Home Drug Guide Allopurinol Sodium

Drug Guide

Generic Name

Allopurinol Sodium

Brand Names Aloprim

Classification

Therapeutic: Antigout agent

Pharmacological: Xanthine oxidase inhibitor

FDA Approved Indications

  • Gout and hyperuricemia associated with cancer therapy

Mechanism of Action

Inhibits xanthine oxidase, reducing the production of uric acid from hypoxanthine and xanthine, thereby decreasing uric acid levels in the blood and tissues.

Dosage and Administration

Adult: Initial dose usually 300 mg daily, adjusted based on response and uric acid levels.

Pediatric: Use with caution; consult specific pediatric dosing guidelines.

Geriatric: Start at lower doses due to potential renal impairment, monitor closely.

Renal Impairment: Reduce dose according to renal function; frequent monitoring needed.

Hepatic Impairment: Use with caution; no specific dose adjustment established.

Pharmacokinetics

Absorption: Rapidly absorbed after IV administration.

Distribution: Widely distributed; crosses the placenta, minimal CNS penetration.

Metabolism: Metabolized minimally; primarily excreted unchanged.

Excretion: Primarily excreted via the kidneys.

Half Life: Approximately 1-2 hours; longer in renal impairment.

Contraindications

  • Hypersensitivity to allopurinol or xenobiotic hypersensitivity reactions.

Precautions

  • Monitor for hypersensitivity reactions, especially in patients with renal impairment. Use with caution in patients with liver disease, cardiovascular disease, or those prone to skin reactions.

Adverse Reactions - Common

  • Rash, including Stevens-Johnson syndrome (Variable, can be serious)
  • Gastrointestinal upset (Common)

Adverse Reactions - Serious

  • Allergic skin reactions, eosinophilia, hepatitis (Serious but less common)
  • Hepatotoxicity (Rare)
  • Hematologic reactions (e.g., aplastic anemia, agranulocytosis) (Rare)

Drug-Drug Interactions

  • Azathioprine, mercaptopurine (risk of toxicity increases)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor uric acid levels, renal and hepatic function before and during therapy. Watch for hypersensitivity reactions.

Diagnoses:

  • Risk for hypersensitivity reactions,
  • Impaired skin integrity

Implementation: Administer after meals to minimize GI upset. Hydrate adequately. Educate about signs of hypersensitivity.

Evaluation: Maintain target uric acid levels, monitor for adverse reactions.

Patient/Family Teaching

  • Take medication as directed.
  • Report any signs of rash, fever, or hypersensitivity immediately.
  • Maintain adequate hydration.
  • Avoid alcohol and certain medications that can increase uric acid levels or interact with allopurinol.

Special Considerations

Black Box Warnings:

  • Severe hypotension and skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, especially when administered rapidly or in high doses.

Genetic Factors: Higher risk of severe skin reactions in HLA-B*58:01 allele carriers, particularly in Asian populations.

Lab Test Interference: Can affect renal function tests and uric acid levels.

Overdose Management

Signs/Symptoms: Hypotension, skin reactions, nausea, vomiting.

Treatment: Supportive care, activated charcoal if ingestion recent, and symptomatic treatment. No specific antidote.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.