Idiopathic gout, uric acid lithiasis, acute uric acid nephropathy; neoplastic & myeloproliferative disease w/ high cell turnover rates in which high urate levels occur either spontaneously or after cytotoxic therapy; certain enzyme disorders ie, hypoxanthine guanine phosphoribosyltransferase eg, Lesch-Nyhan syndrome; glucose-6-phosphatase eg, glycogen storage disease; phosphoribosylpyrophosphate synthetase & amidotransferase; adenine phosphoribosyltransferase. Management of 2, 8-dihydroxyadenine renal stones related to deficient activity of adenine phosphoribosyltransferase & recurrent mixed Ca oxalate renal stones in the presence of hyperuricosuria.
Adult Mild conditions 2-10 mg/kg daily or 100-200 mg daily. Moderately severe conditions 300-600 mg daily. Severe conditions 700-900 mg daily. Childn <15 yr 10-20 mg/kg daily or up to max: 400 mg daily.
Discontinue use if hypersensitivity reactions occur. HTN or cardiac insufficiency. Not for asymptomatic hyperuricaemia. Not to be started until acute gout has completely subsided. Conditions w/ increased urate formation eg, malignant disease, Lesch-Nyhan syndrome. Impaction of uric acid renal stones. HLA-B*5801 allele carrier. Increased TSH values on long-term use. Ensure adequate hydration. Not to be taken by patients w/ intolerance, Lapp lactose deficiency or glucose-galactose malabsorption. Concomitant use w/ diuretics. May affect ability to drive & use machines. Renal or hepatic impairment. Pregnancy.
Increased plasma t½ of vidarabine. Decreased effect by uricosurics eg, probenecid & large doses of salicylates. Increased risk of prolonged hypoglycaemic activity w/ chlorpropamide. Increased effect of warfarin, other coumarin anticoagulants. Inhibited hepatic oxidation of phenytoin. Inhibited metabolism of theophylline. Increased frequency of skin rash w/ ampicillin or amoxicillin. Enhanced bone marrow suppression by cyclophosphamide. Increased plasma conc of cyclosporin, oxipurinol, serum urate. Doubled plasma Cmax & AUC of didanosine. Increased risk of hypersensitivity w/ diuretics, ACE inhibitors. Concurrent use w/ 6-mercaptopurine or azathioprine.
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