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Allopurinol - instructions for use, reviews, analogs and forms of release (100 mg tablets and 300 mg Egis) medicines for the treatment and prevention of gout in adults, children and pregnancy. Composition and interaction with alcohol

Allopurinol - instructions for use, reviews, analogs and forms of release (100 mg tablets and 300 mg Egis) medicines for the treatment and prevention of gout in adults, children and pregnancy. Composition and interaction with alcohol

In this article, you can read the instructions for using the drug Allopurinol. There are reviews of visitors to the site - consumers of this medication, as well as opinions of physicians specialists on the use of Allopurinol in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Allopurinol in the presence of existing structural analogues. Use to treat and prevent gout in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

 

Allopurinol - a remedy that interferes with the synthesis of uric acid. It is a structural analogue of hypoxanthine. It inhibits the enzyme xanthine oxidase, which is involved in the conversion of hypoxanthine to xanthine and xanthine into uric acid. This is due to a decrease in the concentration of uric acid and its salts in the liquid media of the body and urine, which helps dissolve the existing urate deposits and prevents their formation in tissues and kidneys. When taking allopurinol, the excretion of urine hypoxanthine and xanthine increases.

 

Composition

 

Allopurinol + auxiliary substances.

 

Pharmacokinetics

 

After oral administration, almost completely (by 90%) is absorbed from the digestive tract. Metabolized with the formation of alloxanthin, which retains the ability to inhibit xanthine oxidase long enough. About 20% of the dose is taken 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) that occurs in diseases accompanied by increased decay of nucleoproteins and an increase in the content of uric acid in the blood, incl.at various hematoblastoses (acute leukemia, chronic myeloleukemia, lymphosarcoma, etc.), with cytostatic and radiation therapy of tumors (including in children), psoriasis, extensive traumatic injuries, due to enzymatic disorders (Lesch-Nichin syndrome), as well as with massive therapy with glucocorticosteroids, when the amount of purines in the blood increases significantly as a result of intensive tissue decay.

 

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

 

Recurrent mixed oxalate-calcium kidney stones (in the presence of uricosuria).

 

Forms of release

 

Tablets of 100 mg and 300 mg (Aegis).

 

Instructions for use and reception scheme

 

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

 

Adults

 

To reduce the risk of a possible side effect, 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 (with the control of 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.

 

Oncological patients receiving allopurinol should be started 1-2 days before the start of antitumor therapy. The drug should be given daily at a dose of 600-800 mg for 2-3 days, after which continue to receive a maintenance dose prescribed on the basis of the level of the wetted acid serum.

 

Children

 

In secondary hyperuricemia associated with malignant diseases of the blood system and other organs, as well as with certain disturbances in the functions of enzymes, the usual daily dose is 10-20 mg / kg of 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 hepatic function

 

Elderly patients should always be prescribed the lowest possible clinically effective dose; always consider the possibility of reduced kidney and / or liver function.

 

Depending on the degree of impairment of kidney and liver function, the dose should be reduced, as these conditions increase the risk of toxic effects of the drug.

 

Side effect

  • itching;
  • maculopapular rash;
  • peeling;
  • fever;
  • lymphadenopathy;
  • arthralgia;
  • eosinophilia;
  • vasculitis;
  • epileptic seizures;
  • anaphylactic shock;
  • an 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 hepatic impairment;
  • severe renal insufficiency;
  • primary (idiopathic) hemochromatosis (even in the presence of a family history);
  • asymptomatic hyperuricemia;
  • an acute attack of gout;
  • pregnancy;
  • lactation period.

 

Application in pregnancy and lactation

 

The property of allopurinol to cause a pathology of the human fetus is not revealed. However, sufficient reliable studies on the use of the drug during pregnancy and lactation in humans have not been conducted. Therefore, pregnant women can take this medication only according to the doctor's prescription and only in the absence of a therapeutic alternative, when the disease presents a greater risk to the fetus and mother than allopurinol.Since allopurinol and oxypurinol are excreted in breast milk, during the lactation period one should refrain from prescribing the drug, or resolve the issue of stopping breastfeeding during treatment.

 

Application in elderly patients

 

Elderly patients should always be prescribed the lowest possible clinically effective dose; always consider the possibility of reduced kidney and / or liver function.

 

In the elderly, the use of Allopurinol requires careful medical observation.

 

Use in children

 

Children under 14 years can not be prescribed Allopurinol, except for cases of cytostatic therapy of leukemia and other malignant diseases, as well as 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, which occurs without clinical manifestations.

 

Children can not be prescribed Allopurinol, except for cases of secondary hyperuricemia associated with malignant tumors of the blood system and other localization, as well as some disorders of enzyme functions.

 

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

 

If there are factors predisposing to a decrease in renal function (elderly age, administration of diuretics, treatment of hypertension or heart failure with ACE inhibitors), the use of Allopurinol requires careful medical observation.

 

At the beginning of therapy, monitoring of liver function is recommended.

 

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

 

If during the reception of Allopurinol a gout attack occurs, the drug should be continued in the same doses, and for treatment of an attack should use a non-steroidal anti-inflammatory drug or colchicine.

 

At a very high level of uric acid (malignant neoplasms and their treatment, Lesch-Naychen syndrome), the administration of allopurinol can cause xanthine deposition in the tissues.The risk of this effect can be reduced by the intake of a sufficient amount of liquid. In cases of hemopoiesis, regular monitoring of the blood formula is recommended. Each 100 mg tablet contains 5% mg of lactose, which should be taken into account when preparing a diet for a patient with lactose intolerance. Tablets of 300 mg do not contain lactose.

 

During the reception of allopurinol, alcohol is not allowed.

 

Impact on the ability to drive vehicles and manage mechanisms

 

In some cases, the drug can cause side effects in the form of drowsiness, dizziness and decreased ability to concentrate attention. Therefore, the degree of restriction or prohibition of driving and working with the mechanisms of the doctor should be determined for each patient individually.

 

Drug Interactions

 

Care should be taken when combining with the following:

  • 6-mercaptopurine or azathioprine - 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 (arabinoside adenine) - elongated half-life of this drug;
  • cytostatic drugs (cyclophosphamide, doxorubicin, bleomycin, procarbazine, mechlorethamine) - increases the risk of damage to the hematopoietic organs;
  • chlorpropamide - in case of impaired renal function, the risk of prolonged hypoglycemia increases;
  • drugs that increase uric acid excretion in the urine, sulfinpyrazone, probenecid or high doses of salicylates, because they increase the excretion of oxypurinol and, thus, can reduce the therapeutic effect of allopurinol;
  • theophylline and aminophylline, since suppression of their metabolism by allopurinol, presumably mediated by oppression of the xanthine oxidase enzyme, was detected;
  • cyclosporine - it is possible to increase its concentration in blood plasma and toxicity;
  • Coumarin derivatives - in some cases, a decrease in their anticoagulant effect is possible;
  • ampicillin and amoxicillin - may increase the risk of skin reactions.

 

In case of renal insufficiency, the dose should be reduced, it should not exceed 100 mg in when the clearance is less than 20 ml / min. You can also give regular doses of 100 mg of the drug not every day, but with a longer interval. It is strongly recommended to monitor the level of allopurinol plasma. This level should not exceed 100 μmol / l (15.2 mg / l).

 

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

 

Analogues of the drug Allopurinol

 

Structural analogs for the active substance:

  • Allopurinol Aegis;
  • Allpol;
  • Alopron;
  • Purinol;
  • Sanphipurol.

Similar medicines:

Other medicines:

Reviews (13):
Guests
Rustam
I suffer from gout more than 10 years. Since this year began to take allopurinol 300 - 1A pharma. Before taking medicine, urine. acid = 7.7 mg / dl. Now the norm is 5.2 mg / dl. It is a pity that he began to receive lek-va late, earning a deforming arthrosis of the knee. At whom the beginning of illness or disease, accept allopurinol + a rigid diet (meat is possible, but only boiled 3-4 times a week). Alcohol and tobacco are a direct road to endless suffering.
Guests
Oleg Maksimov
I take allopurinol for about 8 years now, to relieve gout attacks.
Guests
Liek
From gout only allopurinolom and save myself, plus the strictest diet, especially at the time of exacerbation, then generally turn to salt-free, bezmyasnuyu, etc. In a word porridge on the porridge. But this is better than tolerating pain, swelling and other symptoms. Medicines without a lifestyle in the case of this disease do not work as much as we would like.
Guests
Irina Alkseevna
And what if the head started to hurt immediately? Refuse the drug? How to live further? Or to choose between a headache and a gout?
Administrators
admin
Irina Alkseevna, Refer to a doctor who prescribes the medicine so that he understands the cause of the headache (perhaps the problem is not related to taking Allopurinol) and adjusted the treatment regimen (dosage if possible) or picked up an analogue.
Guests
Carat
Allopurinol drink periods of 10 days after a 5 -7 day break. In severe attacks Colchicum-dispersant is required according to the scheme. For small pains and swelling, NSAIDs such as Naise (Nimulide), Nimesil, etc. Well and a diet. Alcohol in small quantities can be, beer and wine is not desirable. Smoking is also not good. All of health.
Guests
Ezekiel
Drink more water - 3 liters, well, and diet. Alcohol is your enemy. Be healthy!
Guests
Akim
And that this gout is incurable?
Administrators
admin
Akim, Yes, this is a chronic disease.Requires a continuous control of nutrition, periodic treatment with appropriate medications.
Guests
Mila Netska
I took allopurinol for 10 days. I do not understand that with me - a weakness, I want to sleep constantly, lie, my head hurts, I think that allopurinol side effects. I read the instruction, there it is (such side effects). I want to stop and look at the condition to draw a conclusion from allopurinol or something else.
Guests
Lyudmila
I took the drug when the pain on the foot began to ache and increase. Saw on 100h3p a day. It's all over.
There is a good analogue of adenuric. We brought them from the Czech Republic. It maintains a good level of uric acid. But in Russia I do not see him in pharmacies. It's a pity.
Guests
TATYANA
Saw Allopurinol for five days. My legs swelled very much and I always wanted to sleep, my back ached badly. I stopped taking it and it all went away.
Guests
GalinaH
She started taking allopurinol. I have elevated uric acid in my blood, I have arthrosis of the knee joints. I hope it will become easier to walk.

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