Brand name: Zyloprim

Generic name: Allopurinol

Indications: to control primary hyperuricemia that accompanies severe gout and to prevent possibility of
flare-up of acute gouty attack: to prevent recurrent calcium oxalate stones: prophylactically to
reduce severity of hyperuricemia associated with antineoplastic and radiation therapies, both
of which greatly increase plasma uric acid levels by promoting nucleic acid degradation.
Drug classification: Antigout Agent
Mechanism of action: allopurinol reduces endogenous uric acid by selectively inhibiting action of
xanthine oxidase, the enzyme responsible for converting hypo-xanthine to xanthine and
xanthine to uric acid (end product of purine catabolism). Has no analgesic, anti-inflammatory,
or uricosuric action.
Dosage: Treatment hyperuricemia
Adult: PO 100mg/d, may increase by 100mg/wk (max: 800mg/d), divide doses >300mg/d. IV
200-400mg/m2/d (max: 600mg/d) in 1-4 divided doses
Child: PO <10 y, 10mg/kg/d in 2-3 divided doses (max: 800mg/d) IV 200mg/m2/d in 1-4
divided doses.
Treatment secondary hyperuricemia
Adult: PO 200-800mg/d for 2-3 or longer, divide doses >300mg/d
Child: PO 6-10 y, 100mg tid, <6 y, 50mg tid
Renal impairment Clcr
80ml/min: 250mg/d ; 60ml/min: 200mg/d ; 40ml/min: 150mg/d ; 20ml/min: 100mg/d ;
10ml/min: 100mg q2d ; 0ml/min: 100mg q3d
Special precaution: impaired hepatic or renal function, history of peptic ulcer, lower GI tract disease,
bone marrow depression.
Pregnancy risk category: C
Adverse reaction: CNS: drowsiness, headache, vertigo. GI: nausea, vomiting, diarrhea, abdominal
discomfort, indigestion. HEMATOLOGIC: agranulocytosis, aplastic anemia, bone marrow
depression, thrombocytopenia. SKIN: urticaria or pruritus, pruritic maculopapular rash, toxic
epidermal necrolysis. OTHER: hepatotoxicity.
Contraindication: hypersensitivity to allopurinol: as initial treatment for acute gouty attacks: idiopathic
hemochromatosis (or those with family history): children (except those with hyperuricemia
secondary to neoplastic disease and chemotherapy). Safety during pregnancy or lactation is
not established.
Form: 100 mg, 300 mg tablets: 500 mg vial
Nursing responsibility: Monitor serum and urinary uric acid level usually by 1-3 weeks, gradual
decrease in size of tophi, absence of new tophaceous deposits, with consequent relief of joint
pain and increased joint mobility. Monitor for signs and symptoms of an acute gouty attack.
Monitor patients with renal disorders more often; they tend to have a higher incidence of renal
stones and drug toxicity problem. Report onset of rash or fever immediately to the physician;
withdraw drug.