Drug ID: 1d00000057
Drug Name: Allopurinol
Generic Names: Lodiric SR (250mg) | Aloric (300mg) | Ureka (100mg) | Urlo (100mg) | Urxoall (100mg) | Kayloric (100mg) | Alopur (100mg) | Kayloric (100mg) (KCM Lab) | Riloric (300mg) | Uridip (100mg) | Aloriv (100mg) | Alopur (300mg) | Alnol (300mg) | Allgout (100mg) | Logout SR (250mg) | B Loric (100mg) | Aloric (100mg) | Urid (100mg) | Klorinol (100mg) | Olru (300mg) | Urlo (300mg) | Uripure (100mg) | Aluric (300mg) | Zeric (100mg) | Burin (300mg) | Zyloric (300mg) | Purolic (100mg) | Zanupirol (100mg) (V&B Healthcare) | Urigon (100mg) | Puril (100mg) | Zyloprim | More
Category: Gout Therapy
Legal Status: Non Opioid Prescription only drug
Indication for Mother: Category C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Recommended Dose: Adult: Oral- Gout and Hyperuricaemia- Initial: 100 mg/day, may adjust dose according to response. Max: 800 mg/day.
Prevention of hyperuricaemia associated with chemotherapy treatment or enzyme disorders- 600-800 mg/day, starting 2-3 days before cancer treatment.
IV- Gout and Hyperuricaemia: As Na: 200-400 mg/m2/day. Max: 600 mg/day.
Recommended In: This medication is a xanthine oxidase inhibitor, prescribed for gout. It is used to treat high uric acid levels in the blood or urine caused by certain types of cancer chemotherapy.
Directions For Use: It comes as a tablet to take by mouth, with food.
Storage: Store it at controlled room temperature (15° to 25°C) and in an airtight container.
Dosage Forms: Tablet
Side Effects: Gastrointestinal - Diarrhea, nausea and increased level of liver enzymes.
Metabolic - Acute attacks of gout.
Skin - Rash.
In Case of Overdose: Massive overdosing or acute poisoning by allopurinol has not been reported.
In the management of overdosage there is no specific antidote for allopurinol. There has been no clinical experience in the management of a patient who has taken massive amounts of allopurinol.
Both allopurinol is dialyzable; however, the usefulness of hemodialysis or peritoneal dialysis in the management of an overdose of allopurinol is unknown.
Avoid If: Caution should be exercised in patients with history of kidney or liver diseases, heart problems, bone marrow problems, high blood pressure, diabetes, who are taking other medication, any allergy, children, during pregnancy and breastfeeding.
It may cause drowsiness, do not drive a car or operate machinery while taking this medication.
Monitor kidney and liver function regularly while taking this medication.
Drug Interaction: In patients receiving mercaptopurine or IMU-RAN azathioprine, the concomitant administration of 300 to 600 mg of allopurinol per day will require a reduction in dose to approximately one third to one fourth of the usual dose of mercaptopurine or azathioprine. Subsequent adjustment of doses of mercaptopurine or azathioprine should be made on the basis of therapeutic response and the appearance of toxic effects.
It has been reported that allopurinol prolongs the half-life of the anticoagulant, dicumarol. The clinical basis of this drug interaction has not been established but should be noted when allopurinol is given to patients already on dicumarol therapy.
Since the excretion of oxipurinol is similar to that of urate, uricosuric agents, which increase the excretion of urate, are also likely to increase the excretion of oxipurinol and thus lower the degree of inhibition of xanthine oxidase. The concomitant administration of uricosuric agents and ZYLOPRIM (allopurinol) has been associated with a decrease in the excretion of oxypurines (hypoxanthine and xanthine) and an increase in urinary uric acid excretion compared with that observed with ZYLOPRIM (allopurinol) alone. Although clinical evidence to date has not demonstrated renal precipitation of oxypurines in patients either on ZYLO-PRIM alone or in combination with uricosuric agents, the possibility should be kept in mind.
The reports that the concomitant use of allopurinol and thi-azide diuretics may contribute to the enhancement of allopuri-nol toxicity in some patients have been reviewed in an attempt to establish a cause-and-effect relationship and a mechanism of causation. Review of these case reports indicates that the patients were mainly receiving thiazide diuretics for hypertension and that tests to rule out decreased renal function secondary to hypertensive nephropathy were not often performed. In those patients in whom renal insufficiency was documented, however, the recommendation to lower the dose of allopurinol was not followed. Although a causal mechanism and a cause-and-effect relationship have not been established, current evidence suggests that renal function should be monitored in patients on thi-azide diuretics and allopurinol even in the absence of renal failure, and dosage levels should be even more conservatively adjusted in those patients on such combined therapy if diminished renal function is detected.
An increase in the frequency of skin rash has been reported among patients receiving ampicillin or amoxicillin concurrently with allopurinol compared to patients who are not receiving both drugs. The cause of the reported association has not been established.
Enhanced bone marrow suppression by cyclophosphamide and other cytotoxic agents has been reported among patients with neoplastic disease, except leukemia, in the presence of allopurinol. However, in a well-controlled study of patients with lymphoma on combination therapy, allopurinol did not increase the marrow toxicity of patients treated with cyclophos-phamide, doxorubicin, bleomycin, procarbazine, and/or mechlorethamine.
Tolbutamide's conversion to inactive metabolites has been shown to be catalyzed by xanthine oxidase from rat liver. The clinical significance, if any, of these observations is unknown.
Chlorpropamide's plasma half-life may be prolonged by allopurinol, since allopurinol and chlorpropamide may compete for excretion in the renal tubule. The risk of hypoglycemia secondary to this mechanism may be increased if allopurinol and chlorpropamide are given concomitantly in the presence of renal insufficiency.
Rare reports indicate that cyclosporine levels may be increased during concomitant treatment with allopurinol. Monitoring of cyclosporine levels and possible adjustment of cyclo-sporine dosage should be considered when these drugs are co-administered.