Allopurinol 300mg Domesco treat hyperuricemia, kidney stones (2 blisters x 10 tablets)

Dosage form Box of 2 blisters x 10 tablets
Specifications Allopurinol
Ingredient Gout

Ingredient

Composition informationContent
Allopurinol300mg

Uses

indicated

allopurinol is assigned to:

Long -term treatment for hyperuricemia caused by chronic gout arthritis.

Kidney stones caused by uric acid (attached or without gout arthritis).

Treatment of recurrent calcium oxalate stones in men with urate excretion in urine above 800 mg/day and 750 mg/day.

Hyperglycemia when using chemotherapy to treat cancer in leukemia, lymphoma, and malignant tumor.

Pharmacokology

allopurinol and its metabolites are oxipurinol that reduces the production of uric acid due to inhibition of xanthin oxidase, which is hypoxanthin into xanthin and turning xanthin into uric acid. Therefore Allopurinol reduces uric acid levels both in serum and urine.

The oxidase xanthin concentration does not change when prolonged allopurinol. Allopurinol also increases the use of hypoxanthin and xanthin to synthesize nucleic and nucleotid acids, resulting in an increase in nucleotid levels, resulting in a again inhibitor of purin synthesis.

Serum uric acid concentration is usually significantly reduced 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 the drug is stopped 1-2 weeks.

normal urine purin flow is almost entirely uric acid, but after treatment with allopurinol, urine releases uric acid, xanthin and hypoxanthin, each of which has its own solubility. Thus, the risk of crystal cards decreases, this risk decreases if the urine alkalinization.

Due to reducing the concentration of uric acid in both serum and urine below the solubility limit, allopurinol prevents or reduces urate deposition, thus preventing the occurrence or progression of both arthritis in gout and urate kidney disease. In patients with chronic gout, Allopurinol can prevent or reduce the formation of urate crystals (tophi seeds) and chronic changes in the joints. After a few months of treatment, reducing the frequency of acute gout attacks, reducing urate concentration in urine, preventing or reducing the formation of uric acid or calcium oxalate stones 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 -dose

allopurinol 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.

Dynamic pharmacokinetics

After drinking, about 80 - 90% of oral dose is absorbed quickly through the digestive tract. The peak concentration in plasma is achieved after 2-6 hours at the usual dose. About 70 - 76% Allopurinol is metabolized mainly in the liver into oxipurinol. Allopurinol and oxipurinol are not attached to plasma proteins.

After taking a 300mg dose, the highest plasma concentration of allopurinol is about 2 - 3 micrograms/ml and of oxipurinol about 5 - 6.5 micrograms/ml, which can be increased to 30 - 50 micrograms/ml in patients with renal failure.

Allopurinol's plasma semi -discharged 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 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 (2 blisters x 10 tablets)

How to use

Take oral use, right after eating.

Dosage

Starting dose:

When starting to treat gout arthritis with allopurinol, the agent increases uric acid waste through the kidneys, may start acute gout. 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 ≥ 30kg (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 hyperuricic 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

10-20 ml/minute

At the standard dose

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 should be changed from 300mg - 400mg 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 expert

What to do when using overdose?

There is no report on acute poisoning due to overdose. Absorbing large amounts of allopurinol can significantly inhibit the activity of xanthin oxidase but do not cause adverse reactions unless use with adenin arabinosid, azathioprin or 6-mercaptopurin. In this case, the risk of increasing the effects of the drugs being used.

Symptoms of overdose: Nausea, vomiting, diarrhea, dizziness, headache, drowsiness and abdominal pain. Rare kidney failure and hepatitis.

How to deal with overdose drugs:

  • Not yet determined the effectiveness of gastric lavage. If the patient takes more than 50 mg/kg Allopurinol within 1 hour, activated carbon can be used (50g for adults; 1g/kg for children). If using more than 50mg/kg Allopurinol, you need to check the electrolytes, urea and liver function tests.
  • Water compensation to maintain maximum diuretic, facilitating the elimination of allopurinol and metabolites. Other measures are indicated according to the patient's clinical condition.
  • Hemon decomposes are not required. Hematoparology can be considered in patients with severe renal impairment or liver failure.

    • What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

    Side Effects

    Common

  • Skin and subcutaneous tissue: rash.

    • Less

  • Immune: Hypersensitivity reaction;
  • Digestive: Nausea, vomiting;
  • Hepatitis: Hepatitis (including liver necrosis and granular hepatitis).

    • Very rare

  • Infections and parasites: pimples. Sense.

    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

    sensitive to allopurinol or any other ingredient of the drug.

    Gout acute (if there is a acute gout while using allopurinol, continues to use Allopurinol and treat separately).

    Increasing blood uric acid is as simple as symptoms.

    Be cautious when using

    stop using allopurinol when there is a skin rash or the symptoms of the reaction too

    Serious hypersensitivity (such as Stevens-Johnson syndrome and poisoned epidermal necrosis).

  • It is necessary to reduce the dose when there is a dysfunction of liver or kidneys.
  • Serious skin reactions threatening life (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 syndrome (SJS) and poisoning epidermal necrosis (ten) during the first week of treatment.

  • stop treatment with Allopurinol if the signs or symptoms of SJS or ten (such as skin rash with blisters or mucosal lesions).
  • Early diagnosis to detect SJS and Ten syndrome and stop any suspected drug. The early stopping of the drug will give better effect during the treatment of these syndrome.

    • Medication syndrome syndrome 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 Allopurinol in these patients.
  • Incredible hyperuricemiaemiasis of blood often do not need to use allopurinol. Should change eating habits and control the potential causes to improve this situation.
  • Gout acute: Do not start treatment with allopurinol until the acute gout has decreased completely, as Allopurinol can cause worse gout attacks. In the early stages of treatment with allopurinol, as well as urinary urinary drugs, it 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 there is an acute gout attack 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 cases of 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 due to uric acid: appropriate treatment for allopurinol will lead to the solubility of large stones caused by uric acid in the renal pelvis, the ability to block the ureter is less likely.
  • Lactose intolerance: Allopurinol 300mg tablets contain lactose. Patients with rare genetic problems are galactose intolerance, lactase lactase deficiency or Glucose-Galactose should not be used.
  • The drug contains the Yellow E100 Sunset 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 the mother using Allopurinol 300mg/day. However, there are no data related to the effects of allopurinol or metabolic substances of Allopurinol on breastfed babies.

    Interactive drug

  • azathioprin and 6-mercaptopurin: simultaneously use azathioprin or 6-mercaptopurin with allopurinol, the dose of these drugs should be reduced by ¼ because the inhibition of xanthin oxidase will extend the effects of medications used simultaneously.
    • vidarabin (adenin arabinosid): Be careful when using simultaneously Allopurinol and adenin arabinosid because allopurinol increases the waste time of adenin arabinosid, thus should be cautious 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: Allopurinol's main metabolites are 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 drugs: Although there is no evidence that there is an interaction between allopurinol and cooumarin, be cautious when patients use oral anticoagulants and allopurinol.
  • Clorpropamid: simultaneous use of Allopurinol with chlorpropamid in people with impaired renal function may increase the risk of prolonged hypoglycemia.
    • phenytoin: Allopurinol may inhibit phenytoin oxidation in the liver but have not been clinically proven. Theophylllin: Allopurinol inhibits theophyllin's metabolic process 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: Increases 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.

    cyclophosphamid, doxorubicin, bheomycin, processbazin, mecloroethamine: Increased bone marrow inhibition when using allopurinol with cyclophosphamid and other cytotoxicide causing to be reported in patients with cancer (other than leukemia). However, in a study, patients treated with cyclophosphamid, doxorubicin, bheomycin, processbazin and/or mloroethamine (clormethin hydrochloride), allopurinol without increasing cytotoxic reactions. ciclosporin: The concentration of ciclosporin 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 enzyme inhibitors that increase the risk of hematology reactions such as leukopenia, especially if the patient has a history of kidney failure.

    • Storage

    Store in a dry place, avoid light, temperatures below 30 ° C.

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