PHAR 200 Midterm: Gout: Allopurinol
Document Summary
Allopurinol is the first-line agent for the treatment of chronic gout in the period between attacks and it tends to prolong the intercritical period. Allopurinol should not be started during an acute gout attack because sudden shifts in. Sua levels may precipitate or exacerbate gouty arthritis. A prophylactic dose of colchicine (0. 6 mg/day) should be initiated concurrently with antihyperuricemic therapy until sua is normalized and continued for 6 months. Oxypurinol is cleared primarily renally: sua levels must be monitored periodically. Maculopapular rash (2%) although usually mild, this can progress to severe skin reactions such as stevens-johnson syndrome. Allopurinol hypersentivity syndrome (stevens-johnson syndrome) 20% mortality rate. Drug interactions: allopurinol is indicated for the treatment of hyperuricemia secondary to blood dyscrasias, especially during cancer chemotherapy (azathioprine). Inhibition of the metabolism of 6-mercaptopurine and its prodrug azathioprine: their dose must be reduced by 75% with allopurinol co-therapy.
