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Allopurinol (Oral route)

Pronunciation:

al-oh-PURE-i-nol

Brand Names:

  • Zyloprim

Dosage Forms:

  • Capsule
  • Tablet

Classifications:

Therapeutic—

Antigout

Pharmacologic—

Xanthine Oxidase Inhibitor

Uses of This Medicine:

Allopurinol is used to prevent or treat high uric acid levels in the blood. Gout or gouty arthritis (inflammation and pain in a joint) is caused by high uric acid levels. Allopurinol is a xanthine oxidase inhibitor that works by causing less uric acid to be produced by the body.

Allopurinol is also used to prevent or treat high uric acid levels that may be caused by cancer medicines or for patients with kidney stones that contain calcium.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of allopurinol in children with high uric acid levels caused by cancer.

Older adults—

No information is available on the relationship of age to the effects of allopurinol in geriatric patients.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Didanosine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acenocoumarol
  • Azathioprine
  • Captopril
  • Enalapril
  • Enalaprilat
  • Fluorouracil
  • Mercaptopurine
  • Pegloticase
  • Phenprocoumon
  • Tegafur
  • Warfarin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aluminum Hydroxide
  • Cyclosporine
  • Vidarabine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bone marrow problems or
  • Liver disease—Use with caution. May make these conditions worse.
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of This Medicine:

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

Take this medicine after meals to avoid stomach upset.

Take this medicine with plenty of liquids to help prevent kidney stones. Check with your doctor about the amount of liquid you or your child should drink each day.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For treatment of gout:
      • Adults—At first, 100 to 300 milligrams (mg) per day, taken once a day or in divided doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of high uric acid levels caused by cancer medicines:
      • Adults, teenagers, and children 11 years of age and older—600 to 800 milligrams (mg) per day, taken in divided doses for 2 to 3 days.
      • Children 6 to 10 years of age—300 mg per day, taken once a day for 2 to 3 days.
      • Children younger than 6 years of age—150 mg per day, taken once a day for 2 to 3 days.
    • For treatment of kidney stones:
      • Adults—200 to 300 milligrams (mg) per day, taken once a day or in divided doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your or your child's progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

When you start using this medicine, you may have more gout attacks. Keep using the medicine even if this happens. Your doctor may give you other medicines (eg, colchicine or pain medicines [NSAIDs]) to help prevent the gout attacks.

If you or your child develop a skin rash, hives, swelling of the lips or mouth, or any allergic reaction to this medicine, stop taking the medicine and call your doctor right away.

Check with your doctor right away if you or your child have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Ankle, knee, or great toe joint pain
joint stiffness or swelling
rash
rash with flat lesions or small raised lesions on the skin
Rare
Abdominal or stomach pain
agitation
ammonia-like breath odor
anxiety
bleeding gums
blistering, peeling, or loosening of the skin
blood in the urine or stools
bloody nose
bloody or black, tarry stools
blue or pale skin
bruising
changes in skin color
chest pain or discomfort
chest pain, possibly moving to the left arm, neck, or shoulder
chills
clay-colored stools
cloudy urine
coma
confusion
constipation
cough or hoarseness
coughing up blood
cracks in the skin
dark urine
decreased urine output
depression
diarrhea
difficulty with breathing
dizziness
drowsiness
dry mouth
feeling faint, dizzy, or lightheaded
feeling of warmth or heat
fever
fever with or without chills
flushing or redness of the skin, especially on the face and neck
general feeling of discomfort or illness
general feeling of tiredness or weakness
headache
hostility
incoherent speech
increased urination
irritability
itching
joint or muscle pain
large, flat, blue or purplish patches in the skin
lethargy
light-colored stools
loss of appetite
loss of heat from the body
lower back or side pain
metallic taste
muscle twitching
muscle weakness
nausea or vomiting
pain, tenderness, or swelling of the foot or leg
painful or difficult urination
pinpoint red or purple spots on the skin
rapid weight gain
rash
red, irritated eyes
red, swollen skin
redness, soreness, or itching skin
right upper abdominal or stomach pain and fullness
scaly skin
seizures
severe stomach pain
shortness of breath
slow or irregular heartbeat
sore throat
sores, ulcers, or white spots on the lips or in the mouth
sores, welting, or blisters
stupor
sweating
swelling of the face, ankles, hands, or lower legs
swollen or painful glands
swollen, painful, or tender lymph glands in the neck, armpit, or groin
thirst
tightness in the chest
unpleasant breath odor
unusual bleeding or bruising
unusual weight gain or loss
vomiting of blood or material that looks like coffee grounds
wheezing
yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare
Bad, unusual, or unpleasant (after) taste
blindness
blue-yellow color blindness
blurred vision
body aches or pain
burning feeling in the chest or stomach
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
burning, dry, or itching eyes
burning, numbness, tingling, or painful sensations
change in taste
change in vision
congestion
continuing ringing or buzzing or other unexplained noise in the ears
decreased interest in sexual intercourse
decreased vision
difficulty with moving
discharge or excessive tearing
feeling of constant movement of self or surroundings
hair loss or thinning of the hair
hearing loss
hives or welts
impaired vision
inability to have or keep an erection
indigestion
lack or loss of strength
loss in sexual ability, desire, drive, or performance
loss of appetite
loss of memory
multiple swollen and inflamed skin lesions
muscle aching or cramping
muscle pain or stiffness
muscular pain, tenderness, wasting, or weakness
noisy breathing
problems with memory
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
runny nose
sensation of spinning
sensitivity to light
sleepiness or unusual drowsiness
sleeplessness
sneezing
stomach upset
stuffy nose
sweating
swelling of the breasts or breast soreness in both females and males
swelling of the salivary glands
swelling or inflammation of the mouth
swollen joints
tearing
tender, swollen glands in the neck
tenderness in the stomach area
throbbing pain
tightness in the chest
trouble getting pregnant
trouble with sleeping
trouble with swallowing
unable to sleep
unsteadiness or awkwardness
voice changes
weakness in the arms, hands, legs, or feet
weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 9/4/2017
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