Allopurinol

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Administration

  • Type: xanthine oxidase inhibitor
  • Dosage Forms:
  • Routes of Administration: IV, PO
  • Common Trade Names:

Adult Dosing

  • Gout, nephrolithiasis: 100-300mg PO 1-2 times daily
  • Tumor lysis syndrome/hyperuricemia in liquid malignancies: 200-800 mg PO or IV daily

Pediatric Dosing

  • <6yo: 150 mg PO daily for 2 to 3 days, then adjust dose for maintenance
  • >6yo: 300 mg PO daily for 2 to 3 days, then adjust dose for maintenance
  • 200 mg/m(2)/day IV

Special Populations

Renal Dosing

  • CrCl 10-20: 200 mg PO or IV daily
  • CrCl 3-10: max daily dose 100 mg PO or IV
  • CrCl <3: 100mg PO or IV at "extended intervals"

Hepatic Dosing

  • No adjustment

Contraindications

  • Allergy to class/drug
  • Concomitant use with didanosine

Adverse Reactions

Serious

  • Cardiac arrest, ventricular fibrilliation, heart failure
  • SJS/TEN
  • Agranulocytosis, myelosuppression, aplastic anemia, thrombocytopenia, eosinophilia
  • DIC
  • Renal failure
  • Respiratory distress
  • Hepatotoxicity, granulomatous hepatitis
  • Stroke, seizure

Common

  • Nausea, vomiting
  • Rash, pruritus

Pharmacology

  • Half-life: 1-2 hours
  • Metabolism: Hepatic
  • Excretion: Renal

Mechanism of Action

  • Inhibits xanthine oxidase (converts hypoxanthine/xanthine to uric acid), leading to decreased uric acid concentration

Comments

See Also

References