Allopurinol(al oh pure’ i nole)
Aloprim, Apo-Allopurinol (CAN), Zyloprim
PREGNANCY CATEGORY C
Drug Classes
Antigout drug
Purine analogue
Therapeutic Actions
Inhibits the enzyme responsible for the conversion of purines to uric acid, thus reducing the production of uric acid with a decrease in serum and sometimes in urinary uric acid levels, relieving the signs and symptoms of gout.
Indications
Management of the signs and symptoms of primary and secondary gout
Management of patients with leukemia, lymphoma, and malignancies who are undergoing chemotherapy expected to result in elevations of serum and urinary uric acid
Management of patients with recurrent calcium oxalate calculi whose daily uric acid excretion exceeds 800 mg/day (males) or 750 mg/day (females)
Orphan drug use: Treatment of Chagas’ disease; cutaneous and visceral leishmaniasis
Unlabeled uses: Amelioration of granulocyte suppression with 5-FU; as a mouthwash to prevent 5-FU–induced stomatitis; prevention of ischemic reperfusion tissue damage; reduction of perioperative mortality and postoperative arrhythmias in CABG surgery; reduction of relapse of Helicobacter pylori–induced duodenal ulcers; treatment of hematemesis from NSAID–induced erosive gastritis; alleviation of pain of acute pancreatitis; vivo preservation and function of organs for liver and kidney transplantation; reduction of rejection in adult cadaver renal transplant recipients; epileptic seizures
Contraindications and Cautions
Contraindicated with allergy to allopurinol, blood dyscrasias.
Use cautiously with liver disease, renal failure, lactation, pregnancy.
Available Forms
Tablets—100, 300 mg; powder for injection—500 mg
Dosages
Adults
Gout and hyperuricemia: 100–800 mg/day PO in divided doses, depending on the severity of the disease (200–300 mg/day is usual dose). Maintenance: Establish dose that maintains serum uric acid levels within normal limits.
Hyperuricosuria: 200–300 mg/day PO; adjust dose based on 24-hr urinary urate levels.
Prevention of acute gouty attacks: 100 mg/day PO; increase the dose by 100 mg at weekly intervals until uric acid levels are 6 mg/dL or less.
Prevention of uric acid nephropathy in certain malignancies: 600–800 mg/day PO for 2–3 days with a high fluid intake; maintenance dose should then be established as above.
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