Allopurinol
When ATH:
M04AA01
Characteristic.
White or white with blue polka crystalline powder, insoluble in water and alcohol.
Pharmacological action.
Gipourikemicheskoe, protivopodagricakih.
Application.
Hyperuricemia: Primary and secondary gout, urolithiasis with the formation of uric acid stones, disease, involving enhanced dissolution of nucleoproteins, incl. gematoblastomah, cytostatic and radiation therapy of tumors, psoriasis, compression syndrome, corticosteroid therapy for the prevention of Uric acid nephropathy; malignant neoplasms and congenital disorders of purine metabolism in children.
Contraindications.
Hypersensitivity, severe renal insufficiency, pregnancy and breastfeeding.
Pregnancy and breast-feeding.
Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)
Side effects.
Reversible angioimmunnoblastnaya lymphadenopathy and granulomatous hepatitis, thrombocytopenia, agranulocytosis, aplasticheskaya anemia (more frequently in patients with impaired liver function and kidney function), nausea, vomiting, taste disturbance, stomatitis, fever, general malaise, asthenia, headache, vertigo, ataxia, drowsiness, coma, depression, paralysis, paraesthesia, neuropathy, visual disturbances, Cataract, angina, bradycardia, hypertension, swelling, alopecia, furunculosis, giperglikemiâ, hyperlipidemia, hematuria, uremia, gynecomastia, infertility, impotence, allergic skin reactions, angioedema.
Cooperation.
Increasing the concentration in blood, and toxicity azathioprine, merkaptopurina, methotrexate, xanthine (teofillina, aminofillina), hypoglycemic effect hlorpropamida, protivosvertawati — indirect anticoagulants. Pyrazinamide, salicilaty, urikozuricheskih funds, thiazide diuretics, furosemid, ethacrynic acid weaken the influence gipourikemicheskoe. Against the background of amoxicillin, Ampicillin, bakampitsillina increases the likelihood of skin rash.
Overdose.
Symptoms: nausea, vomiting, diarrhea, dizziness, oligurija.
Treatment: diurez, gemo- E pyeritonyealinyi dialysis.
Dosing and Administration.
Inside, after meal. Begin with 100 mg / day, single, then gradually increase the dose. If the dose of 300 mg per day are side effects from the blood, possible fractional reception.
Adults-100-200 mg/day, with a moderate-300-600 mg/day, with heavy-700-900 mg/day.
Children up 15 years is 10-20 mg/kg/day (to 400 mg/day maximum). When expressed kidney failure — 100 mg/day or 100 mg at intervals of more than, than 1 day.
Older patients are recommended lowest dose.
Precautions.
It is necessary to maintain a urine output of at least 2 liters per day, and a neutral or slightly alkaline reaction of urine, tk. This prevents the precipitation of urate stones and education. Do not start treatment until complete relief of acute attacks of gout; during the first month of treatment is recommended prophylactic NSAIDs or colchicine; in the event of an acute attack of gout during treatment additionally appoint anti-inflammatory drugs. If the kidney function and liver (It increases the risk of side effects) reduce the dose. The use of azathioprine or 6-mercaptopurine amid allopurinol admits 4 fold decrease their doses. With care combined with vidarabine.
Cooperation
Active substance | Description of interaction |
Azathioprine | FKV. FMR: synergism. Against the background of increasing the concentration of allopurinol in the blood and the risk of toxicity. |
Aminofillin | FKV. FMR. Against the background of increasing the concentration of allopurinol in the blood and the risk of toxicity. |
Amoksiцillin | Increases (mutually) the likelihood of skin rash. |
Amoksiцillin + Clavulanic acid | FKV. FMR. Against the background of allopurinol increases the concentration of amoxicillin in the blood (and the risk of skin rashes). |
Ampicillin | Increases (mutually) the likelihood of skin rash. |
Ampicillin + Oxacillin | FKV. Against the background of allopurinol (blocks tubular secretion) increased concentration in the blood and increases the chance of side effects (skin rash and so on.). |
Bleomycin | FMR. Strengthens (mutually) marrow suppression. |
Warfarin | FMR: synergism. Against the backdrop of increasing the effect of allopurinol. |
Vynkrystyn | FMR. Strengthens (mutually) marrow suppression. |
Gidroxlorotiazid + Fosinopril | FMR. Strengthens (mutually) the risk of leukopenia. |
Daunorubicin | FMR. Strengthens (mutually) marrow suppression. |
Didanosine | FKV. Against the background of allopurinol increases the concentration in the blood; concomitant use is not recommended. |
Doxorubicin | FMR. Strengthens (mutually) marrow suppression. |
Merkaptopurin | FKV. FMR. Against the background of increasing the concentration of allopurinol in the blood and the risk of toxicity. |
Methotrexate | FKV. FMR. Against the background of increasing the concentration of allopurinol in the blood and the risk of toxicity. |
Mytoksantron | FMR. Strengthens (mutually) marrow suppression. |
Pyrazinamide | FMR: antagonizm. It weakens the effect gipourikemichesky. |
Procarbazine | FMR. Strengthens (mutually) marrow suppression. |
Tamoxifen | FMR: synergism. Strengthens bone marrow suppression. |
Theophylline | FKV. FMR. Against the background of increasing the concentration of allopurinol in the blood and the risk of toxicity. |
Fosinopril | FMR. Increases (mutually) the risk of neutropenia. Against the backdrop of allopurinol increases the risk of developing Stevens-Johnson Syndrome. |
Furosemid | FMR: antagonizm. It weakens the effect gipourikemichesky. |
Cyclosporine | FKV. FMR. Against the background of allopurinol (ингибирует CYP3A) zamedlyaetsya biotransformation, increasing the concentration in blood and the risk of toxicity. |
Cyclophosphamide | FMR. Strengthens (mutually) marrow suppression. |
Epirubicin | FMR. Strengthens (mutually) marrow suppression. |
Ethacrynic acid | FMR: antagonizm. It weakens the effect gipourikemichesky. |