Indications
Aallopurinol reduces serum and urinary uric acid concentrations. Its use should be individualized for each patient and requires an understanding of its mode of action and pharma-cokinetics. Allopurinol is indicated in:
- The management of patients with signs and symptoms of primary or secondary gout (acute attacks, tophi, joint destruction, uric acid lithiasis, and/or nephropathy).
- The management of patients with leukemia, lymphoma and malignancies who are receiving cancer therapy which causes elevations of serum and urinary uric acid levels. Treatment with Allopurinol should be discontinued when the potential for overproduction of uric acid is no longer present.
- The management of patients with recurrent calcium oxalate calculi whose daily uric acid excretion exceeds 800 mg/day in male patients and 750 mg/day in female patients. Therapy in such patients should be carefully assessed initially and reassessed periodically to determine in each case that treatment is beneficial and that the benefits outweigh the risks.
Therapeutic Class
Pharmacology
Dosage & Administration
Adults:
- Mild gout: 200 to 300 mg/day.
- Moderately severe tophaceous gout: 400 to 600 mg/day. The minimal effective dosage is 100 to 200 mg daily and the maximal recommended dosage is 800 mg daily. To reduce the possibility of flare-up of acute gouty attacks, it is recommended that the patient start with a low dose of Allopurinol (100 mg daily) and increase at weekly intervals by 100 mg until a serum uric acid level of 6 mg/day or less is attained but without exceeding the maximal recommended dosage.
- Recurrent calcium oxalate stones: 200 to 300 mg/day.
Children:
- Age 6-10 years: In secondary hyperuricemia associated with malignancies may be given 300 mg Allopurinol daily.
- Age under 6 years: generally given 150 mg daily.
Interaction
Anticoagulant: Allopurinol prolongs the half life of the anticoagulant, dicumarol.
Diuretic: Concomitant use of Allopurinol and thiazide diuretics may contribute to the enhancement of Allopurinol toxicity.
Cytotoxic agent: Enhanced bone marrow suppression by cyclophosphamide and other cytotoxic agent has been reported among patients with neoplastic disease.
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