Today, Allopurinol is the basic (main and pathogenetically substantiated) drug used in the complex therapy of such a disease as gout. Each person, before trying something new, tries to find as much useful information about it as possible. Therefore, we propose to understand in more detail when it is worth using Allopurinol. Feedback from patients and doctors will be presented in our material, and you will also learn what to be afraid of while taking this drug.
Pharmacological characteristics of the drug
"Allopurinol" belongs to the group of anti-gout drugs. 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 a urostatic effect. Ultimately, this leads to a decrease in its concentration fromsubsequent 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 ingestion, 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 excretion of "Allopurinol" (reviews of doctors confirm this) is not recommended for use by people with renal insufficiency. In patients with preserved renal excretory function, cumulation is not observed.
"Allopurinol": indications for use
Reviews of doctors prescribing this drug claim that its use is most effective and justified in cases of hyperuricemia (increased uric acid content per unit volume of blood) when:
- gouty arthritis (gout);
- urate diseases of the urogenital area (nephropathy, urolithiasis);
- blood cancer;
- congenital anomalies of the enzymatic system.
In some cases it is possibleprescribing the drug to children for the treatment of urate nephropathy, which arose during leukemia therapy, in congenital diseases associated with impaired metabolism of uric acid, secondary hyperuricemia of various origins.
Features of the use of the drug
Allopurinol tablets (reviews warn of strict adherence to recommendations when taking the medicine) are taken after meals, they should never be chewed, but on the contrary, they are drunk whole and washed down with at least a glass of warm water.
People taking this medicine should always watch their diet, and in case of errors in the diet, be sure to adjust its dosage, but only under the supervision of your treating specialist.
The dose of Allopurinol required for treatment is determined depending on the content of uric acid in the bloodstream. As a rule, it ranges from 100 to 300 mg per dose of Allopurinol. Feedback from patients and doctors regarding this dosage is positive, since the medicine is taken only once a day.
Gout therapy starts with 100mg once a day. In case of insufficient effectiveness and a slight decrease in the level of uric acid, the dosage is gradually increased (by 100 mg every two to three weeks), bringing the level of uric acid to an effective therapeutic level under laboratory control. In such cases, the average dosage and further maintenance dose is from 200 to 400 mg, however, in some situations, the dosethe drug can be up to 800 mg. In this case, it is divided into several times a day.
When prescribing the drug to patients with renal insufficiency, 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 insufficiency, as well as pregnant and lactating women. It is also not recommended to prescribe this drug to patients who have allergic reactions or hypersensitivity to one or more components of the drug. It is forbidden to use the drug in persons with a borderline content of uric acid in the blood plasma, since its reduction can be successfully achieved by adjusting the diet.
"Allopurinol" side effects
Reviews of patients who used this drug for the first time indicate that it is often possible to exacerbate the disease and increase the symptoms of gout with the onset of so-called attacks. But this phenomenon is short-term, and you should not be afraid of it so much as to stop therapy. But in cases of any rashes, discomfort, or early absent signs, you must immediately inform the doctor about this. In this case, the intake of "Allopurinol" must be stopped immediately, and as the symptoms disappear, the specialist may again prescribe the drug, but at a lower dosage (starting from 50 mg). Reception should be carried out under the close supervision of the attending physicianand in separation.
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 depression of bone marrow function with the occurrence of thrombocytopenia, aplastic anemia is rarely observed.
When taking the drug, the development of metabolic disorders in the form of diabetes mellitus, an increase in the level of fatty acids in the blood plasma is possible.
From the side of the cardiovascular system, the development of arterial hypertension, bradycardia is possible.
The incidence of adverse reactions to this drug increases when the patient has kidney failure.
Form of release and dosage
"Allopurinol" is available in tablet form (30 or 50 pieces per pack) at a dosage of 100 and 300 mg of the active ingredient in one tablet. Allopurinol Sandoz 300 is present on the domestic market. Reviews about it are positive, since the drug in this dosage is prescribed only once a day, which practically negates the possibility of skipping the drug.
Poisoning and drug overdose
Poisoning is extremely rare, but there are cases of a single dose of 20 grams of the drug. The following symptoms were observed: dizziness, vomiting, nausea, diarrhea. With renal failure and prolonged administration of large doses of the drug, severe symptoms of intoxication were noted in the form of fever, hepatitis, exacerbationkidney failure.
Therapy of acute poisoning and overdose is symptomatic, aimed at accelerated elimination of the drug from the body. There is no specific antidote. For the speedy removal of the drug from the body, dialysis detoxification methods are effective.
Reviews
Given the fact that the period of accumulation of this medicinal substance in the blood (in sufficient concentration to provide a therapeutic effect) is on average one week, patients suffering from gout should use Allopurinol for almost a lifetime. Reviews of doctors are unambiguous: 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 of a lifestyle than a chronic disease. But it is Allopurinol that helps to 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 Allopurinol, the doctors' reviews are also positive, because in most cases the patient needs to take the medicine once a day. This minimizes the chance of missing a medication and therefore increases the effectiveness of the therapy.
Conclusion
Thus, the main cure for gout is Allopurinol. Reviews of specialists and patients taking this remedy are positive, and this once again confirms the effectiveness of the usemedication in the treatment of gout and disorders of uric acid metabolism. Thanks to the use of this drug, a huge number of patients gain hope for reducing the complications of diabetes.
