Allopurinol is a hormonal drug or not. Allopurinol: instructions for use, properties, indications

Allopurinol is a drug used to treat gout. It helps to reduce the rate of synthesis of lactic acid, thereby reducing the severity of the symptoms of pathology and preventing its exacerbation.

Clinical studies have shown that Allopurinol is particularly effective in treating the underlying cause of gout. Let's consider in more detail what the drug Allopurinol is, instructions for use, price and reviews.

Characteristics of the drug

Allopurinol is an anti-gout uricostatic agent, the main function of which is decreased synthesis of lactic acid, due to which the symptoms of pathology significantly weaken, the number of exacerbations decreases and the lost ability to work returns.

This medicinal product is not intended to eliminate lactic acid, i.e. it may prevent future exacerbations, but has no therapeutic effect. If the treatment of gout is carried out by other means, then the use of Allopurinol accelerates remission.

Allopurinol: release form and composition

Release form of the drug - tablets of 100 and 300 mg... The active ingredient of the drug is allopurinol.

Allopurinol excipients: sucrose, colloidal silicon dioxide, lactose monohydrate, food gelatin, magnesium stearate, potato starch.

Pharmacological properties

The drug helps to reduce the synthesis of uric acid in the body, the appearance of which is associated with the metabolism of foods containing purines.

With an excessive formation of uric acid, the excretory system begins to fail to cope with its excretion, while in the blood its indicator begins to increase.

Overloading with lactic acid leads to the formation of crystals that contribute to the formation of stones in the bladder or kidneys. In addition, crystal deposition also occurs in the joints.

This leads to the development of gout, which is characterized by the following symptoms:

• joint inflammation;
• redness;
• pain;
• swelling;
• temperature rise;
• limitation of mobility.

As a result of the use of Allopurinol:

• the production of lactic acid decreases;
• edema decreases;
• the synthesis of some enzymes that can form lactic acid is blocked;
• the appearance of urolithiasis is prevented;
• the dissolution of salts in the joints is accelerated;
• improves the function of the kidneys and excretory system.

When taken orally, the drug begins to dissolve under the influence of gastric juice and is absorbed, thus getting into the blood. The maximum concentration of the drug is observed 1.5 hours after consumption. Then the level and absorption of active components in the small intestine and duodenum begin to decrease gradually.

Indications for use of the drug, according to the instructions, are as follows:

As evidenced by patient reviews, Allopurinol is used as prevention possible exacerbations and relapses.

Dosage

Taking the drug, you need to control the volume of urine, which should be more than two liters per day. Otherwise, a malfunction of the organs of the excretory system and, first of all, the kidneys may occur.

To reduce the risk of side effects, the course of treatment should begin with 100 mg of the product once a day... If the need arises, then the daily dose can be gradually increased. The usual maintenance daily dose is 200-600 mg.

Sometimes the dosage is increased to 800 mg. As indicated in the instructions, the dosage of Allopurinol for children is 10-20 mg per 1 kg of body weight... The required dose should be divided into 3 parts and taken 3 times a day.

Allopurinol: contraindications

This drug has the following contraindications:

Side effects

According to reviews of the drug Allopurinol, side effects are very rare and affect only 5% of patients.

Common side effects are skin hypersensitivity reactionsthat can appear at any time during treatment. This can be itching, maculopapular rash, itching, or scaling. In this case, you should stop taking Allopurinol.

If the skin reactions are rather weak, then after they disappear, the drug is resumed in small doses, which are then increased. If there is a relapse of skin reactions, then Allopurinol canceled immediately and permanently.

In addition, the following side effects occur:

• Hematopoietic system: decreased leukocyte count, angioimmunoblastic lymphadenopathy, leukocytosis, eosinophilia, aplastic anemia, agranulocytosis, decreased platelet count and other changes.
• Works of the gallbladder and liver: liver necrosis, hepatitis, inflammation of the bile ducts, the appearance of stones.
• Nervous system: periodic paresthesias, drowsiness, neuropathy, depression, the appearance of outbreaks of aggression, headache.
• Sense organs: pathologies of the lens of the eye and retina, changes in taste, decreased visual acuity.
• Cardiovascular: lowering pressure, slowing heart rate.
• Reproductive system: weakening of erection, inflammation of the mammary glands, infertility.
• Allergic reactions: vasculitis, edema, dermatitis and various rashes.

May occur other adverse reactions: pain in muscles and joints, edema, nausea, vomiting, stomatitis, weakness, diarrhea. At the beginning of treatment, gout attacks may intensify, which is an undesirable reaction, but withdrawal of treatment in this case is not required.

The risk of developing the above-described side effects increases if the patient has problems with the kidneys or liver. Adverse reactions of the body can also be triggered by taking antibiotics, for example, ampicillin or.

special instructions

During treatment with Allopurinol, large urate stones may begin to dissolve. If they get into the ureter, then there is a high probability of developing renal colic.

In pediatrics, this drug is used only if available congenital disorders of purine metabolism or malignant neoplasms.

Allopurinol treatment is not started until stopped an acute attack of gout... As a preventive measure, nonsteroidal anti-inflammatory drugs should be taken in the first months of therapy. In the event of an exacerbation of the disease, anti-inflammatory drugs are additionally prescribed.

To normalize the liver and kidneys, the dosage of Allopurinol should be reduced. During treatment, the amount of fluid consumed per day should be not less than two liters... This drug should be used with caution in patients whose activities are associated with increased concentration.

If it was not possible to find Allopurinol in pharmacies, analogues of the drug can replace it, since they contain the same active ingredient. These include the following:

1. Allozyme.
2. Purinol.
3. Sanfipurol.
4. Milurite.
5. Remid.
6. Allupol.
7. Alopron.
8. Allokin alpha.
9. Zilorik.
10. Allopurinol-Egis.
11. Allopurinol-Teva.

Before using analogs of Allopurinol, you must consult a doctor.

Allopurinol is a fairly inexpensive drug, the price of which depends on the manufacturer and dosage. The domestic remedy costs on average 90 rubles, and the price of an imported drug ranges from 100 to 130 rubles.

In this article, you can read the instructions for using the drug Allopurinol... Reviews of website visitors - consumers of this medication, as well as opinions of doctors of specialists on the use of Allopurinol in their practice are presented. A big request to more actively add your reviews about the drug: did the medicine help or did not help get rid of the disease, what complications and side effects were observed that may not have been declared by the manufacturer in the annotation. Analogues of Allopurinol in the presence of available structural analogs. Use for the treatment and prevention of gout in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

Allopurinol - an agent that disrupts the synthesis of uric acid. It is a structural analogue of hypoxanthine. Inhibits the enzyme xanthine oxidase, which is involved in the conversion of hypoxanthine to xanthine and xanthine to uric acid. This is due to a decrease in the concentration of uric acid and its salts in body fluids and urine, which helps dissolve the existing urate deposits and prevents their formation in tissues and kidneys. When allopurinol is taken, the urinary excretion of hypoxanthine and xanthine increases.

Composition

Allopurinol + excipients.

Pharmacokinetics

After oral administration, it is almost completely (90%) absorbed from the gastrointestinal tract. It is metabolized to form alloxanthin, which retains the ability to inhibit xanthine oxidase for a long time. About 20% of the dose taken is excreted through the intestines, the rest - by the kidneys.

Indications

Diseases accompanied by hyperuricemia (treatment and prevention):

• gout (primary and secondary);
• urolithiasis (with the formation of urates).

Hyperuricemia (primary and secondary), which occurs in diseases accompanied by increased disintegration of nucleoproteins and an increase in the content of uric acid in the blood, incl. with various hematoblastosis (acute leukemia, chronic myeloid leukemia, lymphosarcoma, etc.), with cytostatic and radiation therapy of tumors (including in children), psoriasis, extensive traumatic injuries due to enzyme disorders (Lesch-Nyhan syndrome), and with massive therapy with glucocorticosteroids, when, due to the intensive breakdown of tissues, the amount of purines in the blood significantly increases.

Uric acid nephropathy with impaired renal function (renal failure).

Recurrent mixed calcium oxalate kidney stones (if uricosuria is present).

Release forms

Tablets 100 mg and 300 mg (Egis).

Instructions for use and reception scheme

Inside. The drug should be taken after meals with plenty of water. The daily urine volume should be more than 2 liters, and the urine reaction is neutral or slightly alkaline. A daily dose of more than 300 mg must be divided into several doses.

Adults

To reduce the risk of possible side effects, it is recommended to start the course with a dose of 100 mg once a day. If necessary, the daily dose can be gradually increased (while monitoring the level of uric acid in the blood serum with an interval of 1-3 weeks) in steps of 100 mg until the desired effect is achieved.

The usual maintenance dose is 200-600 mg per day. In some cases, it may be necessary to increase the daily dose to 800 mg.

In terms of body weight, you can give 2-10 mg / kg per day.

For cancer patients, allopurinol should be started 1-2 days before the start of anticancer therapy.The drug should be given daily at a dose of 600-800 mg for 2-3 days, after which the maintenance dose should be continued based on the level of urinary serum acid.

For children

In secondary hyperuricemia associated with malignant diseases of the blood system and other organs, as well as in some dysfunctions of enzymes, the usual daily dose is 10-20 mg / kg body weight, depending on the size of the tumor, the number of peripheral blast cells or the degree of bone marrow infiltration ...

Elderly patients, as well as with impaired renal and liver function

Depending on the degree of impaired renal and liver function, the dose should be reduced, since in these conditions the risk of toxic effects of the drug increases.

Side effect

• maculopapular rash;
• peeling;
• fever;
• lymphadenopathy;
• arthralgia;
• eosinophilia;
• vasculitis;
• epileptic seizures;
• anaphylactic shock;
• acute attack of gout;
• nausea, vomiting (they can be avoided by taking the drug after meals);
• abdominal pain;
• diarrhea;
• hepatitis;
• thrombocytopenia, agranulocytosis and aplastic anemia;
• alopecia;
• headache;
• drowsiness;
• asthenia;
• dizziness;
• neuropathy;
• cataract;
• visual impairment.

Contraindications

• hypersensitivity;
• severe liver failure;
• severe renal failure;
• primary (idiopathic) hemochromatosis (even if there is a family history);
• asymptomatic hyperuricemia;
• acute attack of gout;
• pregnancy;
• lactation period.

Application during pregnancy and lactation

The property of allopurinol to cause pathology of the human fetus has not been identified. However, there have been no sufficient reliable studies on the use of the drug during pregnancy and lactation in humans. Therefore, pregnant women can only take this drug as directed by a doctor and only in the absence of a therapeutic alternative, when the disease poses a greater risk to the fetus and mother than allopurinol. Since allopurinol and oxypurinol are excreted in breast milk, during lactation, you should refrain from prescribing the drug, or decide whether to stop breastfeeding during treatment.

Use in elderly patients

Elderly patients should always be given the lowest clinically effective dose possible; the possibility of decreased renal and / or liver function should always be considered.

In old age, the use of Allopurinol requires careful medical supervision.

Application in children

Children under 14 years old should not be prescribed Allopurinol, except in cases of cytostatic therapy of leukemia and other malignant diseases, as well as the treatment of enzyme disorders.

special instructions

Allopurinol should be discontinued immediately if any signs of a hypersensitivity reaction appear.

Allopurinol is not indicated in all cases of hyperuricemia without clinical manifestations.

Children should not be prescribed Allopurinol, except in cases of secondary hyperuricemia associated with malignant tumors of the blood system and other localization, as well as some dysfunctions of enzymes.

During the course of treatment, you should ensure an abundant fluid intake. The daily urine volume should be at least 2 liters with a neutral or slightly alkaline pH.

In the presence of factors predisposing to a decrease in renal function (old age, administration of diuretics, treatment of hypertension or heart failure with ACE inhibitors), the use of Allopurinol requires careful medical supervision.

Starting allopurinol can trigger an acute gout attack. To prevent this attack, it is recommended to combine Allopurinol with a non-steroidal anti-inflammatory drug or daily intake of colchicine at a dose of 0.5-1 mg for at least 1 month of the initial period of therapy.

If a gout attack occurs while taking Allopurinol, the drug should be continued at the same doses, and a non-steroidal anti-inflammatory drug or colchicine should be used to treat the attack.

At very high levels of uric acid (malignant neoplasms and their treatment, Lesch-Nychen syndrome), administration of Allopurinol can cause xanthine deposition in tissues. The risk of this effect can be reduced by drinking enough fluids. In case of hematopoiesis disorders, regular monitoring of the blood count is recommended. Each 100 mg tablet contains 5% mg of lactose, which should be taken into account when formulating a diet for a patient with lactose intolerance. 300 mg tablets are lactose free.

During the period of taking allopurinol, alcohol is not allowed.

Influence on the ability to drive vehicles and use mechanisms

In some cases, the drug can cause side effects such as drowsiness, dizziness and decreased ability to concentrate. Therefore, the doctor should determine the degree of restriction or prohibition on driving vehicles and working with mechanisms for each patient individually.

Drug interactions

Caution should be exercised when combined with the following:

• 6-mercaptopurine or azathioprine - by inhibiting the metabolism of these drugs, allopurinol increases their toxicity; therefore, doses of 6-mercaptopurine and azathioprine should be reduced to 1 / 4-1 / 3 of the normal level;
• vidarabine (adenine arabinoside) - the half-life of this drug is lengthened;
• cytostatic drugs (cyclophosphamide, doxorubicin, bleomycin, procarbazine, mechlorethamine) - the risk of damage to hematopoietic organs increases;
• chlorpropamide - with impaired renal function, the risk of prolonged hypoglycemia increases;
• drugs that increase the excretion of uric acid in the urine, sulfinpyrazone, probenecid or high doses of salicylates, because they increase the excretion of oxypurinol and thus may reduce the therapeutic effect of allopurinol;
• theophylline and aminophylline, since suppression of their metabolism by allopurinol was found, presumably mediated by inhibition of the xanthine oxidase enzyme;
• cyclosporine - an increase in its concentration in blood plasma and toxicity is possible;
• coumarin derivatives - in some cases, a decrease in their anticoagulant effect is possible;
• ampicillin and amoxicillin - the risk of skin reactions may increase.

In renal insufficiency, the dose should be reduced, it should not exceed 100 mg in with a clearance below 20 ml / min. It is also possible to give regular doses of 100 mg of the drug not daily, but at a longer interval. It is highly recommended to monitor blood plasma allopurinol levels. This level should not exceed 100 μmol / L (15.2 mg / L).

Allopurinol and its metabolites are excreted during hemodialysis. In the case of hemodialysis, a single injection of 300-400 mg of the drug immediately after hemodialysis is recommended 2-3 times a week, and on days when hemodialysis is not performed, the drug should not be administered.

Analogues of the drug Allopurinol

Structural analogues for the active substance:

• Allopurinol Egis;
• Allupol;
• Alopron;
• Purinol;
• Sanfipurol.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and see the available analogues for the therapeutic effect.

Allopurinol is used to treat gout.

It reduces the rate of lactic acid synthesis, thereby reducing the severity of disease symptoms and preventing exacerbation. Medical research in a clinical setting has proven beneficial in treating gout, especially the underlying cause.

On this page you will find all the information about Allopurinol: full instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews of people who have already used Allopurinol. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

The drug belongs to the pharmacological group of xanthine oxidase inhibitors. Anti-gout drug.

Terms of dispensing from pharmacies

The drug is available by prescription.

Prices

How much does Allopurinol cost? The average price in pharmacies is at the level of 100 rubles.

Release form and composition

The drug is available in the form of white round tablets with a flat surface, beveled and scored.

Their composition is indicated in the table:

pharmachologic effect

The main action is to reduce the synthesis of uric acid in the human body. Uric acid is the result of the metabolism of foods containing purines.

When the formation of uric acid is excessive, or the excretory system cannot cope with its excretion, the level of uric acid in the blood will increase. When oversaturated, urates will form - crystals of uric acid, which can cause the formation of stones in the bladder, kidneys, or be deposited in the joints. This is how the characteristic signs of gouty arthritis (gout) arise: joint inflammation, swelling, pain, redness, limited mobility, and fever. That is why it is so important to control the level of uric acid, and not to exceed the norm.

When taking allopurinol, the activity of a special enzyme that promotes the formation of uric acid is inhibited. The drug reduces the synthesis of uric acid and accelerates the dissolution of already deposited urate salts.

Indications for use

The main indications for the use of Allopurinol tablets are the following conditions:

• As part of the complex treatment of acute leukemia;
• As part of the complex treatment of lymphosarcoma;
• Disorders of metabolic processes in the body, namely purines and pyrimidines;
• As part of complex therapy for acute and chronic myeloid leukemia;
• Numerous injuries and pathologies of the locomotor system, which can lead to numerous disorders of metabolic processes in the body;
• Side effects that develop in a patient as a result of prolonged or uncontrolled treatment with glucocorticoids or their synthetic analogues;
• Increased concentration - this condition is checked through blood tests, which are taken strictly on an empty stomach;
• Revealed stones and sand in the urinary tract and kidneys - the drug is indicated only if the stone does not block the ureter, and its dimensions do not exceed 2 mm in diameter;
• After completing a course of cancer chemotherapy in order to prevent the formation of urate stones in the urinary organs.

Contraindications

The use of Allopurinol is contraindicated in people with intolerance to the active substance or auxiliary components of the drug. Other contraindications are severe liver dysfunction, renal failure with creatinine clearance less than 2 ml / min, age up to 15 years. Allopurinol is not prescribed in cases where plasma uric acid levels can be regulated by diet.

The drug is prescribed with caution to patients with hematopoietic disorders, hepatic and renal insufficiency. Also, with arterial hypertension and heart failure, when the patient is being treated with angiotensin-converting enzyme inhibitors and diuretics. Allopurinol is not prescribed for people suffering from acute attacks of gout, treatment with the drug can only be started when the patient's condition improves.

Application during pregnancy and lactation

Allopurinol has not been tested on pregnant women, and it is not recommended to use the drug during pregnancy.

Allopurinol is determined in breast milk. Taking the drug Allopurinol during lactation is undesirable.

Instructions for use Allopurinol

The instructions for use indicate that Allopurinol tablets are intended for oral administration. It is recommended to swallow them without chewing, drinking plenty of drinking water. It is advisable to take Allopurinol after meals. When taking the drug Allopurinol, it is necessary to consume a large amount of liquid to maintain normal diuresis, if necessary, you can also alkalinize the urine (in this case, the excretion of uric acid improves).

The duration of treatment and the dose of Allopurinol is determined by the doctor. The daily dose is calculated taking into account the plasma uric acid levels. The average daily dose is 100-300 mg of allopurinol. The daily dose can be administered in one dose. It is recommended to start therapy with a minimum dose (100 mg per day) and adjust it if necessary. Adjustment of the dose of allopurinol is carried out once every 1-3 weeks, taking into account the level of uric acid in the plasma.

The average maintenance dose is 200-600 mg of allopurinol per day. In some cases, high-dose treatment (600-800 mg of allopurinol per day) may be required. If the daily dose of the drug Allopurinol exceeds 300 mg, it should be divided into several doses (no more than 300 mg of allopurinol per dose). When the dose of allopurinol is increased, the level of the main metabolite in the blood (oxypurinol) should also be monitored, which should not exceed 15 μg / ml (100 μmol).

The maximum daily dose of allopurinol is 800 mg.

Dosing for specific patient groups

For patients with renal insufficiency, allopurinol is prescribed at an initial dose of 100 mg per day. The effectiveness of the drug is determined depending on the level of uric acid in the plasma 1-3 weeks after the start of treatment. If the effectiveness of the drug Allopurinol is insufficient, the dose is gradually increased (while it is necessary to carefully monitor the level of oxypurinol in the plasma).

1. Patients with a creatinine clearance of more than 20 ml / min should not be prescribed more than 300 mg of allopurinol per day.
2. Patients with a creatinine clearance of 10-20 ml / min should not be prescribed more than 200 mg of allopurinol per day.
3. Patients with creatinine clearance less than 10 ml / min should be prescribed allopurinol at a dose of 100 mg per day.

If necessary, the dose is increased, while increasing the intervals between doses of allopurinol (100-300 mg every 48-72 hours).

Patients on hemodialysis are prescribed 300-400 mg of allopurinol after each dialysis session (2-3 times a week).

When treating urolithiasis and gout, the daily urine output should be at least 2 liters.

Dosing for children

The daily dose of allopurinol for children is calculated using the formula 10-20 mg / kg of body weight.

The received dose must be divided into 3 doses. The maximum daily dose of allopurinol for children over 15 years of age is 400 mg.

Possible side effects

The drug is easily tolerated and usually does not have side effects, however, in rare cases, the following undesirable side effects may develop:

1. Central nervous system: the development of depressive conditions, headache, neuropathy.
2. Cardiovascular system: high blood pressure, the likelihood of developing bradycardia, leukocytosis, leukopenia.
3. Gastrointestinal tract: development of dyspeptic disorders (nausea, vomiting, abdominal pain, diarrhea); ...
4. Genitourinary system: development of acute renal failure, formation of peripheral edema, weakening of potency.
5. Development of allergic reactions. Allopurinol can provoke the formation of skin rash, itching, exudative erythema multiforme, toxic epidermal necrolysis, purpura, and bullous dermatitis. In rare cases, bronchospasm may develop.

If you observe these symptoms, you must stop using the drug and consult a doctor.

special instructions

At the beginning of the course of treatment for gout, an exacerbation of the disease may occur. For prophylaxis, you can use either colchicine (0.5 mg 3 times / day). It should be borne in mind that with adequate therapy with allopurinol, large urate stones may dissolve in the renal pelvis and subsequently enter the ureter.

Allopurinol should be used with caution in case of impaired liver and / or kidney function (in both cases, a dose reduction is necessary), hypothyroidism. In the initial period of the course of therapy with allopurinol, a systematic assessment of liver function parameters is necessary.
During the period of treatment with allopurinol, the daily amount of fluid consumed should be at least 2 liters (under the control of diuresis).

Asymptomatic hyperuricemia is not an indication for the use of allopurinol. In babies, they are used only for malignant neoplasms (especially leukemia), as well as for some enzyme disorders (Lesch-Nian syndrome).

To correct hyperuricemia in patients with neoplastic diseases, it is recommended to use allopurinol before starting treatment with cytostatics. In such cases, the minimum effective dose should be used. In addition, in order to reduce the risk of xanthine deposition in the urinary tract, measures must be taken to maintain optimal urine output and urinary alkalization. With the simultaneous use of allopurinol and cytostatics, more frequent monitoring of the peripheral blood picture is necessary.

Avoid drinking alcohol while taking allopurinol.

Interaction with other groups of drugs

The drug can increase the content of cyclosporine in the blood plasma, which can lead to the development of nephrotoxicity.

With simultaneous use with furosemide, ethacrynic acid, thiophosphamide, drugs of the thiazide diuretic group, it is possible to reduce the pharmacological effects of Allopurinol. The combination with vidabarine should be carried out with extreme caution and under the supervision of a physician.

Concomitant use with ampicillin and amoxicillin may increase the risk of developing allergic reactions.

Analogs

On the shelves of pharmacies, you can find direct analogues of Allopurinol, known under the names Allopurinol-Egis, Allopurinol Sandoz, Allohexal or Purinol. They are similar in composition, active substance.

Indirect analogues of the drug that exhibit the same therapeutic effect are the following medicines:

• Adenuric;
• Febux-40;
• Febux-80.

Before using analogs, consult your doctor.

Storage conditions and periods

Store in a place protected from light and out of reach of children at a temperature not exceeding 30 ° C. The shelf life of 100 mg tablets is 5 years, 300 mg - 3 years.

Content

In 1739, the Frenchman Mosheron wrote a treatise "On the noble gout and its virtues", but today there is hardly a person who would wish to mark himself with such a "privilege". Lack of treatment for gout can lead to disability. Complex therapy for this ailment differs in duration, but the time will not be wasted if you drink Allopurinol for gout - an anti-inflammatory drug that has a huge number of positive reviews from people who have undergone treatment with it and observed the timing of courses and dosages.

What is Allopurinol

The substance allopurinol is an inhibitor of xanthine oxidase, a catalyst that converts xanthine to uric acid. The drug begins to be used at the stage when the tests indicate hyperuricemia, that is, an increase in the level of uric acid in the blood. Systemic use of the drug becomes necessary if hyperuricemia has given such a complication as gout.

Allopurinol is available in tablet form and consists of 10 pieces in a blister pack. The medicine is sold in cardboard boxes, 3 or 5 blisters each. The drug can be presented in vials of an opaque color, containing 50 pieces (allopurinol 100 mg per tablet) or 30 pieces (300 mg of active substance per tablet). The vials are placed in a cardboard box.

Treatment of gout with Allopurinol

With a systematically elevated level of uric acid in the human body, a pathological condition (gout) develops, associated with the deposition of its salts - urates in the tissues. Symptoms of gout are expressed in the form of recurrent acute arthritis, inflammation and pain syndromes. Allopurinol has a depressing effect on the formation of urate. According to reviews, the drug is not intended to quickly relieve pain, but to gradually eliminate the very cause of painful manifestations in gout.

Indications for use

Allopurinol is used to help patients diagnosed with hyperuricemia that cannot be corrected by diet. The drug is also used for the following indications:

• urate urolithiasis;
• urate nephropathy;
• excretion of uric acid;
• treatment of primary or secondary hyperuricemia of various origins;
• congenital enzymatic insufficiency;
• urolithiasis disease;
• the consequences of kidney stones (in the form of the formation of stones);
• radiation, cytostatic therapy, and treatment with corticosteroids;
• prevention of hyperuricemia.

Composition

Widely presented in pharmacy chains, the drug has a composition that depends on the content of the active substance. One tablet contains 100 mg of allopurinol, has a color from grayish-white to white, flat shape. Detailed composition:

• allopurinol - 0.1 g;
• lactose monohydrate - 50 mg;
• potato starch - 32 mg;
• povidone K25 - 6.5 mg;
• talc - 6 mg;
• magnesium stearate - 3 mg;
• sodium carboxymethyl starch - 2.5 mg.

Tablets with allopurinol in a volume of 300 mg are grayish-white to white, flat in shape, on one side at risk, on the other - engraved "E352". In addition to the main substance, one tablet contains the following components:

• microcrystalline cellulose - 52 mg;
• sodium carboxymethyl starch - 20 mg;
• gelatin - 12 mg;
• colloidal anhydrous silicon dioxide - 3 mg;
• magnesium stearate - 3 mg.

pharmachologic effect

The drug helps to reduce the concentration of uric acid in the urine and blood, which reduces the intensity of processes for the deposition of its crystals. Under the influence of allopurinol, already deposited crystals undergo gradual dissolution. The drug allows you to upset the synthesis of uric acid (urostatic effect), which leads to a decrease in its level in the body.

The effectiveness of the treatment

Before starting therapy, it is necessary to carefully study the possible contraindications of the drug and compare them with the state of health. All doubts must be resolved by contacting a specialist. With strict adherence to the instructions for taking the drug, relief should appear after a few months. The medicine has a cumulative effect, so it is important to withstand all courses of use. As a result, the number and brightness of attacks, the rate of urate deposition will noticeably decrease.

How to take Allopurinol for gout

Tablets for gout are taken orally, by the oral method, washed down with water, without chewing or crushing the dose. In renal and hepatic insufficiency, the dosage of the drug is reduced and depends on the patient's condition, creatinine clearance in the blood serum. During pill treatment, it is important to maintain adequate hydration, drink plenty of water, and follow a specific diet to maintain normal urine output and increase urate solubility.

Dosage

Taking Allopurinol for gout occurs after eating. Adults and children over 10 years of age are prescribed a daily dose of 100-300 mg / day. The initial dosage is 100 mg once a day, gradually increasing by 100 mg every 1-3 weeks. The maintenance dose is considered to be 200-600 mg / day, in some cases, doctors prescribe 600-800 mg / day. If the daily dosage exceeds 300 mg, it is divided into 2-4 doses at regular intervals.

The maximum single dose is 300 mg, the maximum daily dose is 800 mg. Children aged 3-6 years receive a dose based on body weight - 5 mg for each kg of weight, 6-10 years old - 10 mg. Frequency rate - three times / day, the maximum daily dosage should not exceed 400 mg. In patients with impaired renal function or chronic renal failure, the dosage is reduced by 100 mg every 1-2 days, with hemodialysis - 300-400 mg after each session (2-3 times a week). It is necessary to cancel the drug carefully, not abruptly, so that the remission lasts longer.

Course and duration of treatment

Normalization of uric acid levels in the blood with gout is achieved 4-6 months after the start of Allopurinol intake. According to reviews, seizures can be stopped after 6-12 months, the same time is needed for the resorption of gouty nodes in the joints. You can take tablets for 2-3 years with short interruptions. An independent decision to stop taking may provoke an exacerbation and destroy all the achieved results of therapy.

Contraindications

There are a number of contraindications - factors in which Allopurinol pills for gout are prohibited or not recommended by doctors due to dangerous consequences for the body:

• hypersensitivity to drug components;
• severe renal dysfunction, liver disease, decreased creatinine clearance;
• acute pain and attacks of gout;
• pregnancy;
• children's age up to three years.

Side effects

Reception of Allopurinol may be accompanied by the appearance of rare side effects, which are due to insufficient liver and kidney function. Undesirable consequences are as follows:

• furunculosis;
• disorders of the lymphatic and circulatory systems (anemia, agranulocytosis, thrombocytopenia, leukocytosis, leukopenia, eosinophilia and aplasia);
• immune system: hypersensitivity (arthralgia, fever, desquamation of the epidermis, lymphadenopathy);
• metabolic processes (hyperlipidemia, diabetes mellitus);
• depression;
• drowsiness, headache, paresthesia, neuropathy, loss of mobility;
• vision (macular changes, deterioration in the quality of vision);
• symptoms of angina pectoris;
• increased blood pressure;
• diarrhea, nausea;
• from the biliary tract and liver - hepatitis;
• rash, Stevenson-Johnson syndrome, epidermal necrolysis, loss of hair color;
• myalgia;
• hematuria, uremia, renal failure;
• erectile dysfunction, gynecomastia.

Overdose

Taking 20 g of Allopurinol is tolerated by the body without negative reactions. Sometimes a dose less than the specified one can lead to an overdose, manifested by nausea, diarrhea, dizziness. Long-term intake of 200-400 mg tablets / day is marked by skin reactions of intoxication, fever, hepatitis. To eliminate the signs of poisoning, symptomatic and supportive measures, adequate hydration, and hemodialysis are taken. There is no specific antidote for the excretion of allopurinol and metabolic products.

Allopurinol and alcohol compatibility

Doctors do not recommend combining Allopurinol and alcohol, because any alcoholic drinks increase the level of uric acid in the body, which only exacerbates the disease. Allopurinol and alcohol are antagonists. It is impossible to drink tablets and ethanol at the same time, this leads to the risk of dizziness, diarrhea, vomiting, apathy, convulsions. Bleeding of internal organs may begin.

Drug analogues

There are few direct analogues of Allopurinol in terms of the content of the active enzyme. Most drug substitutes have a different active ingredient, but the principle of action remains the same. On the shelves of pharmacies, you can find the following analogues of Allopurinol:

• Allohexal
• Adenuric;
• Febux-40;
• Allupol;
• Alopron;
• Purinol;
• Sanfipurol.

Price

Allopurinol is sold through pharmacies with a prescription, it can be ordered through a catalog or bought from an online store. The cost of the medicine is affected by the number of tablets in the package. Pharmacies in Moscow and St. Petersburg offer medication at the following prices:

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Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can diagnose and give recommendations for treatment, based on the individual characteristics of a particular patient.

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Allopurinol is an anti-gout drug that inhibits the synthesis of uric acid and its salts in the body. The drug has the specific ability to inhibit the xanthine oxidase enzyme, which is involved in the conversion of hypoxanthine to xanthine and xanthine to uric acid. As a result, the content of urates in the blood plasma decreases and their deposition in tissues and kidneys is prevented.
When using the drug, the excretion of uric acid in the urine decreases and the excretion of more readily soluble hypoxanthine and xanthine increases.
Allopurinol is converted in the body to alloxanthin, which also prevents the formation of uric acid, but is inferior to allopurinol in terms of activity.
After oral administration, about 90% of the drug is absorbed in the digestive tract. The maximum concentration of allopurinol in blood plasma is reached on average after 1.5 hours. The half-life of allopurinol is 1-2 hours, of alloxanthin - about 15 hours, so the inhibition of xanthine oxidase activity can last for 24 hours after a single dose of the drug. About 20% of the dose taken is excreted in the feces, the rest of the drug and its metabolites - in the urine.

Indications for the use of the drug Allopurinol

Diseases accompanied by hyperuricemia, including primary and secondary gout, urolithiasis (with the formation of urates), primary and secondary hyperuricemia, which occurs during pathological processes accompanied by increased disintegration of nucleoproteins and an increase in the uric acid content in the blood, including various hemoblastomas (acute leukemia, lymphosarcoma, etc.), conditions during cytostatic and radiation therapy of tumors, psoriasis, massive therapy with corticosteroid drugs. There is evidence of the use of the drug in the complex therapy of epilepsy in children (increased serotonin biosynthesis).

Application of the drug Allopurinol

Inside after eating. Doses are set depending on the concentration of uric acid in the blood. The minimum daily therapeutic dose for adults is 0.1 g, the maximum is 0.8 g. Usually, with moderate hyperuricemia (70-100 mg / l), 0.2-0.4 g / day is prescribed 1-2 times a day for for 2-3 weeks, then they switch to taking a maintenance dose - 0.2-0.3 g / day in 2-3 doses.
In severe forms of gout, significant deposits of urate in the tissues and severe hyperuricemia (over 80-100 mg / l), the drug is prescribed fractionally (no more than 0.2 g per dose) up to 0.6-0.8 g / day for 2- 4 weeks, and then they switch to maintenance doses - 0.1-0.3 g / day, which are taken for a long time, for several months.
When using the drug to prevent hyperuricemia during radiation therapy and chemotherapy of tumors, the average daily dose is 0.4 g. The drug is taken 2-3 days before the start of therapy (or at the same time) and continued for several more days after the end of specific therapy.
For children under 6 years of age, the drug is prescribed in a daily dose of 5 mg / kg of body weight; from 6 to 10 years old - 10 mg / kg / day. The frequency of admission is 3-4 times a day. In the complex treatment of epilepsy in children, the dose of the drug is 4-5 mg / kg 2 times a day for 10 days; break between repeated courses - 1.5-2 months.
If the time for taking the drug is missed, then take the next dose as soon as possible. If the next dose of the drug is planned in 12 hours or more, it is necessary to take Allopurinol immediately, and the next dose at the set time. If there is less than 12 hours left before taking the next dose, you should skip the appointment and then continue treatment as usual.

Contraindications to the use of the drug Allopurinol

Renal failure, pregnancy and lactation, allergy to the components of the drug.

Side effects of the drug Allopurinol

Patients generally tolerate treatment with Allopurinol well. With gout, an exacerbation may occur at the beginning of treatment due to the mobilization of uric acid from gouty nodules and other depots.
In some cases, it is possible:
dyspeptic symptoms - nausea, vomiting, epigastric pain, diarrhea;
allergic reactions - skin rash, itching, hyperemia, rarely - exfoliative dermatitis, fever, arthralgia;
on the part of the blood system - leukopenia, leukocytosis, eosinophilia;
from the side of the central nervous system - neuritis, sleep disturbances, depression, amnesia.

Special instructions for the use of the drug Allopurinol

It should be borne in mind that on the 3-4th day after stopping the intake of Allopurinol, the indicators of uricosuria and uricemia return to the initial, increased level. Treatment should be long, an interval of more than 2-3 days between doses of the drug is undesirable.
The drug must be used with caution in case of mild renal failure (adults at a dose of no more than 0.2 g / day). During the use of Allopurinol, diuresis in adult patients should be maintained at a level of at least 2 l / day. It is necessary to provide a neutral or slightly alkaline urine reaction to prevent the formation of calculi. For this purpose, drugs that alkalize urine are used simultaneously with Allopurinol.
To prevent possible attacks of gouty arthritis at the beginning of treatment, NSAIDs or colchicine (for adults, 0.5 mg 3 times a day) can be prescribed.
At the beginning of treatment with Allopurinol, a systematic study of the functional state of the kidneys should be carried out.

Allopurinol drug interactions

When treating hemoblastomas with anticancer drugs (methotrexate, mercaptopurine, etc.), it should be borne in mind that the simultaneous use of Allopurinol not only inhibits the enzymatic oxidation of these drugs and enhances their antitumor activity, but also significantly increases toxicity. Doses of anticancer agents in such cases should be reduced by 50%.
Under the influence of Allopurinol, it is also possible to enhance the effects (including unwanted) of indirect anticoagulants, antipyrine, diphenin, theophylline, since their inactivation in the liver slows down.
With simultaneous use with ampicillin preparations, the risk of skin rashes increases.
Under the influence of thiazide diuretics, furosemide, ethacrynic acid, the antihyperuricemic effect of Allopurinol is weakened, since these drugs increase the level of uric acid in the blood plasma.
Allopurinol should not be used in combination with iron-containing drugs due to the possible accumulation of iron in the liver.

Allopurinol overdose, symptoms and treatment

Symptoms: nausea, vomiting, diarrhea, dizziness, oliguria.
Treatment: forced diuresis, hemodialysis and peritoneal dialysis.

Storage conditions of the drug Allopurinol

In a dry, dark place at a temperature not exceeding 25 ° C. Shelf life is 5 years.

List of pharmacies where you can buy Allopurinol:

• St. Petersburg