some websites say alcohol raises allopurinol's blood levels. The FDA label does not describe that.
What Happens If You Drink Alcohol While Taking Allopurinol?
Allopurinol lowers uric acid by cutting how much of it your body makes, according to its FDA label. Alcohol pushes in the other direction.
In a small 1982 study in the New England Journal of Medicine, six people with gout drank large daily doses of alcohol for eight days. Their average uric acid rose from 8.4 to 10.1 mg/dL, and the researchers concluded that alcohol makes the body produce more uric acid. A much larger national survey of 14,809 U.S. adults found uric acid levels rose with each daily beer or serving of liquor.
Drinking is also linked to attacks within a short window. A 2014 study of 724 people with gout compared the 24 hours before each person's attacks with their own attack-free days. The more they drank in that window, the higher the risk:
| Drinks in the past 24 hours | Gout attack risk vs. no drinks |
|---|---|
| None | Baseline |
| Up to 1 | 1.13 times (too uncertain to call a difference) |
| More than 1, up to 2 | 1.36 times higher |
| More than 2, up to 4 | 1.51 times higher |
| More than 4, up to 6 | 1.87 times higher |
| More than 6, up to 8 | 2.33 times higher |
| More than 8 | 3.13 times higher |
Source: Neogi et al., American Journal of Medicine, 2014. One drink = a 12-ounce beer, a 5-ounce glass of wine, or 1 to 1.5 ounces of liquor.
An earlier study by the same Boston team found the effect "was likely to occur within 24 hours" of drinking.
Does Alcohol Affect Allopurinol?
Two studies suggest it works the other way around: allopurinol seems to soften alcohol's effect on uric acid and attacks.
The 2014 study also split the results by whether people had taken allopurinol in the prior 24 hours. The authors wrote that allopurinol "mitigated the effects of alcohol intake." Among people not on allopurinol, more than two drinks in 24 hours went with about 1.7 times the attack risk of a no-drink day. The numbers with allopurinol came out lower, but two of the three drinking groups were too uncertain to rely on.
A tiny 2006 study points the same way. When five healthy volunteers took allopurinol before drinking beer, it held back the beer-driven rise in uric acid.
That is not a free pass. Neither study was a trial in people with gout, and neither can tell you how many drinks are safe for you. The fair summary: allopurinol still seems to help when you drink, but alcohol makes its job harder.
Allopurinol and Alcohol Side Effects
The one side effect the label ties to alcohol is drowsiness or dizziness. The FDA label advises avoiding driving or using dangerous machinery "when starting allopurinol tablets or increasing the dose, until they know how the drug affects them."
The label also warns about liver problems with allopurinol. It does not connect them to alcohol, but if you drink heavily or have had liver trouble, tell your doctor.
Can You Drink Beer or Wine While Taking Allopurinol?
In the two largest studies on drink type, beer was the hardest on gout. Wine is less clear-cut.
| Drink | What the research found | Who was studied |
|---|---|---|
| Beer | Each daily 12-ounce beer: 1.49 times the risk of new gout. Raised uric acid the most. | Men without gout; U.S. adults |
| Liquor | Each daily shot: 1.15 times the risk of new gout. Raised uric acid less than beer. | Men without gout; U.S. adults |
| Wine | No added risk of new gout. But more than one glass (up to two) in a day was linked to more attacks in people who already had gout. | Men without gout; people with gout |
These numbers come from a 12-year study of 47,150 men and the national uric acid survey. Beer likely leads because it brings its own purines. A 1984 study found beer's main purine is guanosine, probably the most easily absorbed purine in food, on top of the alcohol itself.
Wine is where the messages get mixed. Those two studies looked at men without gout and the general public, and moderate wine did not raise risk or uric acid. But the 2014 study of people who already had gout found that wine, beer, and liquor were each linked to more attacks. If you already have gout, "wine is safe" is not a rule you can lean on.
Allopurinol, Colchicine, and Alcohol in the First Few Months
The first months on allopurinol are a risky time to drink, because the FDA label says starting the drug can trigger flares on its own.
The label explains that as uric acid drops, crystals stored in your joints start to break loose. It says "it may require several months" before flares settle. That is why the label recommends a flare-prevention medicine, colchicine or an anti-inflammatory, when you start. The ACR guideline strongly recommends keeping it going for at least 3 to 6 months, and longer if flares continue. Our guide to why a gout flare can hit right after starting allopurinol walks through that window.
Drinking during this stretch adds a second trigger on top of the first. Rheumatologist Dr. Theodore Fields told CreakyJoints that people on allopurinol who have gone six months without a flare can often relax their drinking "at least a little." That is one doctor's view, not a rule.
If your flare medicine is an NSAID, it has its own alcohol concerns: see ibuprofen and alcohol and naproxen and alcohol.
Can I Skip Allopurinol to Drink?
No. Nothing in the label or the studies we read suggests skipping a dose makes a drink safer. If drinking plans make you want to skip, talk to your doctor first.
Allopurinol's active form, oxypurinol, has a half-life of about 15 hours, according to the FDA label. Our reading is that skipping one dose would not clear it before a night out anyway. No study has tested this, so treat it as reasoning, not proof.
Here is what the label does say. If you miss a dose, "there is no need to double the dose." If a flare happens on allopurinol, the drug "need not be discontinued." Staying on it is already hard. A review of adherence data cites an Italian study of 3,727 people with gout where the share taking allopurinol as prescribed fell from 45.9% in the first month to 3.2% at one year. The same "skip it to drink" question comes up with other daily medicines too, like Lexapro.
Still Getting Gout on Allopurinol After Drinking? Other Causes to Check
Not every flare after a night out is the alcohol's fault. Check these too:
- You recently started allopurinol or your dose was changed. The label ties early flares to changing uric acid levels and keeps flare medicine going while the dose is adjusted.
- You ate a big, purine-heavy meal. In the 2014 study, a high-purine day raised attack risk even with no alcohol at all.
- You take a water pill (diuretic). In the same study, more than two drinks while on a diuretic was linked to the highest attack risk of any group.
- You got dehydrated, sick, or hurt a joint. The NHS lists dehydration, an illness with a high temperature, and a joint injury as triggers.
- Your uric acid is not at target yet. A blood test tells your doctor where you stand.
One flare needs urgent care whatever caused it. The NHS says to get urgent medical help for sudden pain and swelling in a joint if the pain is getting worse, you have a very high temperature or feel hot, cold or shivery, or you feel sick or cannot eat. These could mean an infection inside the joint.
The allopurinol label also asks adults to drink at least 2 liters of liquids a day to help prevent kidney stones. Here is how much water to drink a day. For other drugs and drinking, see our medication and alcohol guide, and for another common gout question, tart cherry juice with allopurinol.
How Pillo Helps You Stay on Track
Allopurinol is an every-day medicine, including the morning after a late night. Pillo's persistent alarm keeps ringing until you mark your dose, so a groggy morning does not turn into a missed day. If you leave home without your pills, location-based snooze holds the reminder and fires again when you walk back in the door.
You can also add a dose note, like "two beers last night." Then bring your adherence history to your doctor when you ask how much drinking is OK for you. Pillo is free for unlimited medications, with ads.
FAQ
Is there a direct interaction between allopurinol and alcohol?
The FDA label lists one: drowsiness and dizziness from allopurinol may add to the same effects from alcohol. The bigger issue is that alcohol raises uric acid and gout attack risk.
How long after drinking can I take allopurinol?
There is no waiting time between a drink and a dose in the allopurinol label, and it does not suggest skipping doses around drinking. Ask your pharmacist if you are unsure.
Does alcohol make allopurinol stop working?
The studies we could read suggest it does not. A 2014 study of people with gout found allopurinol "mitigated the effects of alcohol intake" on attack risk. Alcohol still raises uric acid, so it makes reaching your target harder.
Can I drink red wine on allopurinol?
In men without gout, moderate wine did not raise gout risk. In people who already had gout, more than one glass (up to two) in a day was linked to more attacks. Ask your doctor what is reasonable for you.
Should I stop allopurinol if I get a flare after drinking?
The FDA label says allopurinol "need not be discontinued" during a flare. Call your doctor about treating the flare. Consult your doctor or pharmacist for advice specific to your medications.
