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Drug Interactions between allopurinol and Bumex

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

allopurinol bumetanide

Applies to: allopurinol and Bumex (bumetanide)

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with furosemide may increase the plasma concentrations of oxypurinol, the active metabolite of allopurinol, and the serum urate concentrations. It is unclear if all diuretics have the same effect on oxypurinol. However, other diuretics (e.g., torsemide, bumetanide, ethacrynic acid) are also known to increase serum urate concentrations thus lowering the efficacy of allopurinol. Higher levels of oxypurinol have been associated with an increased risk of allopurinol hypersensitivity reactions, such as skin rash, drug reaction with eosinophilia and systemic symptoms (DRESS) and severe cutaneous adverse reactions (SCAR). Renal impairment has been demonstrated to also be a risk factor for allopurinol hypersensitivity. One proposed mechanism for this interaction is related to the interference of furosemide with the renal clearance of oxypurinol, although the exact details are still unclear.

MANAGEMENT: Caution is recommended when diuretics and allopurinol are coadministered. Patients should be monitored for increased toxicity as well as reduced efficacy, depending on the diuretic agent administered. Particularly when coadministered with furosemide, patients should be advised to stop allopurinol and promptly report any signs of hypersensitivity, including rash, pruritus, fever, or chills.

Drug and food interactions

Moderate

allopurinol food

Applies to: allopurinol

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: The tolerability of allopurinol may be improved by giving it after a meal. Additionally, when the dose is greater than 300 mg, dividing the total daily dose into smaller doses administered more often may be appropriate to help minimize gastrointestinal irritation.

MONITOR: Concomitant use of allopurinol with central nervous system (CNS) depressants, including alcohol, may potentiate adverse effects such as somnolence and sedation.

MANAGEMENT: To improve tolerability, some manufacturers suggest administering allopurinol after a meal. Additionally, if the daily dose is greater than 300 mg, administering allopurinol in divided doses may help reduce gastrointestinal intolerance. Patients should also be counseled to avoid or limit consumption of alcohol and to avoid activities requiring mental alertness such as driving or operating hazardous machinery until they know how the medication affects them.

Moderate

bumetanide food

Applies to: Bumex (bumetanide)

Bumetanide and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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 interaction information available.

Further information

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