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Allopurinol (Zyloprim)
Available:
100 mg and 300 mg tablets
Dose:
100-800 mg daily, depending upon what is necessary to achieve
control of uric acid levels
Cost:
Generic 100 mg, 100 pills = $12.99; 300 mg, 100 pills =
$22.99
Indications:
Long-term therapy of gout,
prevention of recurrent flares, prevention of uric
acid-related kidney stones
Side
effects: Though rare, the most significant reaction is
the allopurinol hypersensitivity syndrome,
characterized by a rash and fever, sometimes accompanied by
low blood counts, kidney and liver function abnormalities.
Other more common side effects include nausea, diarrhea,
abdominal pain, headache, a metallic taste in the mouth, and
drowsiness. Uncommonly, prolonged use of allopurinol has been
associated with an increased risk for cataracts.
Monitoring:
Uric acid levels should be obtained weekly to monthly
while adjusting the dose of the medication. Blood counts,
kidney and liver function studies can be obtained annually or
if signs of hypersensitivity develop.
Important
points to know: This medication�s role is to reduce uric
acid levels and stabilize the course of gout, preventing acute
flares. During an acute flare, the dose of the
medication should not be changed, as allopurinol does not have
a direct effect on inflammation, and shifts in the uric acid
levels tend to worsen symptoms. Do not discontinue
this drug without notifying the provider. Allopurinol may
interact with other medications such as warfarin (coumadin)
and azathioprine (Imuran), notify your provider
if you are taking either of these medications. Rashes are
more common when allopurinol is taken with the antibiotic
ampicillin.
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