Rheumatology Medical News about hyperuricemia in gout;allopurinol

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A critical reappraisal of allopurinol dosing, safety, and efficacy for hyperuricemia in gout
Current Rheumatology Reports, 03/25/09

Chao J et al. - This review summarizes the current allopurinol dosing guidelines, safety, and efficacy in gout hyperuricemia and in patients with chronic kidney disease.

Allopurinol, drug for serum urate-lowering in gout, is approved by the US FDA for a dose up to 800 mg/d
However, the vast majority of allopurinol prescriptions are for doses ≤300 mg/d, which often fails to adequately treat the symptoms
This situation has been promoted by longstanding, non-evidence-based guidelines for its use and to avoid allopurinol hypersensitivity syndrome
Limiting allopurinol dosing to ≤300 mg/d suboptimally controls hyperuricemia and fails to adequately prevent hypersensitivity reactions
However, the long-term safety of elevating allopurinol dosages in chronic kidney disease requires further study

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