Today, the drug "Allopurinol" is a basic (basic and pathogenetically substantiated) drug that is used in the complex treatment of a disease such as gout. Before trying something new, everyone tries to find the maximum of useful information about it. Therefore, we offer a more detailed understanding of when it is worth using Allopurinol. Reviews of patients and doctors will be presented in our material, and you will also find out what to fear while taking this medication.
Pharmacological characteristics of the drug
"Allopurinol" refers to the group of antigout medications. The main active ingredients are allopurinol and its active metabolite, oxypurinol. Their pharmacodynamic effects are due to a violation of the synthesis of uric acid with the development of an urostatic effect. Ultimately, this leads to a decrease in its concentration with subsequent dissolution of urates.
Due to its good solubility, Allopurinol has a high bioavailability. The drug is well absorbed in the lumen of the small intestine. In the stomach, it does not enter the systemic circulation. The presence in the blood plasma is observed already half an hour after administration, and the maximum concentration is observed after 1.5 hours. Accordingly, the maximum concentration of the allopurinol metabolite, oxypurinol, is observed three hours after oral administration.
The drug has a long half-life and therefore is capable of cumulation. In patients at the beginning of therapy, an increase in the concentration of the drug is observed, which stabilizes after one to two weeks of therapy. Due to the long-term withdrawal of "Allopurinol" (doctors' reviews confirm this), it is not recommended for use by persons with renal failure. In patients with preserved renal excretory function, cumulation is not observed.
Allopurinol: indications for use
The reviews of the doctors prescribing this drug claim that its use is most effective and justified in cases of hyperuricemia (increased uric acid per unit volume of blood) with:
- gouty arthritis (gout);
- urate diseases of the genitourinary sphere (nephropathy, urolithiasis);
- oncological diseases of the blood;
- congenital malformations of the enzymatic system.
In some cases, it is possible to prescribe the drug to children for the treatment of urate nephropathy, which arose during the treatment of leukemia, with congenital diseases associated with impaired uric acid metabolism, secondary hyperuricemia of various origins.
Features of the use of the drug
Allopurinol tablets (reviews warn of strict adherence to the recommendations when taking the medicine) are taken after meals, they should never be chewed, but rather, they are drunk whole and washed down with at least a glass of warm water.
People taking this medicine should always monitor their diet, and in cases of errors in the diet, be sure to adjust its dosage, but only under the supervision of your healthcare professional.
The dose of Allopurinol needed for treatment is determined depending on the uric acid content in the bloodstream. As a rule, it is from 100 to 300 mg per dose of Allopurinol. Reviews of patients and doctors regarding such dosing are positive, since the medicine is taken only once a day.
Gout therapy begins with the appointment of 100 mg of the drug once a day. In case of insufficient efficiency and a slight decrease in the level of uric acid, the dosage is gradually increased (by 100 mg every two to three weeks), bringing to the effective therapeutic level of uric acid under laboratory control. In such cases, the average dosage and further maintenance dose range from 200 to 400 mg, however, in some situations, the dose can be up to 800 mg. In this case, it is broken several times a day.
When prescribing the drug to patients with renal failure, it is necessary to focus on creatinine clearance.
Contraindications to the appointment of "Allopurinol"
The drug is contraindicated for use in patients with severe renal failure, as well as pregnant and lactating women. It is also not recommended to prescribe this drug to patients with allergic reactions or hypersensitivity to one or more components of the drug. It is forbidden to use the drug in people with borderline uric acid in plasma, since it can be successfully reduced by adjusting the diet.
Allopurinol: side effects
Reviews of patients who used this drug for the first time indicate that quite often an exacerbation of the disease and an increase in symptoms of gout with the occurrence of the so-called seizures are possible. But this phenomenon is short-term, and one should not be so afraid of it as to discontinue therapy. But in cases of any rashes, discomfort or earlier absent symptoms, you should immediately inform your doctor. In this case, the reception of "Allopurinol" must be stopped immediately, and as the symptoms disappear, the specialist can again prescribe the drug, but in a lower dosage (starting from 50 mg). Admission should be carried out under the close supervision of the attending physician and in a ward.
Among the adverse reactions from the nervous system and higher mental functions, depression may occur. On the part of the hematopoietic system, the development of inhibition of bone marrow function with the occurrence of thrombocytopenia, aplastic anemia is rarely observed.
When taking the drug, it is possible to develop metabolic disorders in the form of diabetes mellitus, an increase in the level of fatty acids in blood plasma.
On the part of the cardiovascular system, the development of arterial hypertension, bradycardia is possible.
The incidence of adverse reactions to this drug increases if the patient has renal failure.
Release form and dosage
"Allopurinol" is available in tablet form (30 or 50 pieces per pack) in a dosage of 100 and 300 mg of the active substance in one tablet. Allopurinol Sandoz 300 is present on the domestic market. Reviews about him are positive, since the drug in this dosage is prescribed only once a day, which practically negates the opportunity to skip taking the drug.
Poisoning and overdose of the drug
Poisoning is extremely rare, however, cases of a single dose of 20 grams of the drug are known. The following symptoms were observed: dizziness, vomiting, nausea, diarrhea. With renal failure and prolonged administration of large doses of the drug, severe intoxication symptoms were noted in the form of fever, hepatitis, and exacerbation of renal failure.
Therapy of acute poisoning and overdose is symptomatic, aimed at accelerated removal of the drug from the body. There is no specific antidote. For the speedy removal of the drug from the body, dialysis methods of detoxification are effective.
Reviews
Given the fact that the accumulation period of this drug in the blood (in sufficient concentration to provide a therapeutic effect) is on average one week, patients with gout should use Allopurinol for almost a lifetime. Reviews of doctors are unequivocal: the drug has proven itself well. But this is not a “miracle pill” that you can drink and forget about the disease. Gout is more a lifestyle than a chronic disease. But it is Allopurinol that helps control the level of lactic acid and prevent the exacerbation of the disease and its further progression.
From the point of view of the convenience of prescribing the drug “Allopurinol”, the reviews of doctors are also positive, because in most cases the patient needs to take the medicine once a day. This minimizes the likelihood of missing a medication and, therefore, increases the effectiveness of the therapy.
Conclusion
Thus, the main cure for gout is Allopurinol. The reviews of specialists and patients taking this drug are positive, and this once again confirms the effectiveness of the use of the drug in the treatment of gout and metabolic disorders of uric acid. Thanks to the use of this drug, a huge number of patients are hoping to reduce the complications of diabetes.