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 (Inhibits 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.