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Brand name: allopurinol
Generic name: Puricos, Zyloprim, Allohexal, Allosig, Progout, Zyloric
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Studies of patients with allopurinol-induced crystalluria and nephrolithiasis have revealed both urate and allopurinol/oxypurinol (allopurinol metabolite) calculi. At least 3 cases of allopurinol hypersensitivity syndrome have also been reported. Allopurinol-induced aseptic meningitis has been reported in two isolated cases where 60-year-old Caucasian men developed high fevers soon after taking an initial dose of 300 mg allopurinol, and when rechallenged, with quick improvement after allopurinol was stopped. Conversion to inactive 6-thiouric acid by xanthine oxidase is an important degradative pathway, and the inhibition of this pathway in patients receiving allopurinol is the basis for the azathioprine dosage reduction required in these patients (see Drug Interactions under PRECAUTIONS). A first of a kind case report, allopurinol hypersensitivity syndrome, elevations in pancreatic exocrine enzyme level, and new-onset type 1 diabetes mellitus have been reported in a 58-year-old Cambodian female. See the package inserts or Acetazolamide in Carbonic Anhydrase Inhibitors (Systemic) , Allopurinol (Systemic) , and/or Potassium Citrate in Citrates (Systemic) for specific dosing guidelines for use of these products. Past experience suggested that the most frequent event following the initiation of allopurinol treatment was an increase in acute attacks of gout (average 6% in early studies). There is a case report of a patient with no history of psychiatric disease whose allopurinol-associated catatonia, rash, and fever responded to steroids. DermatologicAllopurinol-induced rash may be followed by more severe hypersensitivity reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, vasculitis, nephrotoxicity, and hepatotoxicity.
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