Clinical beta
FMBM is currently in clinical beta. Content is for professional review/testing and must not replace local protocols, senior clinical judgment, or official prescribing references.
Drug Monograph
USE IF: Chronic gout / recurrent flares / tophaceous disease with urate-lowering plan; TLS prevention in protocol-led oncology care β with low-start dosing, renal adjustment, flare prophylaxis at initiation, and immediate stop rules for rash.
AVOID IF: Acute gout attack as sole analgesic strategy; rapid dose escalation; prior severe allopurinol reaction; continued use after any new rash; ignoring azathioprine/6-MP interaction risk.
Allopurinol
Xanthine oxidase inhibitor (urate-lowering)
Indication
Chronic urate lowering β’ TLS prevention (selected protocols)
INDICATIONS (CORE USE)
- Chronic gout (urate lowering) - Recurrent gout flares - Tophaceous gout - Tumor lysis syndrome (prevention; protocol-based)
ADULT DOSE (STANDARD)
Start low (e.g., 100 mg PO daily) Lower starting dose in CKD Titrate gradually on serum uric acid
MAX DOSE
Individualized; avoid simplistic fixed max messaging β titrate on urate, renal function, and tolerability
Route
PO
PEDIATRIC DOSE
Specialist / protocol-based (e.g., oncology contexts)
Must-not-miss safety points
Major warning
- Allopurinol hypersensitivity syndrome (AHS) β life-threatening (rash, systemic involvement) - Start low and titrate slowly (especially renal impairment) - NOT an acute gout pain treatment - Initiation can trigger gout flare β prophylaxis often required - Stop immediately if rash develops
Primary
Secondary
STANDARD (ADULT PO)
Adult PO: start low (e.g., 100 mg daily) β lower start in CKD β titrate slowly to urate target
ADULT DOSE
STANDARD (ADULT PO): - Start low (e.g., 100 mg daily) - Lower starting dose in CKD - Titrate gradually based on serum uric acid
PEDIATRIC DOSE
Specialist / protocol-based (e.g., oncology contexts)
MAX DOSE
Individualized; avoid simplistic fixed max messaging
Practical Note
- Target serum uric acid (e.g., <6 mg/dL β context-dependent guideline targets) - Do NOT escalate rapidly - Flare prophylaxis (important): initiation may trigger gout flare β consider prophylaxis (e.g., colchicine / NSAID) in early phase per pathway
Clinical warnings
Pediatrics
Specialist / protocol-based (e.g., oncology contexts)
Pregnancy
Pregnancy /
Lactation
use only when benefit outweighs risk per specialist and labeling. Genetic risk: - HLA-B*58:01 and related pharmacogenomic context β higher AHS risk in specific populations β follow regional testing / labeling recommendations where applicable
Renal impairment
Lower starting dose; careful titration; oxypurinol accumulates β follow labeling and urate/renal monitoring.
Hepatic impairment
Monitor LFTs; dose adjustment in significant hepatic impairment per labeling / hepatology input.
Elderly
Higher hypersensitivity risk; lower starting dose; vigilant rash and lab monitoring.
- PO once daily (or divided per product / pathway) - Take consistently - Hydration recommended (especially TLS prevention contexts)
Clinical Picture
GI symptoms Rash Renal / hepatic dysfunction (severe cases)
Immediate Actions
Stop drug Supportive care
Antidote
None
Decontamination
Large acute ingestion: poison center; supportive care.
Escalation
Severe rash, mucosal involvement, or organ dysfunction β emergency care / ICU pathway.
Common mistakes, resistance logic, and bedside traps
Pharmacy Tool
suspension Β· oral
Pharmacist verification beta
Preparation formulas are currently in pharmacist verification beta and must be validated against institutional protocols before use.
Acknowledge the statements above to unlock volume scaling and ingredient quantities.
- Active metabolite oxypurinol (longer half-life than parent) - Renal elimination important (dose adjustment in CKD)
- Xanthine oxidase inhibition β decreased uric acid production
Saudi Arabia
Zyloric, Allopurinol
Global
Zyloprim, Aloprim, (placeholder β verify local formulation)
Common trade names are curated examples only β formulations and availability vary. Verify the exact product name with your local pharmacy and national regulator before prescribing or dispensing.
Global data (no country-specific data available)
Saudi Arabia
International