Allopurinol (Lopurin/Zyloprim) Medicare Coverage

Allopurinol
Chemical name: Allopurinol

Brand name: Lopurin, Zyloprim

Typical dosage: 300mg

Typical type: Tablet1

Allopurinol is a medication used to treat gout and prevent kidney stones and Tumor Lysis Syndrome (TLS). Allopurinol is available as a brand name and as a generic and comes as an oral tablet or oral solution.

Allopurinol is a medication used to treat gout. It can also be used to prevent kidney stones and Tumor Lysis Syndrome (TLS), a condition common in cancer patients receiving treatment. The brand name equivalents of Allopurinol are called Lopurin and Zyloprim.

Your Allopurinol dose will depend on what you are treating and is typically given 1 to 3 times daily.

Allopurinol inhibits the production of uric acid in the body, which prevents gout and kidney stones from occurring. Major side effects that you may experience with allopurinol include upset stomach and diarrhea.

Does Medicare cover Allopurinol, Zyloprim or Lopurin?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Allopurinol.1

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.2

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Allopurinol.

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Average costs for Allopurinol with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
Free – $18 Free – $20

Additional information

You should keep taking your Allopurinol as your doctor instructed, even if you feel well. For the best results, take Allopurinol after a meal.

It can take several weeks to see the full effect of Allopurinol. Your chance of gout attacks can increase a few months after you start taking this drug. Do not stop taking Allopurinol without talking to your doctor.

Liver and kidney problems have happened while taking Allopurinol. Signs of liver or kidney problems include inability to pass urine, blood in the urine, noticeable weight gain, fatigue and upset stomach.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.