DOCSLIB.ORG

ALLOPURINOL 300Mg TABLETS (Allopurinol)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
ALLOPURINOL 300Mg TABLETS (Allopurinol) 310 x180mm - side1 PACKAGE LEAFLET: INFORMATION FOR THE USER ALLOPURINOL 300mg TABLETS (Allopurinol) Read all of this leaflet carefully before you start taking this medicine. • Keep this leaflet. You may need to read it again. • If you have any further questions, ask your doctor or pharmacist. • This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. • If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet: 1. What Allopurinol Tablets are and what they are used for 2. Before you take Allopurinol Tablets 3. How to take Allopurinol Tablets 4. Possible side effects 5. How to store Allopurinol Tablets 6. Further information 1. WHAT ALLOPURINOL TABLETS ARE AND WHAT • Thiazide diuretics (certain fluid tablets) • Aspirin or related medicines (Salicylates) THEY ARE USED FOR • Probenecid (used in gout) The name of your medicine is Allopurinol 300mg Tablets. They • Chlorpropamide (used in diabetes) contain the active ingredient called Allopurinol, that belongs to a • Warfarin (used to help prevent blood clots) group of medicines called enzyme inhibitors, which act to control the • Phenytoin (used in epilepsy) speed at which chemical changes occur in the body. • Theophylline, used to treat asthma • Certain antibiotics like Amoxicillin and Ampicillin Allopurinol reduces the formation and accumulation of uric acid in the • Ciclosporin (used to treat psoriasis, rheumatoid arthritis or after body. They are used to prevent gout and gouty arthritis. These tablets organ transplants) should not be used to treat sudden attack of gout. • Didanosine [used to treat human immunodeficiency virus (HIV) Allopurinol is also used to relieve the symptoms of pain and infection] inflammation due to the following conditions: Serious skin rashes (Hypersensitivity syndrome, Stevens- Johnson • Gouty arthritis or gout syndrome, toxic epidermal necrolysis) have been reported with the • certain types of kidney stones use of allopurinol. Frequently, the rash can involve ulcers of mouth, • increased uric acid level following some anti-cancer treatments throat, nose, genitals and conjunctivitis ( red and swollen eyes). These serious skin rashes are often preceded by influenza-like symptoms: • Lesch-Nyhan Syndrome in children [inheritable disorder that affects fever, headache, body ache. The rash may progress to widespread how the body builds and breaks down purines, characterized by blistering and peeling of the skin. increased blood and uric acid levels and by the absence of the enzyme hypoxanthine guanine phosphoribosyltransferase (HGP)] These serious skin reactions can be more common in people of Han • Psoriasis (skin disease that causes itchy or sore patches of thick, Chinese or Thai origin. red skin with silvery scales) If you develop a rash or any of the skin symptoms, stop taking To prevent an attack of gouty arthritis your doctor may prescribe a allopurinol and contact your doctor immediately. suitable anti-inflammatory medicine or colchicine for at least a month. Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a 2. BEFORE YOU TAKE ALLOPURINOL TABLETS prescription. This is because Allopurinol can affect the way some medicines work. Also some other medicines can affect the way Do not take Allopurinol Tablets if you: Allopurinol works. • are allergic to Allopurinol or any of other ingredients in this medicine (see section 6). Symptoms of allergic reaction to Allopurinol may Pegnancy and Breast-feeding include: Allopurinol Tablets are not recommended for use during pregnancy or • shortness of breath, wheezing or difficulty in breathing if you are intending to become pregnant, unless you and your doctor • swelling of the face, lips, tongue or other parts of the body have discussed the risk and benefits involved. Allopurinol Tablets are • rash, itching or hives on the skin not recommended if you are breast-feeding or plan to breast-feed. • are currently suffering from an acute attack of gout. Allopurinol passes into breastmilk and therefore it is recommended to Treatments with Allopurinol should not be started until an consult your doctor. acute attack of gout is over. Your doctor may wish to prescribe Ask your doctor or pharmacist for advice before taking any medicine. another medicine to relieve the acute attack. Laboratory tests Take special care if you: Keep all appointment with your doctor and clinic. Your doctor will • are suffering, or have suffered from any liver or kidney problems order certain lab test (like sugar tests, liver function tests, etc) to • are suffering from high blood pressure check your body’s reponse to Allopurinol. • have, or ever had heart disease Taking Allopurinol with food and drink Check with your doctor or pharmacist before taking Allopurinol Drink at least eight glasses of water or other fluids each day while Tablets in such case. taking Allopurinol Tablets unless directed to do otherwise by your doctor. Taking other medicines Check with your doctor or pharmacist if you are taking any of the Driving and using machines following medicines: Allopurinol may cause drowsiness, dizziness, affect your co-ordination • medicines used to treat high blood pressure (like Captopril) or heart or make you sleepy. Make sure you are not affected before you drive problems or operate machinery. • Azathioprine (used to treat rheumatoid arthritis and after organ transplants) Important information about some of the ingredients of • 6-mercaptopurine (used to treat some cancers and bowel diseases) Allopurinol Tablets • Vidarabine (used to treat herpes infections) This product contains Lactose. If you have been told by your doctor • Capecitabine, Cyclophosphamide (used to treat certain types of that you have an intolerance to some sugars, contact your doctor cancer) before taking this medicine. 310 x180mm - side2 If you experience any of the following, stop your tablets and tell your 3. HOW TO TAKE ALLOPURINOL TABLETS doctor immediately: The amount of Allopurinol Tablets that people can taken can vary. Rare (occurring in less than 1 in 1000 patients) Always take Allopurinol Tablets exactly as your doctor has told you. • Joint pain or painful swelling in the groin, armpits or neck; You should check with your doctor or pharmacist if you are not sure. • liver or kidney problems • Jaundice (yellowing of the skin and eyes); and Instructions for proper use • Feeling sick (nausea) or being sick (vomiting) (in some cases, blood Take your Allopurinol Tablets after a meal, preferably at the same time may be present) each day. Taking your tablets at the same time each day will have the • Bleeding in the lips, eyes, mouth, nose or genitals. best effect. It will also help you remember when to take the tablets. • fever and chills, headache, aching muscles (flu-like symptoms) and Allopurinol Tablets are usually taken once daily. However, if your dose generally feeling unwell is more than 300mg, your doctor may advise you to take it morning • any changes to your skin, for example ulcers of the mouth, throat, and night after breakfast and dinner for a twice daily dosage. nose, genitals and conjunctivitis (red and swollen eyes), widespread blisters or peeling Swallow Allopurinol Tablets with a full glass of water. • Serious hypersensitivity reactions involving fever, skin rash, joint pain, and abnormalities in blood and liver function tests (these may be It is important to drink plenty of water while taking Allopurinol and it is signs of a multi-organ sensitivity disorder). recommended that you should drink at least 2 litres per day. • Rarely, Allopurinol tablets may affect your liver or kidney function. Dosage (blood in urine, abnormal liver function tests) The usual starting dose is in the range of 100 - 300mg daily, Adults:- Very rare (occurring in less than 1 in 10,000 patients) which may be taken as a single dose after a meal. The dose may be Tell your doctor as soon as you can if you notice you bruise more increased upto 900mg daily, depending upon the severity of your easily, or if you develop a sore throat and fever or other signs of an condition. infection as occasionally allopurinol may affect your blood and Elderly:- Your doctor will prescribe the lowest dose of Allopurinol lymphatic system or if you feel thirsty, tired, lose weight as may be Tablets that best control your symptoms. signs of developing diabetes. Children under 15 years:- The usual dose is in the range of Very rare side effects of Allopurinol include male infertility, erectile 100 - 400mg daily. dysfunction, enlargement of the breasts in men as well as women, a change in taste perception, cataracts, hair loss or discolouration, If you have liver problems, your doctor will prescribe the lowest convulsions, fits or depression, high temperature, blood in your urine dose of Allopurinol Tablets that best controls your symptoms. Your (haematuria), high levels of cholesterol in your blood (hyperlipidaemia), doctor will arrange for you to have liver function tests during the early a general feeling of being unwell, weakness, numbness, unsteadiness stages of your treatment. on your feet, feeling unable to move muscles (paralysis) or loss of consciousness, headache, dizziness, drowsiness or disturbance of If you have kidney problems, your doctor will prescribe the lowest dose of Allopurinol tablets that best controls your symptoms. If you your vision, chest pain, high blood pressure or a slow pulse, build up have serious kidney problems, your doctor may prescribe less than of fluid leading to swelling (oedema) particularly of your ankles. 100mg per day, or tell you to take a single dose of 100mg at longer If the side-effect gets serious, or if you notice any side effect not listed intervals than one day. If you have dialysis two or three times a week, in this leaflet, please tell your doctor or pharmacist.
Load more

Recommended publications
  • ULORIC Safely and Effectively
    HIGHLIGHTS OF PRESCRIBING INFORMATION -------------------------WARNINGS AND PRECAUTIONS-------------------­ These highlights do not include all the information needed to use ULORIC safely and effectively. See full prescribing • Cardiovascular Death: In a CV outcomes study, there was a higher information for ULORIC. rate of CV death in patients treated with ULORIC compared to allopurinol; in the same study ULORIC was non-inferior to ULORIC (febuxostat) tablets, for oral use allopurinol for the primary endpoint of major adverse Initial U.S. Approval: 2009 cardiovascular events (MACE). Consider the risks and benefits of WARNING: CARDIOVASCULAR DEATH ULORIC when deciding to prescribe or continue patients on See full prescribing information for complete boxed warning. ULORIC. (1, 5.1) • Gout patients with established cardiovascular (CV) disease • Gout Flares: An increase in gout flares is frequently observed treated with ULORIC had a higher rate of CV death compared to during initiation of anti-hyperuricemic agents, including ULORIC. If those treated with allopurinol in a CV outcomes study. (5.1) a gout flare occurs during treatment, ULORIC need not be discontinued. Prophylactic therapy (i.e., non-steroidal anti- • Consider the risks and benefits of ULORIC when deciding to inflammatory drug [NSAID] or colchicine upon initiation of prescribe or continue patients on ULORIC. ULORIC should only treatment) may be beneficial for up to six months. (2.4, 5.2) be used in patients who have an inadequate response to a maximally titrated dose of allopurinol, who are intolerant to • Hepatic Effects: Postmarketing reports of hepatic failure, allopurinol, or for whom treatment with allopurinol is not sometimes fatal. Causality cannot be excluded.
    [Show full text]
  • Caffeine in the Treatment of Pain
    Rev Bras Anestesiol ARTIGOS DE REVISÃO 2012; 62: 3: 387-401 ARTIGOS DE REVISÃO Cafeína para o Tratamento de Dor Cristiane Tavares, TSA 1, Rioko Kimiko Sakata, TSA 2 Resumo: Tavares C, Sakata RK – Cafeína para o Tratamento de Dor. Justificativa e objetivos: A cafeína é uma substância amplamente consumida com efeitos em diversos sistemas e que apresenta farmacoci- nética e farmacodinâmica características, causando interações com diversos medicamentos. O objetivo deste estudo é fazer uma revisão sobre os efeitos da cafeína. Conteúdo: Nesta revisão, são abordados a farmacologia da cafeína, os mecanismos de ação, as indicações, as contraindicações, as doses, as interações e os efeitos adversos. Conclusões: Faltam estudos controlados, randomizados e duplos-cegos para avaliar a eficácia analgésica da cafeína nas diversas síndromes dolorosas. Em pacientes com dor crônica, é necessário ter cautela em relação ao desenvolvimento de tolerância, abstinência e interação medi- camentosa no uso crônico de cafeína. Unitermos: ANALGESIA; DOR; DROGAS, Alcaloide/cafeína. ©2012 Elsevier Editora Ltda. Todos os direitos reservados. INTRODUÇÃO Estrutura química A cafeína foi isolada em 1820, mas a estrutura correta des- A cafeína é um alcaloide presente em mais de 60 espécies ta metilxantina foi estabelecida na última década do século de plantas 4. Sua estrutura molecular pertence a um grupo XIX. Os efeitos não foram claramente reconhecidos até 1981, de xantinas trimetiladas que incluem seus compostos inti- quando o bloqueio de receptores adenosina foi correlacio- mamente relacionados: teobromina (presente no cacau) e nado às propriedades estimulantes da cafeína e de seus teofilina (presente no chá) 1. Quimicamente, esses alcaloides análogos 1. Provavelmente a cafeína é uma das substâncias são semelhantes a purinas, xantinas e ácido úrico, que são psicoativas mais utilizadas no mundo, promovendo efeitos compostos metabolicamente importantes 4.
    [Show full text]
  • Report on the Deliberation Results May 8, 2013 Evaluation And
    Report on the Deliberation Results May 8, 2013 Evaluation and Licensing Division, Pharmaceutical and Food Safety Bureau Ministry of Health, Labour and Welfare [Brand name] (a) Topiloric Tablets 20 mg, 40 mg, and 60 mg (b) Uriadec Tablets 20 mg, 40 mg, and 60 mg [Non-proprietary name] Topiroxostat (JAN*) [Applicant] (a) Fujiyakuhin Co., Ltd. (b) Sanwa Kagaku Kenkyusho Co., Ltd. [Date of application] June 26, 2012 [Results of deliberation] In the meeting held on April 26, 2013, the First Committee on New Drugs concluded that the product may be approved and that this result should be presented to the Pharmaceutical Affairs Department of the Pharmaceutical Affairs and Food Sanitation Council. The product is not classified as a biological product or a specified biological product, the re-examination period is 8 years, and neither the drug substance nor the drug product is classified as a poisonous drug or a powerful drug. *Japanese Accepted Name (modified INN) This English version of the Japanese review report is intended to be a reference material to provide convenience for users. In the event of inconsistency between the Japanese original and this English translation, the former shall prevail. The PMDA will not be responsible for any consequence resulting from the use of this English version. Review Report April 15, 2013 Pharmaceuticals and Medical Devices Agency The results of a regulatory review conducted by the Pharmaceuticals and Medical Devices Agency on the following pharmaceutical product submitted for registration are as follows. [Brand name] (a) Topiloric Tablets 20 mg, 40 mg, and 60 mg (b) Uriadec Tablets 20 mg, 40 mg, and 60 mg [Non-proprietary name] Topiroxostat [Applicant] (a) Fujiyakuhin Co., Ltd.
    [Show full text]
  • Allopurinol (Zyloprim, Aloprim) Is a Medication Used the Risk of Gout Attacks
    Allopurinol PATIENT FACT SHEET (Zyloprim, Aloprim) Allopurinol (Zyloprim, Aloprim) is a medication used the risk of gout attacks. However, while uric acid to prevent gout attacks. It works by dissolving uric acid crystals are dissolving, the risk of gout attacks is crystals slowly, over several months, by lowering uric increased for a few months. To prevent gout attacks acid in the blood. Allopurinol lowers the amount of uric in the first few months of taking allopurinol, anti- acid that the body makes. After several months of low inflammatory medications, such as colchicine and WHAT IS IT? uric acid levels, the uric acid crystals dissolve, reducing NSAIDs, may be added until the risk decreases. Allopurinol is usually taken in the morning with food started at a lower dose and increased over time to and water. Because dehydration can worsen gout, it reach an acceptable uric acid level. Some patients (Han is important to stay hydrated while taking allopurinol. Chinese, Thai and Korean) have a genetic predisposition Allopurinol lowers uric acid levels within a few days; to allergic reactions to the allopurinol in this medication, however, it may take up to 6 months before crystallized and your provider may check this (HLA- B5801) marker uric acid dissolves, if uric acid levels are lowered before starting. HOW TO enough (to less than 6 mg/dl). Allopurinol is usually TAKE IT The most significant side effect for allopurinol is the risk of an allergic reaction. If you develop any skin itching, rashes or hives, you should discontinue allopurinol immediately and inform your provider. Allopurinol is safe to use in chronic kidney disease but start doses must be low and slowly increased over time.
    [Show full text]
  • CPY Document
    eAFFEINE 1. ehemicai and Physicai Data 1.1 Synonyms Chem. Abstr. Services Reg. No.: 58-08-2 Chem. Abstr. Name: 3, 7-Dihydro- 1,3, 7-trimethyl-lH-purine-2,6-dione Synonym: Anhydrous caffeine; coffeine; coffeinum; guaranine; methyltheo- bromine; methyltheophylline; thein; theine; 1,3,7-trimethyl-2,6-dioxopurine; 1,3,7-trimethylxanthine 1.2 Structural and molecular fOlmulae and molecular weight o CH3 H3C,Ni/) )):~ oAN ..N 1 CH3 C8HlON40i MoL. wt: 194.19 1.3 Chemical and physical properties of the pure substance (a) Description: White, odourless powder with a slightly bitter taste (Gennaro, 1985; Macrae, 1985; McElvoy, 1989); glistening white crystals or a white crystallne powder (Moffat, 1986); glistening white needles (National Research Council, 1981; Gennaro, 1985; McElvoy, 1989) (b) Sublimation-point: 178°C (Budavari, 1989); about 180°C (Moffat, 1986) (c) Me/ting-point: 234-239°C (Moffat, 1986); 238°C (Budavari, 1989). When crystallized from water, caffeine was thought until recently to contain one molecule of water (monohydrate, CAS No. 5743-12-4); more recent studies indicated that it is in fact a 4/5 hydrate (Macrae, 1985); anhydrous when crystallzed from ethanol, chloroform or diethyl ether (Moffat, 1986) (d) Density: d~8 1.23 (Budavari, 1989) (e) Spectroscopy data: Ultraviolet spectra: aqueous acid; 273 nm (Al = 504a); no alkaline shift; infrared spectra: principal peaks at wave numbers 1658, -291- 292 IARC MONOGRAHS VOLUME 51 1698, 747, 1548, 1242 and 760 nm (potassium bromide di sc); mass spectra: principal peaks at m/z 194, 109,
    [Show full text]
  • Pharmacogenomic Associations Tables
    Pharmacogenomic Associations Tables Disclaimer: This is educational material intended for health care professionals. This list is not comprehensive for all of the drugs in the pharmacopeia but focuses on commonly used drugs with high levels of evidence that the CYPs (CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4 and CYP3A5 only) and other select genes are relevant to a given drug’s metabolism. If a drug is not listed, there is not enough evidence for inclusion at this time. Other CYPs and other genes not described here may also be relevant but are out of scope for this document. This educational material is not intended to supersede the care provider’s experience and knowledge of her or his patient to establish a diagnosis or a treatment plan. All medications require careful clinical monitoring regardless of the information presented here. Table of Contents Table 1: Substrates of Cytochrome P450 (CYP) Enzymes Table 2: Inhibitors of Cytochrome P450 (CYP) Enzymes Table 3: Inducers of Cytochrome P450 (CYP) Enzymes Table 4: Alternate drugs NOT metabolized by CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4 or CYP3A5 enzymes Table 5: Glucose-6-Phosphate Dehydrogenase (G6PD) Associated Drugs and Compounds Table 6: Additional Pharmacogenomic Genes & Associated Drugs Table 1: Substrates of Cytochrome P450 (CYP) Enzymes Allergy Labetalol CYP2C19 Immunosuppressives Loratadine CYP3A4 Lidocaine CYP1A2 CYP2D6 Cyclosporine CYP3A4/5 Analgesic/Anesthesiology CYP3A4/5 Sirolimus CYP3A4/5 Losartan CYP2C9 CYP3A4/5 Codeine CYP2D6 activates Tacrolimus CYP3A4/5 Lovastatin
    [Show full text]
  • 2020 American College of Rheumatology Guideline for the Management of Gout
    Arthritis Care & Research Vol. 0, No. 0, June 2020, pp 1–17 DOI 10.1002/acr.24180 © 2020, American College of Rheumatology ACR GUIDELINE FOR MANAGEMENT OF GOUT 2020 American College of Rheumatology Guideline for the Management of Gout John D. FitzGerald,1 Nicola Dalbeth,2 Ted Mikuls,3 Romina Brignardello-Petersen,4 Gordon Guyatt,4 Aryeh M. Abeles,5 Allan C. Gelber,6 Leslie R. Harrold,7 Dinesh Khanna,8 Charles King,9 Gerald Levy,10 Caryn Libbey,11 David Mount,12 Michael H. Pillinger,5 Ann Rosenthal,13 Jasvinder A. Singh,14 James Edward Sims,15 Benjamin J. Smith,16 Neil S. Wenger,17 Sangmee Sharon Bae,17 Abhijeet Danve,18 Puja P. Khanna,19 Seoyoung C. Kim,20 Aleksander Lenert,21 Samuel Poon,22 Anila Qasim,4 Shiv T. Sehra,23 Tarun Sudhir Kumar Sharma,24 Michael Toprover,5 Marat Turgunbaev,25 Linan Zeng,4 Mary Ann Zhang,20 Amy S. Turner,25 and Tuhina Neogi11 Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to the recommendations within this guideline to be voluntary, with the ultimate determination regarding their application to be made by the physician in light of each patient’s individual circumstances. Guidelines and recommen- dations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed and endorsed by the ACR are subject to periodic revision as warranted by the evolution of med- ical knowledge, technology, and practice.
    [Show full text]
  • Effects, Safety, and Plasma Levels of Topiroxostat and Its Metabolites In
    Oyama et al. Renal Replacement Therapy (2016) 2:56 DOI 10.1186/s41100-016-0068-5 RESEARCH Open Access Effects, safety, and plasma levels of topiroxostat and its metabolites in patients receiving hemodialysis Satoko Oyama1*, Chihiro Hirose1, Kenichiro Hori1, Katsuhiro Sugano1, Jie Zhang1, Miyuki Tamura2 and Kimio Tomita1 Abstract Background: Serum uric acid concentrations have been associated with mortality in patients receiving hemodialysis. Treatment options are sometimes limited because of the accumulation of a drug and/or its metabolites. The aim of the present study is to investigate the efficacy, safety, and plasma levels of topiroxostat, a selective xanthine oxidase inhibitor, and its metabolites in patients receiving hemodialysis. Methods: This was a 52-week open study. The plasma concentrations of topiroxostat and its metabolites were measured. The endpoints selected were effects on serum uric acid concentrations and the safety and tolerability of topiroxostat. A statistical analysis was performed using a paired t test with Bonferroni corrections. Results: Nineteen participants were followed for 52 weeks without significant adverse effects. Serum uric acid concentrations decreased from 527 ± 49 to 325 ± 62, 297 ± 99, 297 ± 68, and 296 ± 83 μmol/L (weeks 4, 12, 26, and 52; p < 0.001, respectively). The dosage of topiroxostat was 20 mg twice per day in all patients. The clearances of topiroxostat and its metabolites by a dialyzer by use of an arterio-venous method were 55.9 ± 31.1 mL/min (topiroxostat), 143.9 ± 37.0 mL/min (N-oxide), 179.0 ± 41.1 mL/min (N1-glucuronide), and 192.9 ± 37.0 mL/min (N2-glucuronide).
    [Show full text]
  • Allopurinol Drug Information
    Allopurinol Drug information Allopurinol is used for the long-term treatment of gout. Allopurinol should effectively and you may have more attacks of treat your condition, and stop it gout during this time. This is more causing damage to your joints. likely if your urate levels are very It has been tested and has helped high or you’ve had gout for a long many people. However, as with time. It doesn’t mean the drug isn’t all drugs some people will have working. Attacks of gout usually side-effects. This leaflet sets stop within a year as long as your out what you need to know. urate level has lowered sufficiently. Usually, you’ll be offered allopurinol What is allopurinol for gout if blood tests show that and how is it used? your urate level is high and one or Allopurinol is used for the long- more of the following applies: term treatment and prevention • you’re having repeated of gout. Taken regularly, it can attacks of gout stop attacks of gout and help • your joints or kidneys have been prevent damage to the joints. damaged by attacks of gout The body naturally produces a • you have deposits of urate crystals substance called urate, which is affecting your skin (gouty tophi). normally dissolved in the blood Your doctor may be cautious until it’s passed out of the body in about prescribing allopurinol the urine. When too much urate if your kidney or liver function is produced, or if the body cannot is significantly impaired. get rid of it properly, the blood can’t dissolve all the urate and solid crystals can form in and around joints causing inflammation and pain.
    [Show full text]
  • Low Allopurinol Doses Are Sufficient to Optimize Azathioprine Therapy in Inflammatory Bowel Disease Patients with Inadequate Thiopurine Metabolite Concentrations
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by RERO DOC Digital Library Eur J Clin Pharmacol (2013) 69:1521–1531 DOI 10.1007/s00228-013-1500-1 PHARMACOKINETICS AND DISPOSITION Low allopurinol doses are sufficient to optimize azathioprine therapy in inflammatory bowel disease patients with inadequate thiopurine metabolite concentrations Ivanka Curkovic & Katharina M. Rentsch & Pascal Frei & Michael Fried & Gerhard Rogler & Gerd A. Kullak-Ublick & Alexander Jetter Received: 30 November 2012 /Accepted: 12 March 2013 /Published online: 16 April 2013 # Springer-Verlag Berlin Heidelberg 2013 Abstract pmol/8×108 erythrocytes) and/or elevated MMPN con- Purpose Recent studies in patients with inflammatory bow- centrations (>5,000 pmol/8×108 erythrocytes) and/or el- el diseases (IBD) on thiopurine therapy suggest that too low evated liver enzymes (alanine aminotransferase and/or 6-thioguanine nucleotide concentrations (6-TGN) and too aspartate aminotransferase levels one- to threefold the high methylmercaptopurine nucleotide concentrations upper limit of normal). Six patients were recruited into (MMPN) can be reversed by a combination therapy of an open study, and five were treated in the context of allopurinol and low-dose thiopurines. To date, however, an individualized therapeutic approach. Adverse effects, optimal dosing has not been established. The aim of this azathioprine metabolites, liver enzymes and whole blood study was to evaluate the minimal allopurinol doses neces- counts were monitored two to three times per month. sary to achieve adequate 6-TGN concentrations in combi- Results Adequate 6-TGN concentrations were achieved nation with low-dose azathioprine. with a combination of 25 mg allopurinol and 50 mg azathi- Methods A stepwise dose-escalation of allopurinol was oprine in one patient and with 50 mg allopurinol and 50 mg performed in 11 azathioprine-pretreated IBD patients azathioprine in nine patients.
    [Show full text]
  • A Guide to Deprescribing Allopurinol
    A GUIDE TO deprescribing ALLOPURINOL KEY POINTS CONTEXT This guide considers the use of allopurinol as urate lowering therapy to Allopurinol is moderately reduce relapses of acute gout. effective in reducing uric acid levels and gout recurrence. RECOMMENDED Patients with a gout history DEPRESCRIBING STRATEGY who remain hyperuricaemic have a higher risk of an acute Determine key aspects of the patient’s gout history: gout attack. The risk of recurrent Presence of factors that contributed to gout attack gout is minimised if serum If the attack was less than or greater than 12 months previously uric acid is maintained below Current uric acid level 0.36mmol/L. Dose of allopurinol Over half of acute gout relapses If the patient’s gout attack was clearly due to precipitating factors such occur within the fi rst 3 months as acute renal failure, use of diuretics, dietary or alcohol indiscretion, which have since been modifi ed, cessation of allopurinol may be after a previous acute attack. reasonable. Gout may be associated with If the patient’s gout attack was more than 12 months previously and various precipitating factors the serum uric acid is well in the normal range (<0.36mmol/L) then (diuretic use, acute renal cessation of low dose (100mg or less) allopurinol may be reasonable (no dysfunction, alcohol or dietary more than a 50% increase in uric acid may be expected). They can then be considered as a patient with asymptomatic hyperuricaemia. indiscretion). When these If the patient’s gout attack was less than 12 months previously and the factors are improved, treatment serum uric acid is high (>0.36mmol/L), then a dose increase or change with allopurinol may become of drug may be required in an attempt to achieve this target.
    [Show full text]
  • Caffeine Citrate (BANM) Dicates Deterioration of Asthma Control and the Need for Review of Бамифиллина Гидрохлорид Therapy
    1116 Bronchodilators and Anti-asthma Drugs renal impairment (see below). It is unsuitable for the relief of three or four times daily as required, up to a maximum daily dose acute bronchospasm or in patients with unstable respiratory dis- of 8 mg. In all cases dosage intervals should be greater than or ease. CH3 equal to 4 hours. Effects on the heart. A prescription event monitoring study O Preparations found an excess risk of non-fatal heart failure in elderly patients H C N Proprietary Preparations (details are given in Part 3) 3 N OH receiving bambuterol, particularly in the first month of treat- N USA: To r n al a t e . ment.1 See also under Salbutamol, p.1131. 1. Martin RM, et al. Risk of non-fatal cardiac failure and ischaemic N heart disease with long acting β agonists. Thorax 1998; 53: O N 558–62. Bufylline (BAN) Interactions CH3 Ambuphylline (USAN); Bufilina; Theophylline-aminoisobutanol. 2- As for Salbutamol, p.1132. Bambuterol inhibits plasma Amino-2-methylpropan-1-ol theophyllinate. cholinesterases and can prolong the action of drugs such as sux- (bamifylline) Буфиллин amethonium (see Sympathomimetics, under Suxamethonium, C11H19N5O3 = 269.3. p.1912) that are inactivated by these enzymes. Profile CAS — 5634-34-4. Pharmacokinetics Bamifylline hydrochloride is a theophylline derivative (p.1140) ATC — R03DA10. Nearly 20% of a dose of bambuterol is absorbed from the gas- that is used for its bronchodilator properties in reversible airways ATC Vet — QR03DA10. trointestinal tract after oral doses. It is slowly metabolised in the obstruction. It is not converted to theophylline in the body.
    [Show full text]