Allopurinol

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Urostatic: Inhibition of xanthine oxidase (reduction of uric acid synthesis), resulting in increased excretion of water-soluble precursors (xanthine, hypoxanthine); feedback inhibition of purine synthesis.

Indication
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Primary and secondary hyperuricemia, gout kidney, urate nephrolithiasis, enzyme defect with overproduction of uric acid.

Dosage and method of use
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Initial dose 300 mg/day or less (administration after breakfast), dose adjustment at 2-weekly intervals according to uric acid level (target: 4-6 mg/dl), maximum daily dose 800 mg/day (2 ED); maintenance dose 200-400 mg/day; dose reduction in renal failure (scheme adapted to creatinine clearance).

Undesirable effects
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Pruritus, lichenoid and multiforme exanthema, urticaria, GIT disorders, bone marrow depression. Hypersensitivity syndrome (a total of 100-150 cases have been published in the literature) with a generalized course (fever, lichenoid or multiform exanthema, headache and limb pain, hepatitis, kidney failure). Cave! Often lethal course (20-30%)! The hypersensitivity syndrome occurs more frequently with simultaneous administration of thiazides and furosemide (see below toxic epidermal necrolysis).

Interactions
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Azathioprine and 6-mercaptopurine are eliminated at a slower rate, the effect of salicylates and anticoagulants are enhanced, rashes are more common with amoxicillin and ampicillin, captopril increases the risk of leukopenia.

Contraindication
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Pregnancy and lactation.

Preparations
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Cyloric

Outgoing links (1)

Toxic epidermal necrolysis;

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Last updated on: 29.10.2020