Brand name: Apo-Allopurinol (CAN), Purinol (CAN), Zyloprim
Pregnancy Category C
Drug class: Antigout drug
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
· Management of the signs and symptoms of primary and secondary gout
· Management of patients with malignancies that 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 fluorouracil; as a mouthwash to prevent fluorouracil-induced stomatitis
· Contraindicated with allergy to allopurinol, blood dyscrasias.
Headache, drowsiness, peripheral neuropathy, neuritis, paresthesias, Rashes--maculopapular, scaly or exfoliative--sometimes fatal, Nausea, vomiting, diarrhea, abdominal pain, gastritis, hepatomegaly, hyperbilirubinemia, cholestatic jaundice, Exacerbation of gout and renal calculi, renal failure, Anemia, leukopenia, agranulocytosis, thrombocytopenia, aplastic anemia, bone marrow depression
· Increased risk of hypersensitivity reaction with ACE inhibitors
· Increased toxicity with thiazide diuretics
· Increased risk of rash with ampicillin
· Increased risk of bone marrow suppression with cyclophosphamide, other cytotoxic agents
· Increased half-life of oral anticoagulants
· Administer drug following meals.
· Force fluids--2.5 to 3 L/day to decrease the risk of renal stone development.
· Check urine alkalinity--urates crystallize in acid urine; sodium bicarbonate or potassium citrate may be ordered to alkalinize urine.
· Arrange for regular medical follow-up and blood tests.