Description of the medicine: Allopurinol (Allopurinolum)
ALLOPURINOL (Allopurinolum). 4-hydroxypyrazolo [3, 4-d] pyrimidine.
Synonyms: Milurit, Allopur, Allopurinol, Apurin, Atisuril, Foligan, Goticur, Lysurin, Milurit, Petrazine, Prynol, Pyral, Purinol, Uridozid, Uriprim, Xanturat, Zylapour, Zyloprim, Zyloric, etc.
Fine crystalline powder, white or white with a creamy tint. Practically insoluble in water and alcohol.
The drug has a specific ability to inhibit the xanthine oxidase enzyme involved in the conversion of hypoxanthine to xanthine and xanthine to uric acid. In this regard, the formation of urate in the blood serum is reduced and their deposition in the tissues and kidneys is prevented. The excretion of uric acid in the urine decreases and the excretion of hypoxanthine and xanthine increases.
Allopurinol is used for the treatment and prevention of diseases accompanied by hyperuricemia: with gout (primary and secondary), kidney stone disease (with the formation of urates), primary and secondary hyperuricemia that occurs in diseases accompanied by increased decay of nucleoproteins and an increase in uric acid in the blood, including among various hematoblastomas (acute leukemia, chronic myeloid leukemia, lymphosarcoma, etc.), with cytostatic and radiation therapy of tumors, psoriasis, as well as with massive therapy and corticosteroid drugs, when, due to intense tissue breakdown, the number of purines in the blood increases significantly, which can lead to urate nephropathy with impaired renal function.
Allopurinol is taken orally (after eating). Doses are determined depending on the content of uric acid in the blood. The minimum therapeutic dose is 0.1 g per day, the maximum is 0.8 g. Usually, with moderate (up to 10 mg%) hyperuricemia, take 0.2 - 0.4 g per day for 2 to 3 weeks, then switch to maintenance dose of 0.2 - 0.3 g per day (in 2 - 3 doses).
In severe cases of gout, with significant deposits of urate in the tissues and high hyperuricemia (over 7 mg%), up to 0.6 - 0.8 g is prescribed fractionally (no more than 0.2 g per reception) for 2 to 4 weeks, then they pass to maintenance doses (0.1 - 0.3 g per day), which give a long time (for several months).
When allopurinol is discontinued, uricemia and uricosuria return to the initial level on the 3rd – 4th day, therefore, treatment should be lengthy. Gaps in taking the drug over 2 to 3 days are undesirable.
For the prevention of hyperuricemia in radiation therapy and chemotherapy of tumors, an average of 0.4 g per day is prescribed; the drug is taken 2 to 3 days before the start of treatment or at the same time and continues for several days after the end of specific therapy.
There is evidence of the effectiveness of allopurinol in the treatment of children with epilepsy. It is believed that the effect is due to the inhibitory effect of the drug on tryptophanpyrrolase and an increase in the biosynthesis of serotonin. Allopurinol (in addition to antiepileptic drugs) was used at a dose of 4-5 mg / kg 2 times a day with 10-day courses with a break of 1, 5 -2 months.
The drug is usually well tolerated.