{"id":1621,"date":"2023-06-25T17:28:42","date_gmt":"2023-06-25T17:28:42","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/allopurinol\/"},"modified":"2023-06-25T19:59:04","modified_gmt":"2023-06-25T19:59:04","slug":"allopurinol","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/allopurinol\/","title":{"rendered":"Allopurinol"},"content":{"rendered":"

<\/p>\n

Allopurinol<\/h1>\n

CLINICAL USE<\/h3>\n
  • Gout prophylaxis<\/li>\n
  • Hyperuricaemia
    \n

    DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

    100\u2013900 mg\/day (usually 300 mg\/day)
    \nDoses above 300 mg should be given in
    \ndivided doses<\/p>\n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :
    \n136.1<\/li>\n
  • %Protein binding                           :
    \n<5<\/li>\n
  • %Excreted unchanged in urine     :<\/li>\n
  • <10           :<\/li>\n
  • Volume of distribution (L\/kg)       :
    \n1.6<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :
    \n1\u20132\/Increased<\/p>\n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : 200\u2013300 mg daily<\/li>\n
  • 10 to 20     : 100\u2013200 mg daily<\/li>\n
  • <10           :
    \n100 mg daily or 100 mg on alternate
    \ndays<\/p>\n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :
    \nDialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/
    \nmin<\/li>\n
  • HD                     :
    \nDialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/
    \nmin<\/li>\n
  • HDF\/high flux   :
    \nDialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/
    \nmin<\/li>\n
  • CAV\/VVHD      :
    \nDialysed. Dose as in GFR=10\u2013
    \n20 mL\/min<\/p>\n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • ACE inhibitors: increased risk of toxicitywith captopril<\/li>\n
  • Ciclosporin: isolated reports of raisedciclosporin levels (risk of nephrotoxicity)<\/li>\n
  • Cytotoxics: effects of azathioprine andmercaptopurine enhanced with increased
    \ntoxicity; avoid concomitant use with
    \ncapecitabine<\/p>\n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n<\/li>\n
  • In all grades of renal impairmentcommence with 100 mg\/day and increase
    \nif serum and\/or urinary urate response is
    \nunsatisfactory. Doses less than 100 mg\/day
    \nmay be required in some patients<\/li>\n
  • Take as a single daily dose, preferably afterfood
    \n

    OTHER INFORMATION<\/h4>\n

    A parenteral preparation is available from<\/p>\n

    Glaxo Wellcome on a named patient basis<\/li>\n

  • HD patients may be given 300 mg postdialysis, i.e. on alternate days<\/li>\n
  • Increased incidence of skin rash inpatients with renal impairment<\/li>\n
  • Efficient dialysis usually controls serumuric acid levels
    \nIf a patient is prescribed azathioprine or<\/p>\n

    6-mercaptopurine concomitantly, reduce
    \nazathioprine or 6-mercaptopurine dose by
    \n66\u201375%<\/li>\n

  • Main active metabolite: oxipurinol \u2013renally excreted; plasma protein binding
    \n17%; half-life: Normal\/ESRF = 13\u2013
    \n30\/>125 hours \u2013 1 week<\/li>\n","protected":false},"excerpt":{"rendered":"

    Allopurinol CLINICAL USE Gout prophylaxis Hyperuricaemia DOSE IN NORMAL RENAL<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1621","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1621","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1621"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1621\/revisions"}],"predecessor-version":[{"id":2938,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1621\/revisions\/2938"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1621"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1621"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1621"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}