Llanol

Allopurinol

Management of signs & symptoms of primary & secondary gout (recurrent acute attacks, arthropathy, tophi, radiographic changes of gout, or associated uric acid nephrolithiasis); patients w/ leukemia, lymphoma & solid tumor malignancies who are undergoing chemotherapy expected to result in tumor lysis & subsequent elevations of serum & urinary uric acid conc; recurrent Ca oxalate renal calculi in males w/ urinary urate excretions >800 mg daily & females >750 mg daily.

Intercritical gout & chronic tophaceous gout Initially 100 mg/ day 2 wk after pain & swelling of acute gouty arthritis have subsided. Titrate dose by 50-100 mg/day every 2-4 wk until serum uric acid is <6 mg/dL (0.36 mmol/L). Max: 300 mg/day. Leukemia, lymphoma & solid tumor malignancies Adult 600-800 mg/day for 2-3 days. Recurrent Ca oxalate renal calculi Initially 200-300 mg/day in divided or single dose. May increase dose depending on control of hyperuricosuria assessed by 24-hr urinary urate excretion. Renal impairment CrCl <10 mL/min Initial dose: <100 mg daily, 10-20 mL/min Initial dose: <200 mg daily, 0 mL/min Maintenance dose: 100 mg every 3 days, 10 mL/min Maintenance dose: 100 mg every 2 days, 20 mL/min Maintenance dose: 100 mg daily, 40 mL/min Maintenance dose: 150 mg daily, 60 mL/min Maintenance dose: 200 mg daily, 80 mL/min Maintenance dose: 250 mg daily.

Should be taken with food.

Hypersensitivity.

W/draw immediately at 1st sign of skin rash, allergic reaction or hypersensitivity; painful urination, blood in the urine, irritation of the eyes or swelling of the lips or mouth. Allopurinol hypersensitivity syndrome. Severe hypersensitivity reactions (eg, exfoliative, urticarial & purpuric lesions) & cutaneous adverse reactions (eg, Stevens-Johnson Syndrome or erythema multiforme exudativum, toxic epidermal necrolysis or Lyell's syndrome &/or generalized vasculitis). HLA-B*5801 allele. Skin & SC reactions. Asymptomatic hyperuricemia. Acute gouty attacks. Neoplastic disease & Lesch-Nyhan syndrome. Impaction of uric acid renal stones. Bone marrow depression. Periodic liver function tests & complete blood count are recommended. Impaired renal function; perform renal function tests (eg, BUN, serum creatinine or CrCl). Patients under treatment for HTN or cardiac insufficiency. Impaired thyroid function. Hemochromatosis. Ensure fluid intake of 2 L/day. Concomitant use w/ dicoumarol, sulfinpyrazone, mercaptopurine, azathioprine, ampicillin, amoxicillin or thiazide diuretics. May cause somnolence, dizziness, ataxia & vertigo. May impair ability to operate hazardous machinery & during motor vehicles. Pregnancy & lactation. Elderly. Childn.

Rashes (maculopapular, pruritic or purpuric); exfoliative rashes, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction w/ eosinophilia & systemic symptoms (DRESS); acute gout attacks; GI effects (eg, diarrhea & nausea); increased liver enzymes & serum alkaline phosphatase.

Increased frequency of skin rash w/ amoxicillin/ampicillin. Increased risk of hypersensitivity reactions (eg, Stevens-Johnson syndrome) w/ ACE inhibitors (eg, captopril). May have decreased blood levels & reduced therapeutic effects w/ antacids (eg, Al hydroxide). May prolong elimination t_½ of coumarin. May increase the risk of prolonged hypoglycemic effect of chlorpropramide. Enhanced bone marrow suppression by cyclophosphamide & other cytotoxic agents in patients w/ neoplastic disease other than leukemia. May increase plasma conc of cislosporin. Increased C_max & AUC values of didanosine. Increased risk of toxicity w/ diuretics (eg, thiazide diuretics & ethacrynic acid). Drugs that increase serum urate conc (eg, pyrazinamide, diazoxide, alcohol, mecylamine). Prolonged activity of mercaptopurine or azathioprine. May inhibit hepatic oxidation of phenytoin. Inhibits theophylline metabolism. Decreased therapeutic activity w/ uricosuric (eg, probenecid) & salicylates. Increased plasma t_½ of vidarabine (adenine arabinoside).

Hyperuricemia & Gout Preparations

M04AA01 - allopurinol ; Belongs to the class of preparations inhibiting uric acid production. Used in the treatment of gout.

Rx