YSP ALLOPURINOL TABLET 300MG [SIN17004P]

Product Info

YSP ALLOPURINOL TABLET 300MG

[SIN17004P]

Indications:
Allopurinol is indicated for reducing urate/uric acid formation in conditions where urate/uric acid deposition has already occurred (e.g. gouty arthritis, skin tophi, nephrolithiasis) or is a predictable clinical risk (e.g. treatment of malignancy potentially leading to acute uric acid nephropathy).

The main clinical conditions where urate/uric acid deposition may occur are:

• idiopathic gout;

• uric acid lithiasis;

• acute uric acid nephropathy;

• neoplastic disease and myeloproliferative disease with high cell turnover rates, in which high urate levels occur either spontaneously, or after cytotoxic therapy;

• certain enzyme disorders which lead to overproduction of urate, for example;

  • hypoxanthine-guanine phosphoribosyltransferase, including Lesch-Nyhan syndrome;

  • glucose-6-phosphatase including glycogen storage disease;

  • phosphoribosylpyrophosphate synthetase;

  • phosphoribosylpyrophosphate amidotransferase;

  • adenine phosphoribosyltransferase.

Allopurinol is indicated for the management of 2,8-dihydroxyadenine (2,8-DHA) renal stones related to deficient activity of adenine phosphoribosyltranferase.

Allopurinol is indicated for the management of recurrent mixed calcium oxalate renal stones in the presence of hyperuricosuria, when fluid, dietary and similar measures have failed.

Dosage and Administrations:
The dosage should be adjusted by monitoring serum urate concentrations and urinary urate/uric acid levels at appropriate intervals.
Allopurinol may be taken orally once a day after a meal. It is well tolerated, especially after food. Should the daily dosage exceed 300 mg and gastrointestinal intolerance be manifested, a divided dose regimen may be appropriate.
Adults
Allopurinol should be introduced at low dosage e.g. 100 mg/day to reduce the risk of adverse reactions and increased only if the serum urate response is unsatisfactory. Extra caution should be exercised if renal function is poor.
The following dosage schedules are suggested:

• 100 to 200 mg daily in mild conditions,

• 300 to 600 mg daily in moderately severe conditions,

• 700 to 900 mg daily in severe conditions.

If dosage on a mg/kg bodyweight basis is required, 2 to 10 mg/kg bodyweight/day should be used.
Children (under 15 years)
10 to 20 mg/kg bodyweight/day up to a maximum of 400 mg daily. Use in children is rarely indicated,except in malignant conditions (especially leukaemia) and certain enzyme disorders such as Lesch-Nyhan syndrome.
Elderly
In the absence of specific data, the lowest dosage which produces satisfactory urate reduction should be used.
Renal impairment
Since allopurinol and its metabolites are excreted by the kidney, impaired renal function may lead to retention of the drug and/or its metabolites with consequent prolongation of plasma half-lives. In severe renal insufficiency, it may be advisable to use less than 100 mg per day or to use single doses of 100mg at longer intervals than one day.
If facilities are available to monitor plasma oxipurinol concentrations, the dose should be adjusted to maintain plasma oxipurinol levels below 100 micromol/litre (15.2 mg/litre).
Allopurinol and its metabolites are removed by renal dialysis. If dialysis is required two to three times a week consideration should be given to an alternative dosage schedule of 300 to 400 mg allopurinol immediately after each dialysis with none in the interim.
Hepatic impairment
Reduced doses should be used in patients with hepatic impairment.
Periodic liver function tests are recommended during the early stages of therapy.
Treatment of High Urate Turnover Conditions e.g. Neoplasia, Lesch-Nyhan Syndrome
It is advisable to correct existing hyperuricaemia and/or hyperuricosuria with allopurinol before starting cytotoxic therapy. Adequate hydration is important to maintain optimum diuresis and alkalinisation of the urine is advisable to increase solubility of urinary urate/uric acid. Dosage of allopurinol should be at the lower end of the recommended dosage schedule.

Contraindications:
Allopurinol tablets should not be administered to individuals known to be hypersensitive to allopurinol or to any of the components of the formulation.