Allopurinol

 

Generic name: allopurinol 
The brand name is Aloprim, Zyloprim, Lopurin
Dosage formats: intravenous powder for injection (500 mg) oral tablet (100 mg 300 mg)
Class of drugs: Antigout agents, Antihyperuricemic agents

 

What is allopurinol?

Allopurinol can reduce the amount of uric acids within the body. Uric acid accumulation can result in kidney or gout stones.

Allopurinol can be used to treat kidney stones.

Allopurinol can also be used to reduce levels of uric acid levels in those who receive chemotherapy for cancer.¶

Warnings

Allopurinol is a drug that can decrease blood cells, which helps your body fight off infections. This makes it easier to lose blood from an injury or fall sick when you are around people who are sick. Your blood could require regular testing. Visit your doctor regularly.

It is advised not to use this medication if you’ve previously experienced an allergy to the drug allopurinol. Do not take the medication and contact your doctor immediately if you notice any sign of a skin rash (no regardless of how slight) or painful urination. blood in your urine, burning sensations in the eyes or on your throat or face.

Do not drink alcohol. It can make your health worse. Allopurinol could affect your reaction or thinking. Be aware when you drive or perform any activity that requires you to be aware.

Allopurinol side effects

Stop taking this medication and seek emergency medical assistance If you experience indications that indicate an allergy reaction (hives or breathing problems and swelling of your throat or face) or a severe skin reaction (fever and burning eyes, sore throat and skin irritation, as well as an ailment that is purple or red that blisters and peels).

Consult a doctor when you experience a severe reaction to a drug that could affect various parts of your body. Symptoms may include the following: a skin rash or fever, swollen glands, muscle pains, abnormal bruising, severe weakness, or the discoloration of your eyes or skin.

Stop taking allopurinol and contact your doctor right away If you are suffering from:

• any skin rash, regardless of how minor;
• bleeding in the urine
• minimal or no urination
• simple bleeding, unusual bruising;
• numbness, tingling, burning pain;
• the symptoms of gout are getting worse and
• liver issues stomach pain, weight loss (upper right) itching and black stools, dark urine jaundice (yellowing of the eyes or skin).

Common allopurinol side effects are:

• an increase in the number of attacks with gout as you begin to take allopurinol orally;
• rash;
• drowsiness;
• fever chills;
• abnormal tests of liver function;
• nausea, diarrhea; or
• joint pain.

This isn’t a complete list of all side effects. other side effects could be present. Contact your physician to seek medical advice on the effects. You can report any adverse reactions to the FDA at 1-800-FDA-1088.

Before taking this medication, you must consult your physician

It is best not to use allopurinol If you have an allergy to it.

To ensure that allopurinol is safe for you, inform your doctor if previously had:

• kidney disease;
• liver disease;
• diabetes;
• congestive heart failure;
• high blood pressure
• If you’re receiving chemotherapy or
• If you are carrying a gene variant known as HLA-B*58:01 (your doctor will examine this).

Inform your doctor if are breastfeeding or pregnant.

Don’t give the medication to children under the age of 18 without medical guidance.

How to take allopurinol?

Allopurinol should be taken exactly as prescribed by your physician. Follow the directions on the prescription label and go through all the medication guides or instructions. The doctor might alter your dosage.

Take allopurinol orally in a drink of fluid. To lower the risk of kidney stones developing take 8-10 full glasses of fluid daily unless your doctor advises you to drink a different amount.

If this medication upsets your stomach, you can take allopurinol orally after eating.

Allopurinol injections can be delivered as an infusion in the vein in case you aren’t able to take the medication by mouth. The healthcare professional will provide the first dose, and guide you in how to take the medicine on your own.

It is possible mix the injection into the liquid (diluent) inside bags for IVs. If you are using injections on your own ensure that you know how to blend and keep the medication. Consult your physician or pharmacist to clarify any directions.

Only inject once you are ready to administer it. Don’t use it when the medication is changing color or contains particles. Contact your pharmacist to inquire about a new medication.

There is a chance that you will require frequent medical tests. Even if there are no symptoms tests can aid your doctor in determining whether allopurinol can be effective.

It is possible that you will experience gout attacks more frequently when you first take this medication in the form of an oral. Your physician may suggest alternative gout medications to take together with allopurinol. Take the medication according to the directions.

It can take 2 to six weeks before you experience fewer attacks of gout. Call your doctor when your symptoms do not improve after six weeks.

It is possible that you will need to adhere to an individualized diet plan to avoid kidney stones. Follow the instructions from your physician or dietitian. Know about the foods you should consume or not eat.

Place in a cool, dry place free of heat and moisture.

Dosing information

Usual Adult Dose of Allopurinol for Gout:

The dose will differ based on how severe the illness:

Initial dosage: 100 mg orally every day, once
In steps of 100 mg a week until a serum urine level of less than 6 mg/dL is achieved.

Mild Gout:
Amount of maintenance dose: 200 to 300 mg taken orally every day
Moderately Severe Tophaceous Gout:
Amount of daily dose of maintenance is 400 – 600 mg daily orally in divided doses
Minimal Effective Dose: 100 to 200 mg per day
Maximum Dose: 800 mg per day

Comments:
Doses in excess of 300 mg per day should be administered in divided doses, and preferably in the morning after eating to avoid gastric irritation.
A gradual dose titration is recommended to lower the risk of having acute Gouty-like attacks.
Normal serum urate levels are typically reached in 1 to 3 weeks.

Use: To manage the condition of patients who exhibit symptoms and signs of secondary or primary gout (acute attacks tophi, joint destruction and uric acid lithiasis or kidney disease).

Usual Adult Dose of Allopurinol for Hyperuricemia Secondary to Chemotherapy:

Parenteral:
200 to 400 mg/m2 daily IV as a single injection or equally divided infusions over 6, 8 or 12 hour intervals.
Maximum dose: 600 mg/day

Oral:
Dose initial: 600 – 800 mg orally divided into doses
Maintenance: Adjust dosage according to serum levels of uric acid.
Maximum dose: 800 mg per day

Comments:
If possible, treatment should begin within 24 to 48 hours prior to the start of chemotherapy. Treatment should be stopped in the event that the possibility of excessive production of uric acids is eliminated.
Doses that exceed 300 mg per day should be administered in doses that are divided, and preferably in the morning after eating to avoid gastric irritation.

The dosage to reduce the uric acid level in serum to near normal or even normal levels is contingent upon the degree of the condition and the following dosing guidelines are recommended doses. The serum levels of uric acids should serve as an indicator.
The intake of fluids should be enough to provide an average daily output of 2 L. Neutral or at least somewhat alkaline urine are ideal.

Use: To treat patients suffering from leukemia-lymphoma, or malignancies who undergo chemotherapy for cancer, which results in an increase in urine uric acid and serum levels. IV therapy is offered to patients who are unable to endure oral therapy.

The Usual Adult Dose Allopurinol to calculate Calcium Oxalate in Hyperuricosuria

200 to 300 mg, orally every day, or in doses divided

Comments:
Carefully evaluate risk and benefit prior to starting therapy and then every few months following.
Adjustments to dosage must be based on the management of hyperuricosuria, based on 24-hour urinary urate tests.
The clinical evidence suggests that patients could benefit from dietary changes, in addition to the drug treatment.

Use: To manage calcium oxalate calculi recurrently in patients whose uric acid excretion is greater than 800 mg/day for males and 750 mg/day for females.

Usual Pediatric Dose for Hyperuricemia Secondary to Chemotherapy:

Parenteral:
Initial dose 200 mg/m2 IV in an infusion in a single dose or in equally divided infusions over 6, 8, or 12 hours intervals.
Maximum dose: 600 mg/day

Oral:
Age: less than 6 years old: 150 mg orally, once a day, or in divided doses
Age: 6-10 years old: 300 mg taken orally daily or divided dosages
Age: Over 10-years: between 600 – 800 mg per day in doses that are divided
After 48 hours, assess and adjust the dosage if needed

Comments:
Oral doses that exceed 300 mg must be administered in doses that are divided.
When possible, treatment should be started within 24 to 48 hours prior to the beginning of chemotherapy. Treatment should be stopped at the point that the risk of the overproduction of uric acid is eliminated.

The dose needed to reduce the uric acid level in serum to near normal or even normal levels is contingent upon how severe the condition The doses listed above are the recommended dosages for children. the levels of uric acid in the serum can be used as an indicator.
The amount of fluid consumed should be enough to provide an average daily output of at minimum 2 liters; neutral or, ideally, somewhat alkaline urine are ideal.

Use: To manage the condition of patients suffering from leukemia, lymphoma, and malignancies that undergo chemotherapy for cancer, which increases urine and urinary uric acids levels.

If I do not take a dose?

Take your allopurinol dosage immediately take it, but do not miss the missed dose if you think it is getting close to the time of the next dose. Don’t take two doses at a time.

Consult your physician for guidance If you missed your injection.

How do I react if consume too much?

Get medical attention immediately or contact toll-free the Poison Help line at 1-800-222-1222.

What to avoid?

Avoid driving or engaging in hazardous activities until you understand the effects of allopurinol on your body. The way you react could be impaired.

Do not drink alcohol. It can aggravate your health.

What other medications could impact allopurinol?

Discuss with your doctor all other medications particularly:

• Azthioprine, mercaptopurine or azathioprine
• chlorpropamide;
• cyclosporine;
• an antibiotic, such as amoxicillin or ampicillin;
• a blood thinner like warfarin Coumadin, Jantoven; or
• a diuretic is also known as a “water pill”.

The list below is not comprehensive. Other drugs can interact with allopurinol. This includes prescription and over-the-counter medicines as well as vitamins and herbal products.

More details

Always consult your doctor to make sure the information presented on this page is applicable to your specific situation.