Allopurinol 300mg Domesco treat hyperuricemia, kidney stones (100 tablets)
Dosage form Box of 100 capsules
Specifications Allopurinol
Ingredient Gout
Ingredient
| Composition information | Content |
| Allopurinol | 300mg |
Uses
indications
Allopurinol 300 mg is indicated in the following cases:
Allopurinol also increases the use of hypoxanthin and xanthin to synthesize nucleic acid and nucleotid, the result increases the concentration of nucleotides, resulting in the inhibitor of the purin synthesis again. Uric acid concentration in serum often significantly decreases within 2-3 days after taking the drug, reaching the lowest concentration after 1-3 weeks of treatment and returning to the value as before the treatment after stopping the drug 1-2 weeks. Normal urine flow is almost entirely uric acid, but after treatment with allopurinol, urine releases uric acid, xanthin and hypoxanthin, each of which has separate solubility. Thus, the risk of crystal cards decreases, this risk decreases if the urine alkalinization.
Due to reducing the concentration of uric acid both in serum and urine below the solubility limit, allopurinol prevents or reduces urate deposition, thus preventing the occurrence or progression of both gout and kidney disease caused by urate. In patients with chronic gout, allopurinol can prevent or reduce the formation of urate (Tophi) and chronic changes in the joints. After a few months of treatment, reduce the frequency of acute gout attacks, reduce urate concentration in urine, prevent or reduce the formation of uric acid stones or calcium oxalate in the kidney.
Allopurinol does not have analgesic and anti -inflammatory effect, so it is not used in the treatment of acute gout. The drug can cause prolonged and severe inflammation during exacerbations.
Allopurinol may increase the frequency of exacerbations in the first 6-12 months of treatment, even if it is maintained with normal or near normal blood urate concentration. Therefore, it is necessary to give a spare dosage at the same time in the first 3-6 months of allopurinol therapy. Even so, an acute attack may occur, but the attack is shorter and lighter. Still have to continue treating Allopurinol, do not change the dose.
Allopurinol is not used in asymptomatic hyperuricemia.
Recently, Allopurinol has been used to prevent the growth of free radicals Superoxid (oxidation stress) in some heart surgery, there are some results.
The low -doseallopurinol has also been included in some immunosuppressive regimens in kidney transplantation or the component of the kidney preservation solution.
Allopurinol is in combination with Pentavalent Antimony to treat visceral Leishmania. Allopurinol has an anti -monitoring effect and is used in Leishmania disease and the American trypanosoma disease.
Pharmacokinetics
absorption
After drinking, about 80 - 90 % of oral dose is quickly absorbed through the gastrointestinal tract. The peak concentration in plasma is achieved after 2-6 hours at the usual dose. After taking a 300 mg dose, the highest plasma concentration of Allopurinol is about 2 - 3 mcg/ml and of oxipurinol about 5 - 6.5 mcg/ml, which can increase to 30 - 50 mcg/ml in patients with renal impairment.
Distribution
Allopurinol and oxipurinol are not attached to plasma proteins.
Metabolism
About 70 - 76 % Allopurinol is metabolized mainly in the liver into oxipurinol. Allopurinol waste time is about 1-3 hours, of oxipurinol about 12 - 30 hours, which lasts clearly in patients with renal impairment. Both allopurinol and oxipurinol are combined into their corresponding ribonucleosid form.
Elimination
Elimination mainly through the kidneys but slowly discharged due to oxipurinol is reabsorbed in the renal tubules. About 70 % of daily dose is eliminated in urine is oxipurinol and up to 10 % is allopurinol. Prolonged use can change this ratio, as Allopurinol inhibits its own metabolism. The rest of the dose is eliminated in the feces. Both allopurinol and oxipurinol are found in breast milk.
Before taking Allopurinol 300mg Domesco treat hyperuricemia, kidney stones (100 tablets)
How to use
use or drink, drink immediately after eating.
Dosage
Always use the right dose in the prescription.
Starting dose
When starting to treat gout arthritis with allopurinol, the agent increases the waste of uric acid through the kidneys, which may initialize acute gout attacks. Therefore, an appropriate anti -inflammatory drug or colchicin should be used for at least a month to prevent.
Adults
Initial dose 300 mg/day. Rarely the dose exceeds 900 mg/day. The dose should be adjusted according to the concentration of uric acid in the blood and urine at an appropriate time until the desired effect (about 1-3 weeks). Maintenance dose of 300 - 600 mg/day.
children> 30 kg (children can swallow tablets)
Indications when treating malignant diseases such as leukemia, dose from 10 - 20 mg/kg body weight/day.
Elderly
Should use a minimum dose to maintain urate concentration in blood and urine.
Treatment of urinary uric acid: The main metabolite of allopurinol is oxipurinol that has the effect of treatment, excreted through the kidneys similar to urate. The drugs have urinary uric acid (such as probenecid or high doses of salicylate) that increases oxipurinol elimination. Therefore, reducing the effectiveness of Allopurinol, however, the effectiveness of treatment depends on each patient.
To prevent acute kidney disease due to uric acid in cancer therapy, allopurinol should be treated before treatment with cytotoxic drugs.
Dosage for patients with renal failure
Renal failure can cause an accumulation of Allopurinol and metabolites (excreted through the kidneys), prolonging the effect of the drug. Therefore, it is necessary to monitor the concentration of uric acid in the blood and adjust the dose accordingly. Dosage recommended in adults:
Creatinine clearance
Dosage
At the standard dose.
10 - 20 ml/minute
100 mg - 200 mg/day.
100 mg/day or reduce the number of drugs.
recommended dose in kidney disease
allopurinol and metabolites are eliminated by hemolysis. If dialysis regularly, the dose is needed from 300 mg - 400 mg after each dialysis, no transfer time.
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do
do when using overdose? What to do when you forget 1 dose?
Drink as soon as you remember. If the time is close to the next medication, skip the forgotten dose and take the next dose at the usual time. Do not use double dose to compensate for the forgotten dose.
Side Effects
When using Allopurinol 300 mg, you may experience unwanted effects (ADR).
Agencies
Frequency (*)
Unwanted reactions
Very rare
pimples.
Very rare
Platelet reduction, anemia, granulocytes.
Unknown leukopenia, eucalyptus, eosin, hemolytic anemia. Reports on hypoglycemia, often associated with kidney and/or liver dysfunction, need special monitoring in this patient group.
immune system disorders
Systemic merciful body reaction (called hypersensitivity syndrome or Dress syndrome) including fever, rash, vascular inflammation, lymph nodes, swollen lymphadenopathy, joint pain, leukopenia, eosinophilia, enlarged liver, abnormal liver function testing and biliary tract damage syndrome (bile ducts in the liver are destroyed and disappearing) occur when using different combinations. Other organs may also be affected (such as liver, lungs, kidneys, pancreas, heart muscle and colon). If this reaction occurs during treatment, it is necessary to stop using allopurinol.
When hypersensitivity reactions occur, often causes liver and/or kidney dysfunction or may cause death.
Hypersensitivity reaction.
Very rare Lymph nodes, anaphylactic lymph nodes.
Unknown
joint pain.
Very rare
diabetes, lipid disorders.
Unknown Acute gout.
Mental disorders Very rare
depression.
Very rare
Loss of air conditioning, coma, headache, neurological pain, abnormalities, loss of feeling, sleeping, taste disorders.
Unknown Dizziness. Very rare cataracts, change gold spots, visual disorders.
Very rare Loss of balance.
cardiovascular disorders Very rare Agina, slow heart rate.
Vascular disorders Very rare
Hypertension.
Unknown
vasculitis.
Less
Nausea, vomiting.
Very rare Change of defecation habits, stomatitis, sweating, vomiting blood.
Unknown
diarrhea, abdominal pain.
Less Askon as symptoms in liver function trials.
Hepatitis (including liver necrosis and granular hepatitis). Common
rash.
Very rare Hair loss, angioedema, change hair color, pink chromosome. Serious unwanted effects in the skin (Scars): Stevens - Johnson syndrome (SJS) and poisoned epidermal necrosis (Ten) have been reported.
Unknown Skin reactions include eosin cells, urticaria. Systemic skin syndrome includes eosin leukemia that has reported. Some cases may be fatal. Non -common skin reactions and can occur during treatment including itching, lumpy, hemorrhage, flaking dermatitis, fever, swollen lymphadenopathy, joint pain and/or eosinophilia like the same as Stevens - Johnson syndrome (SJS), poisoned epidermal necrosis (Ten) and/or Lyell syndrome. Stop using allopurinol when the same reactions occur. Very rare Bleeding, increasing blood urea.
Unknown
kidney stones.
Very rare Big breasts in men, helplessness, infertility.
Unknown
dream.
available).Instructions on how to handle ADR
Immediately stop Allopurinol when the skin appears, accompanied by more severe allergies, especially in people with kidney damage or taking thiazid diuretics. When using allopurinol, the drug must pay attention to drug interactions.
Treatment of hypersensitivity reactions with glucocorticoids, severe reactions must be used for prolonged use. In some patients, if a mild skin reaction can be used carefully at low doses, but must stop immediately and permanently if the reaction reappears.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Allopurinol 300 mg contraindicated in the following cases:
Be cautious when using
stop using allopurinol when there is a skin rash or symptoms of serious hypersensitivity reactions (such as Stevens - Johnson syndrome and poisoned epidermal necrosis).
Need to reduce the dose when there is a dysfunction of liver or kidneys.
Serious skin -threatening skin reactions (Stevens - Johnson syndrome (SJS) and poisoned epidermal necrosis (ten) can occur when using allopurinol.
Patients need to be notified of the signs and symptoms of the skin reactions and should carefully monitor serious skin reactions. The highest risk of Stevens - Johnson (SJS) syndrome and poisoning epidermal necrosis (ten) during the first weeks of treatment.
Stop treatment with Allopurinol if the signs or symptoms of SJS or ten (such as skin rashes have blisters or mucosal lesions).
Early diagnosis to detect SJS and Ten syndrome and stop any suspected drugs. The early stopping of the drug will give better effect during the treatment of these syndrome.
The drug syndrome caused by drugs with eosin hypernage and systemic symptoms (Dress syndrome) are also reported when using allopurinol. Dress syndrome includes fever, eosin hypernage, non -typical lymphocytes, lymphadenopathy and hepatitis.
Hypersensitivity syndrome, sjs and ten: hypersensitivity reactions caused by allopurinol including lumpy rash, hypersensitivity syndrome (Dress syndrome) and SJS, Ten. If these reactions occur during treatment, allurinol should be stopped immediately. Corticosteroids can be used to treat hypersensitivity reactions.
Patients who are treating hypertension or heart failure with diuretics or enzyme inhibitors can impair renal function, should be used with alcohopurinol carefully in these patients.
Incredible hyper uric acid hyperemia usually does not need to use allopurinol. Should change eating habits and control the potential causes to improve this situation.
Acute gout: Do not start treatment with allopurinol until acute gout has decreased completely, as allopurinol can cause more severe gout attacks. In the early stages of treatment with allopurinol, as well as urinary urinary drugs, can cause acute gout attacks. Therefore, it is advisable to prevent appropriate anti -inflammatory drugs or colchicin at least 1 month. Should advise patients on appropriate and cautious dosage when used.
If acute gout attacks in patients with Allopurinol, should continue treatment at the same dose while treating acute gout attacks with appropriate anti -inflammatory drugs.
Xanthin deposits: In cases of increasing urate formation speed (such as malignant disease and treating malignant diseases, Lesch - NYHAN syndrome), rarely encountered the absolute concentration of xanthin increased enough, causing accumulation in the urinary tract. This risk can be reduced by drinking plenty of water to dilute the maximum urine.
Acting on kidney stones caused by uric acid: appropriate treatment for allopurinol will lead to the dissolution of large stones caused by uric acid in the renal pelvis, the ability to block the ureter.
Lactose intolerance: Allopurinol 300 mg tablets contain lactose. Patients with rare genetic problems are galactose intolerance, lactase lactase deficiency or glucose - galactose should not be used.
The drug contains Sunset Yellow E100 color, which can cause allergic reactions.
The ability to drive and operate machinery
Because of unwanted effects such as drowsiness, dizziness and loss of balance in patients using allopurinol, patients should be cautious when driving, operating machinery or participating in dangerous activities until it is sure that Allopurinol does not affect work.
Pregnancy
high doses of Allopurinol in the mouse peritoneum may cause embryo abnormalities, but studies expanding on animals when drinking allopurinol does not show this. During pregnancy in humans, there is no evidence that drinking allopurinol causes abnormalities in the fetus. However, be cautious when using allopurinol during pregnancy.
The period of breastfeeding. The concentration of 1.4 mg/liter Allopurinol and 53.7 mg/liter of oxipurinol has been found in breast milk in a mother using Allopurinol 300 mg/day. However, there are no data related to the effects of allopurinol or metabolic substances of Allopurinol on breastfed babies. Drug interaction
azathioprin and 6 - Mercaptopurin
Simultaneous use of Azathioprin or 6 - Mercaptopurin with Allopurinol, the dose of these drugs should be reduced to 1/4 because of the inhibition of xanthin oxidase will prolong the effects of simultaneous use.
vidarabin (adenin arabinosid)
Be cautious when using allopurinol and adenin arabinosid because allopurinol increases the sale time of adenin arabinosid, so be careful when using these two drugs simultaneously. There is no evidence of allopurinol, which affects other cytotoxic drugs.
salicylate and drugs to eliminate uric acid through urine
The main metabolite of allopurinol is oxipurinol that has the effect of treatment, excreted through the kidneys similar to urate. Uric acid elimination drugs such as probenecid or high doses of salicylate increases oxipurinol elimination. Therefore, reducing the effectiveness of Allopurinol, but it is necessary to evaluate in each case.
Coumarin anticoagulant
Although there is no evidence that there is an interaction between Allopurinol and COMARIN, be cautious when the patient uses oral anticoagulant and Allopurinol.
chlorpropamid
Simultaneous use of Allopurinol with chlorpropamid in people with impaired renal function may increase the risk of prolonging hypoglycemia.
phenytoin
Allopurinol may inhibit phenytoin oxidation in the liver but have not been clinically proven.
Theophyllin
Allopurinol inhibits theophyllin metabolism that has been reported. This interaction is involved in the metabolism of theophyllin in humans. Should monitor theophyllin concentration in patients starting or being treated with Allopurinol.
ampicillin/amoxicillin
Increase the frequency of skin rash in patients with simultaneous use of ampicillin or amoxicillin with allopurinol compared to non -coordinated patients. However, recommendations in patients who are using allopurinol should replace ampicillin or amoxicillin if possible.
cyclophosphamide, doxorubicin, bheomycin, processbazin, mekoroethamine
Increase bone marrow inhibition when using allopurinol with cyclophosphamide and other cytotoxic substances that have been reported in patients with cancer (different from leukemia). However, in a study, patients treated with cyclophosphamid, doxorubicin, bheomycin, processbazin and/or mloroethamine (clormethin hydrochloride), allopurinol without increasing cytotoxic reactions.
ciclosporin
Ciclosporin concentration in plasma may increase when treated simultaneously with allopurinol. Should be cautious when used simultaneously with a variety of drugs, because it can increase ciclosporin's toxicity.
didanosin
In healthy volunteers and HIV patients using Didanosin, the cmax and AUC concentration of the didanosin in plasma has nearly doubled when treated simultaneously with allopurinol (300 mg/day) without affecting the sale time. Do not use these two drugs simultaneously. If required to use simultaneously, Didanosin should be reduced and closely monitor patient condition.
antacids
allopurinol does not reduce the concentration of uric acid in the blood when used simultaneously with aluminum hydroxyd. When taking antacids and allopurinol, it should be about 3 hours apart.
Transfer inhibitors
Simultaneous use of Allopurinol and transferred inhibitors increases the risk of hematology reactions such as leukemia, especially if the patient has a history of kidney failure.
Do not have studies on oral medications, do not mix this drug with other drugs.
Storage
Store in a dry place, temperatures below 30 ° C, avoid light.
Storage in the original packaging of the drug.
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