Minor
Established
Descripción
Low-dose aspirin reduces the uricosuric effect of allopurinol and may increase uric acid levels, potentially triggering gout flares.
Mecanismo
Salicylates compete with uric acid for renal tubular secretion at low doses, reducing uric acid excretion and partially antagonizing allopurinol's ability to lower serum uric acid.
Relevancia clínica
The interaction is most relevant with aspirin doses >1 g/day; low-dose aspirin (81–325 mg) has a smaller but still measurable effect on uric acid.
Manejo clínico
Monitor serum uric acid levels; consider increasing allopurinol dose if uric acid rises above target. Use acetaminophen preferentially in gout patients.