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Allopurinol

Medical and Pharmacy Editor:

Brand Name: Zyloprim, Aloprim

Generic Name: allopurinol

Drug Class: Xanthine Oxidase Inhibitors; Antigout Agents

What Is Allopurinol and How Does It Work?

Allopurinol is a prescription medication used to treat gout and certain types of kidney stones. It is also used to prevent increased uric acid levels in patients receiving chemotherapy. These patients can have increased uric acid levels due to the release of uric acid from the dying cancer cells. Allopurinol works by reducing the amount of uric acid made by the body. Increased uric acid levels can cause gout and kidney problems.

Allopurinol is available under the following different brand names: Zyloprim and Aloprim.

Dosages of Allopurinol:

Adult and pediatric dosages:

Tablet

  • 100 mg
  • 300 mg

Powder for injection

  • 500 mg/vial

Dosage Considerations – Should be Given as Follows:

Gout

  • Adult dosage:
  • Mild: 100 mg per day orally initially, increased weekly to 200-300 mg per day
  • Moderate to severe: 100 mg per day orally initially, increased weekly to 400-600 mg per day

Excess of Uric Acid (Hyperuricemia)

  • Pediatric dosage:
  • 10 mg/kg per day orally divided every 12 hours, not to exceed 600 mg/day

Antineoplastic-Induced Excess of Uric Acid (Hyperuricemia)

  • Pediatric dosage:
  • 10 mg/kg per day orally divided every 12 hours, not to exceed 600 mg/day
  • Adult dosage:
  • 600-800 mg divided every 8-12 hours, starting 1-2 days before chemotherapy
  • Intravenously: 200-400 mg/m2 per day, not to exceed 600 mg/m2 per day, may administer as single infusion or in equally divided doses at 6, 8, and 12 hour intervals beginning 1-2 days before chemotherapy
  • Dosing considerations:
  • Minimum oral dosage: 100-200 mg/day
  • Maximum oral dosage: 800 mg/day
  • Dosing modifications:
  • Renal impairment:
    • Creatinine clearance 10-20 ml/min: 200 mg/day
    • Creatinine clearance 3-10 ml/min: 100 mg/day
    • Creatinine clearance less than 3 ml/min: 100 mg/day at extended intervals
  • Pediatric dosage:
  • Children under 6 years old: 150 mg orally daily divided every 8 hours
  • Children 6-10 years old: 300 mg orally daily in a single dose or divided every 8 hours
  • Children 10 years and older: 600-800 mg orally daily, starting 1-2 days before chemotherapy
  • Intravenously: 200 mg/m2 per day initially, starting 1-2 days before chemotherapy

What Are Side Effects Associated with Using Allopurinol?

Side effects associated with use of Allopurinol, include the following:

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Allopurinol?

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Allopurinol has no known severe interactions with any drugs.

Serious Interactions of Allopurinol include:

Moderate Interactions of Allopurinol include:

Mild Interactions of Allopurinol include:

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

What Are Warnings and Precautions for Allopurinol?

Warnings

  • Hypersensitivity to allopurinol
  • This medication contains allopurinol. Do not take Zyloprim or Aloprim if you are allergic to allopurinol or any ingredients contained in this drug
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately

Contraindications

  • Hypersensitivity to allopurinol

Effects of Drug Abuse

  • No information provided

Short-Term Effects

  • See "What Are Side Effects Associated with Using Allopurinol?"

Long-Term Effects

  • See "What Are Side Effects Associated with Using Allopurinol?"

Cautions

  • Discontinue at first sign of allergic reactions, first sign of rash, inflammation of blood vessels, or Stevens-Johnson syndrome
  • If decrease in bone marrow activity (myelosuppression) reported, use caution when administering other drugs known to cause decrease in bone marrow activity
  • Liver damage (hepatotoxicity) reported (reversible)
  • Not for treatment of asymptomatic hyperuricemia, elevated levels of serum urate with no other symptoms of gout
  • Use with caution in renal impairment
  • Risk of hypersensitivity increased in patients treated with angiotensin-converting enzyme (ACE) inhibitors
  • When taking with amoxicillin or ampicillin, may increase risk of skin rash
  • During concomitant treatment, reduce dosages of azathioprine and mercaptopurine to 25-33% of usual dose
  • Maintain fluid intake necessary to yield urine output of at least 2 liters per day in adults

Pregnancy and Lactation

  • Use allopurinol during pregnancy with caution if benefits outweigh risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done
  • Allopurinol is distributed into breast milk, use with caution when breastfeeding.
Reviewed on 4/20/2017


SOURCE:
Medscape. Allopurinol.
https://reference.medscape.com/drug/zyloprim-aloprim-allopurinol-342811#0

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