CLINICAL USE


Gout prophylaxis Hyperuricaemia

DOSE IN NORMAL RENAL FUNCTION

100–200 mg daily with food (or milk); maximum dose 600–800 mg

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :404.5
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :98
  • %Excreted unchanged in urine &nbsp &nbsp : 22–42

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.06

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :2–4/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function Use lower dose range
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Avoid

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Avoid.

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Avoid.
  • HDF/high flux &nbsp :Unknown dialysability. Avoid. See ‘Other Information’
  • CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10–20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Anticoagulants: enhances anticoagulant effect of coumarinsAntidiabetics: enhances effect of sulphonylureas
  • Anti-epileptics: increases plasma concentration of phenytoin
  • Ciclosporin: may reduce ciclosporin levels

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    An adequate fluid intake of 2–3 litres daily should be taken to reduce risk of uric acid renal calculiUricosuric effects are lost when GFR <10 mL/minReversible acute renal failure may occur especially with high initial dosesCan cause salt and water retention In combination with aspirin, has been shown to improve vascular access thrombosis in haemodialysis patients, but there was an increased occurrence of gastrointestinal bleeding
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