Drug reference

Allopurinol

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1205, 1206

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Prophylaxis of gout and of uric acid and calcium oxalate renal stones | Prophylaxis of hyperuricaemia associated with cancer chemotherapy ▶BY MOUTH ▶Adult: Initially 100 mg daily, for maintenance adjust dose according to plasma or urinary uric acid concentration, dose to be taken preferably after food Prophylaxis of gout and of uric acid and calcium oxalate renal stones (usual maintenance in mild conditions) | Prophylaxis of hyperuricaemia associated with cancer chemotherapy (usual maintenance in mild conditions) ▶BY MOUTH ▶Adult: 100–200 mg daily, dose to be taken preferably after food Prophylaxis of gout and of uric acid and calcium oxalate renal stones (usual maintenance in moderately severe conditions) | Prophylaxis of hyperuricaemia associated with cancer chemotherapy (usual maintenance in moderately severe conditions) ▶BY MOUTH ▶Adult: 300–600 mg daily in divided doses (max. per dose 300 mg), dose to be taken preferably after food Prophylaxis of gout and of uric acid and calcium oxalate renal stones (usual maintenance in severe conditions) | Prophylaxis of hyperuricaemia associated with cancer chemotherapy (usual maintenance in severe conditions) ▶BY MOUTH ▶Adult: 700–900 mg daily in divided doses (max. per dose 300 mg), dose to be taken preferably after food

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Contra Indications

Not a treatment for acute gout but continue if attack develops when already receiving allopurinol, and treat attack separately

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Cautions

Ensure adequate ﬂuid intake (2–3 litres/day). for hyperuricaemia associated with cancer therapy, allopurinol treatment should be started before cancer therapy CAUTIONS, FURTHER INFORMATION Administer prophylactic NSAID (not aspirin or salicylates) or colchicine until at least 1 month after hyperuricaemia corrected (usually for ﬁrst 3 months) to avoid precipitating an acute attack.

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Safety

Interactions

→Appendix 1: allopurinol

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Side Effects

▶Common or very common Rash (discontinue therapy; if rash mild re-introduce cautiously but discontinue immediately if recurrence) ▶Uncommon Hypersensitivity. nausea. vomiting ▶Rare or very rare Agranulocytosis. alopecia. angina pectoris. angioedema. angioimmunoblastic T-cell lymphoma. aplastic anaemia. asthenia. ataxia. boil. bradycardia. cataract. coma. depression. diabetes Musculoskeletal system mellitus. drowsiness. erectile dysfunction. fever. gastrointestinal disorders. gynaecomastia. haemorrhage. hair colour changes. headache. hepatic disorders. hyperlipidaemia. hypertension. infertility male. maculopathy. malaise. oedema. paraesthesia. paralysis. peripheral neuropathy. severe cutaneous adverse reactions (SCARs). skin reactions. stomatitis. taste altered. thrombocytopenia. vertigo. visual impairment

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Pregnancy

Toxicity not reported. Manufacturer advises use only if no safer alternative and disease carries risk for mother or child.

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Breast Feeding

Present in milk—not known to be harmful.

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Hepatic Impairment

Manufacturer advises monitor liver function periodically during early stages of therapy. Dose adjustments Manufacturer advises reduce dose.

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Renal Impairment

Dose adjustments Max. 100 mg daily, increased only if response inadequate; in severe impairment, reduce daily dose below 100 mg, or increase dose interval; if facilities available, adjust dose to maintain plasma-oxipurinol concentration below 100 micromol/litre.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet CAUTIONARY AND ADVISORY LABELS 8, 21, 27 ▶Allopurinol (Non-proprietary) Allopurinol 100 mg Allopurinol 100mg tablets | 28 tablet P £8.15 DT = £1.11 Allopurinol 300 mg Allopurinol 300mg tablets | 28 tablet P £5.85 DT = £1.62 ▶Uricto (Ennogen Pharma Ltd) Allopurinol 100 mg Uricto 100mg tablets | 28 tablet P £0.78 DT = £1.11 Allopurinol 300 mg Uricto 300mg tablets | 28 tablet P £1.85 DT = £1.62 ▶Zyloric (Aspen Pharma Trading Ltd) Allopurinol 100 mg Zyloric 100mg tablets | 100 tablet P £10.19 Allopurinol 300 mg Zyloric 300mg tablets | 28 tablet P £7.31 DT = £1.62

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Dose text by age group

Adult

Initially 100 mg daily, for maintenance adjust

First-line fragment. Read the complete Indications and Dose section above.

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Adult

100–200 mg daily, dose to be taken preferably

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1205

Adult

300–600 mg daily in divided doses (max. per

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1205

Adult

700–900 mg daily in divided doses (max. per

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1205

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Allopurinol

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1205, 1206

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 1205

Contra Indications

Not a treatment for acute gout but continue if attack develops when already receiving allopurinol, and treat attack separately

PDF page 1205

Cautions

PDF pages 1205, 1206

Safety

Interactions

→Appendix 1: allopurinol

PDF page 1206

Side Effects

PDF page 1206

Pregnancy

Toxicity not reported. Manufacturer advises use only if no safer alternative and disease carries risk for mother or child.

PDF page 1206

Breast Feeding

Present in milk—not known to be harmful.

PDF page 1206

Hepatic Impairment

Manufacturer advises monitor liver function periodically during early stages of therapy. Dose adjustments Manufacturer advises reduce dose.

PDF page 1206

Renal Impairment

PDF page 1206

Dose and formulations

Medicinal Forms

PDF page 1206

Dose text by age group

Adult

Initially 100 mg daily, for maintenance adjust

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1205

Adult

100–200 mg daily, dose to be taken preferably

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1205

Adult

300–600 mg daily in divided doses (max. per

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1205

Adult

700–900 mg daily in divided doses (max. per

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1205

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.