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Allopurinol was approved for medical use in the United States in 1966. [7] It is on the World Health Organization's List of Essential Medicines. [10] Allopurinol is available as a generic medication. [7] In 2022, it was the 39th most commonly prescribed medication in the United States, with more than 15 million prescriptions. [11] [12]
Allopurinol hypersensitivity syndrome (AHS) typically occurs in persons with preexisting kidney failure. [3]: 119 Weeks to months after allopurinol is begun, the patient develops a morbilliform eruption [3]: 119 or, less commonly, develops one of the far more serious and potentially lethal severe cutaneous adverse reactions viz., the DRESS syndrome, Stevens Johnson syndrome, or toxic epidermal ...
Benzbromarone is a uricosuric agent and non-competitive inhibitor of xanthine oxidase [1] used in the treatment of gout, especially when allopurinol, a first-line treatment, fails or produces intolerable adverse effects. It is structurally related to the antiarrhythmic amiodarone. [2]
It is generally recommended only for people who cannot take allopurinol. [8] [9] It is taken by mouth. [7] Common side effects include liver problems, nausea, joint pain, and a rash. [7] Serious side effects include an increased risk of death as compared with allopurinol, Stevens–Johnson syndrome, and anaphylaxis.
Drugs with other primary uses, that have known uricosuric properties, include losartan, [1] atorvastatin, and fenofibrate.Although these drugs may have significant uricosuric action, their other significant pharmacological actions in off-label use as a uricosuric requires careful assessment of the patient to achieve the most benefit and least risk.
Pegloticase is useful decreasing tophi but has a high rate of side effects and many people develop resistance to it. [64] Using lesinurad 400 mg plus febuxostat is more beneficial for tophi resolution than lesinural 200 mL with febuxostat, with similar side effects. Lesinural plus allopurinol is not effective for tophi resolution. [81]
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Type A: augmented pharmacological effects, which are dose-dependent and predictable [5]; Type A reactions, which constitute approximately 80% of adverse drug reactions, are usually a consequence of the drug's primary pharmacological effect (e.g., bleeding when using the anticoagulant warfarin) or a low therapeutic index of the drug (e.g., nausea from digoxin), and they are therefore predictable.