Chung Y et al. - Allopurinol is a moderately active hypouricemic drug, that acts by inhibiting the xanthine oxidoreductase by oxypurinol, the active metabolite of allopurinol. Optimal use of allopurinol involves individualization of dose to attain a sufficient decrease in plasma urate concentrations. The initial use of an anti-inflammatory drug or low-dose colchicine decreases but does not eliminate the development of acute attacks of gout during the initiation of therapy with allopurinol. Monitoring of oxypurinol concentrations has shed some light on the efficacy of allopurinol but more data are required particularly in patients with renal impairment.
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