There was no mention of allopurinol being used in the treatment of pseudogout or preventing buildup of calcium crystals. For more specific information, consult with your doctor for guidance based on your health status and current medications, particularly before taking any action.
Kristen Dore, PharmD Q: I've been prescribed allopurinol. What are its side effects? The main side effect from Zyloprim the generic name is allopurinol is skin related. In more than 10 percent of people taking Zyloprim allopurinol , skin rash; scaling skin; dark red, raised hives; or purple spot lesions have been reported, as has Stevens-Johnson syndrome a possibly life-threatening skin condition where the cell death causes the epidermis to separate from the dermis.
Less common side effects, in 1 to 10 percent of the population, include drowsiness, chills, fever, alopecia, nausea, vomiting, diarrhea, abdominal pain, gastritis, dyspepsia, and abnormal liver tests.
This enzyme is required for the conversion of hypoxanthine, xanthine, and guanine to their respective nucleotides. The third patient had lymphosarcoma and produced an extremely large amount of uric acid because of rapid cell lysis during chemotherapy.
Peak plasma levels generally occur at 1. Because of its rapid oxidation to oxipurinol and a renal clearance rate approximately that of glomerular filtration rate, allopurinol has a plasma half-life of about 1 to 2 hours. Oxipurinol, however, has a longer plasma half-life approximately 15 hours and therefore effective xanthine oxidase inhibition is maintained over a hour period with single daily doses of allopurinol.
Whereas allopurinol is cleared essentially by glomerular filtration, oxipurinol is reabsorbed in the kidney tubules in a manner similar to the reabsorption of uric acid. The clearance of oxipurinol is increased by uricosuric drugs, and as a consequence, the addition of a uricosuric agent reduces to some degree the inhibition of xanthine oxidase by oxipurinol and increases to some degree the urinary excretion of uric acid.
In practice, the net effect of such combined therapy may be useful in some patients in achieving minimum serum uric acid levels provided the total urinary uric acid load does not exceed the competence of the patient's renal function. Hyperuricemia may be primary, as in gout, or secondary to diseases such as acute and chronic leukemia, polycythemia vera, multiple myeloma, and psoriasis. It may occur with the use of diuretic agents, during renal dialysis, in the presence of renal damage, during starvation or reducing diets, and in the treatment of neoplastic disease where rapid resolution of tissue masses may occur.
Gout is a metabolic disorder which is characterized by hyperuricemia and resultant deposition of monosodium urate in the tissues, particularly the joints and kidneys. The etiology of this hyperuricemia is the overproduction of uric acid in relation to the patient's ability to excrete it. If progressive deposition of urates is to be arrested or reversed, it is necessary to reduce the serum uric acid level below the saturation point to suppress urate precipitation.
Administration of allopurinol generally results in a fall in both serum and urinary uric acid within 2 to 3 days. The degree of this decrease can be manipulated almost at will since it is dose-dependent.
A week or more of treatment with allopurinol may be required before its full effects are manifested; likewise, uric acid may return to pretreatment levels slowly usually after a period of 7 to 10 days following cessation of therapy. This reflects primarily the accumulation and slow clearance of oxipurinol.
In some patients a dramatic fall in urinary uric acid excretion may not occur, particularly in those with severe tophaceous gout. It has been postulated that this may be due to the mobilization of urate from tissue deposits as the serum uric acid level begins to fall. The action of allopurinol differs from that of uricosuric agents, which lower the serum uric acid level by increasing urinary excretion of uric acid. Allopurinol reduces both the serum and urinary uric acid levels by inhibiting the formation of uric acid.
The use of allopurinol to block the formation of urates avoids the hazard of increased renal excretion of uric acid posed by uricosuric drugs. Allopurinol can substantially reduce serum and urinary uric acid levels in previously refractory patients even in the presence of renal damage serious enough to render uricosuric drugs virtually ineffective. Salicylates may be given conjointly for their antirheumatic effect without compromising the action of allopurinol.
This is in contrast to the nullifying effect of salicylates on uricosuric drugs. Allopurinol also inhibits the enzymatic oxidation of mercaptopurine, the sulfur-containing analogue of hypoxanthine, to 6-thiouric acid. This oxidation, which is catalyzed by xanthine oxidase, inactivates mercaptopurine. Allopurinol tablets USP reduces serum and urinary uric acid concentrations.
It may harm them, even if their symptoms are the same as yours. This includes any possible side effects not listed in this leaflet. Your medicine is available by using the above name but will be referred to as Zyloric throughout the following leaflet. Zyloric Tablets are also available in mg strength. What is in this leaflet: What Zyloric is and what it is used for 2. What you need to know before you take Zyloric 3. How to take Zyloric 4.
Possible side effects 5. How to store Zyloric 6. Contents of the pack and other information 1. It works by slowing down the speed of certain chemical reactions in your body to lower the level of uric acid in the blood and urine. These may include gout or some types of kidney stones or certain other types of kidney problems or when you are having treatment for cancer or some other conditions. In gout the uric acid builds up in your joints and tendons as crystals. A fluid intake sufficient to yield a daily urinary output of at least 2 liters and the maintenance of a neutral or, preferably, slightly alkaline urine are desirable to 1 avoid the theoretical possibility of formation of xanthine calculi under the influence of therapy with ZYLOPRIM allopurinol and 2 help prevent renal precipitation of urates in patients receiving concomitant uricosuric agents.
Although the mechanism responsible for this has not been established, patients with impaired renal function should be carefully observed during the early stages of administration of ZYLOPRIM allopurinol and the dosage decreased or the drug withdrawn if increased abnormalities in renal function appear and persist.
Renal failure in association with administration of ZYLOPRIM allopurinol has been observed among patients with hyperuricemia secondary to neoplastic diseases. Concurrent conditions such as multiple myeloma and congestive myocardial disease were present among those patients whose renal dysfunction increased after ZYLOPRIM allopurinol was begun.
Albuminuria has been observed among patients who developed clinical gout following chronic glomerulonephritis and chronic pyelonephritis. Lower than recommended doses should be used to initiate therapy in any patients with decreased renal function and they should be observed closely during the early stages of administration of ZYLOPRIM allopurinol. In patients with severely impaired renal function or decreased urate clearance, the half-life of oxipurinol in the plasma is greatly prolonged.
Therefore, a dose of mg per day or mg twice a week, or perhaps less, may be sufficient to maintain adequate xanthine oxidase inhibition to reduce serum urate levels.
Bone marrow depression has been reported in patients receiving ZYLOPRIM allopurinol , most of whom received concomitant drugs with the potential for causing this reaction. The correct dosage and schedule for maintaining the serum uric acid within the normal range is best determined by using the serum uric acid as an index. ZYLOPRIM allopurinol and its primary active metabolite, oxipurinol, are eliminated by the kidneys; therefore, changes in renal function have a profound effect on dosage.
In patients with decreased renal function or who have concurrent illnesses which can affect renal function such as hypertension and diabetes mellitus , periodic laboratory parameters of renal function, particularly BUN and serum creatinine or creatinine clearance, should be performed and the patient's dosage of ZYLOPRIM allopurinol reassessed.
There were increased numbers of external malformations in fetuses at both doses of allopurinol on gestation day 10 and increased numbers of skeletal malformations in fetuses at both doses on gestation day It cannot be determined whether this represented a fetal effect or an effect secondary to maternal toxicity. There are, however, no adequate or well-controlled studies in pregnant women.
Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Allopurinol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Pregnancy and breastfeeding warnings in more detail How should I take allopurinol? Take allopurinol exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
In patients 300 decreased renal function or who have concurrent illnesses which can affect renal function such as hypertension and diabetes mellitusperiodic laboratory parameters of renal function, particularly BUN and serum creatinine or creatinine clearance, should be performed and the patient's dosage of ZYLOPRIM allopurinol reassessed. Since the excretion of oxipurinol is similar to that tab dosage, uricosuric agents, which increase the excretion of urate, are also likely to increase the excretion of oxipurinol and thus lower the degree of inhibition of xanthine oxidase. It may occur dosage the tab of diuretic agents, during renal dialysis, in the presence of renal damage, during starvation or reducing diets, and in the treatment of neoplastic disease where rapid resolution of tissue masses may occur. In those patients in whom renal insufficiency was documented, however, the recommendation to lower the dose of allopurinol was not followed, allopurinol dosage 300 mg tab. It cannot be determined whether this represented a fetal effect or an effect secondary to maternal toxicity, allopurinol dosage 300 mg tab. The clearance of oxipurinol is increased by uricosuric drugs, and as a consequence, the addition of a uricosuric agent reduces to some degree the inhibition of xanthine oxidase by oxipurinol and increases allopurinol some degree the urinary excretion of uric acid. Since allopurinol and its metabolites are primarily eliminated only by the kidney, accumulation of the drug can occur in renal failure, and the dose of allopurinol tablets USP should consequently be reduced. The minimal effective dosage is to mg daily and the allopurinol recommended dosage is mg daily. There are two unpublished reports and one published paper of women giving birth to normal offspring after receiving allopurinol during pregnancy. Enhanced tab marrow 300 by cyclophosphamide and dosage cytotoxic agents has been reported among patients with neoplastic disease, except leukemiain the presence of ZYLOPRIM allopurinol. An increase in acute attacks of gout has been reported during the early stages of administration of ZYLOPRIM allopurinoleven when normal or subnormal serum uric acid levels have been attained. Peak 300 levels generally occur at 1. Kristen Dore, PharmD Q: Allopurinol, eosinophilia, leukocytosis, leukopenia, allopurinol dosage 300 mg tab.
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