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Allopurinol / lesinurad Disease Interactions

There are 8 disease interactions with allopurinol / lesinurad:

Major

Antihyperuricemic Agents (Includes Allopurinol/lesinurad) ↔ Secondary Hyperuricemia

Severe Potential Hazard, Moderate plausibility

Applies to: Tumor Lysis Syndrome, Lesch-Nyhan Syndrome, Organ Transplant

No studies with febuxostat or lesinurad have been conducted in patients with secondary hyperuricemia (including organ transplant recipients). The use of these drugs is contraindicated in patients where the uric acid formation is greatly increased, such as patients with malignant disease, tumor lysis syndrome or Lesch-Nyhan syndrome.

Major

Lesinurad (Includes Allopurinol/lesinurad) ↔ Severe Renal Impairment

Severe Potential Hazard, Moderate plausibility

Applies to: Kidney Transplant, Renal Dysfunction

The use of lesinurad is contraindicated in patients with severe renal impairment, end stage renal disease, kidney transplant recipient and patients on dialysis.

Moderate

Allopurinol (Includes Allopurinol/lesinurad) ↔ Bone Marrow Suppression

Moderate Potential Hazard, Moderate plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Bone marrow suppression has been reported in patients receiving allopurinol; however, most of these patients were receiving concomitant medications with the known potential to cause such an effect. The suppression has occurred from as early as 6 weeks to as long as 6 years after the initiation of allopurinol therapy. Therapy with allopurinol should be administered cautiously to patients with or predisposed to bone marrow suppression.

Moderate

Allopurinol (Includes Allopurinol/lesinurad) ↔ Dehydration

Moderate Potential Hazard, High plausibility

Applies to: Dehydration, Diarrhea, Vomiting

Adequate hydration is necessary during therapy with allopurinol to prevent both the formation of xanthine calculi and renal precipitation of urates when concomitant uricosuric agents are given. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluid. In general, fluid intake sufficient to yield a daily urinary output of at least 2 liters is recommended. Maintenance of a slightly alkaline or neutral urine is also desirable.

References

  1. Stote RM, Smith LH, Dubb JW, Moyer TP, Alexander F, Roth JL "Oxypurinol nephrolithiasis in regional enteritis secondary to allopurinol therapy." Ann Intern Med 92 (1980): 384-5
  2. "Product Information. Zyloprim capsules (allopurinol)." Glaxo Wellcome, Research Triangle Park, NC.
  3. McInnes GT, Lawson DH, Jick H "Acute adverse reactions attributed to allopurinol in hospitalized patients." Ann Rheum Dis 40 (1981): 245-9
  4. Landgrebe AR, Nyhan WL, Coleman M "Urinary-tract stones resulting from the excretion of oxypurinol." N Engl J Med 292 (1975): 626-7
View all 4 references
Moderate

Allopurinol (Includes Allopurinol/lesinurad) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The use of allopurinol has infrequently been associated with asymptomatic elevations of serum transaminase and alkaline phosphatase levels. Isolated cases of cholestatic jaundice, hepatic necrosis, granulomatous hepatitis, and hepatomegaly have also been reported. Therapy with allopurinol should be administered cautiously in patients with liver disease. Periodic monitoring of liver function tests is recommended in these patients during the early stages of therapy.

References

  1. Raper R, Ibels L, Lauer C, Barnes P, Lunzer M "Fulminant hepatic failure due to allopurinol." Aust N Z J Med 14 (1984): 63-5
  2. "Product Information. Zyloprim capsules (allopurinol)." Glaxo Wellcome, Research Triangle Park, NC.
  3. Al-Kawas FH, Seeff LB, Berendson RA, Zimmerman HJ, Ishak KG "Allopurinol hepatotoxicity." Ann Intern Med 95 (1981): 588-90
  4. Ohsawa T, Ohtsubo M "Hepatitis associated with allopurinol." Drug Intell Clin Pharm 19 (1985): 431-3
View all 4 references
Moderate

Allopurinol (Includes Allopurinol/lesinurad) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Patients with decreased renal function require lower dosages of allopurinol than normal to control serum urate levels. Therapy should be initiated at reduced dosages with smaller incremental changes in such patients. Additionally, individuals with preexisting renal disease or poor urate clearance have demonstrated a rise in BUN during therapy with allopurinol. Renal failure has also been observed among some with hyperuricemia secondary to neoplastic diseases. Renal function should be monitored during the initial stages of therapy, and the dosage reduced or the drug withdrawn if necessary.

References

  1. Hande K, Reed E, Chabner B "Allopurinol kinetics." Clin Pharmacol Ther 23 (1978): 598-605
  2. "Product Information. Zyloprim capsules (allopurinol)." Glaxo Wellcome, Research Triangle Park, NC.
  3. Hande KR, Noone RM, Stone WJ "Severe allopurinol toxicity: description and guidelines for prevention in patients with renal insufficiency." Am J Med 76 (1984): 47-56
Moderate

Antihyperuricemic Agents (Includes Allopurinol/lesinurad) ↔ Cv Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Cardiovascular Disease

Major adverse cardiovascular events (cardiovascular deaths, non- fatal myocardial infarctions and non- fatal strokes), were reported during clinical trials with some antihyperuricemic agents, such as febuxostat and lesinurad. Although a causal relationship has not been established, caution is advised when used in patients with cardiovascular disease. Monitoring for signs or symptoms of myocardial infarction or stroke is recommended.

Moderate

Febuxostat/Lesinurad (Includes Allopurinol/lesinurad) ↔ Hepatic Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

No studies have been conducted in patients with severe hepatic impairment (Child-Pugh Class C), therefore caution should be exercised if using febuxostat or lesinurad on these patients. No dose adjustment is necessary in patients with mild or moderate hepatic impairment.

allopurinol / lesinurad drug Interactions

There are 387 drug interactions with allopurinol / lesinurad

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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