"Allopurinol": patient reviews in the treatment of gout
The drug "Allopurinol" is used for the base having the effect of reducing the rate of synthesis of uric acid. By inhibiting the enzymatic activity of xanthine oxidase, the drug significantly reduces the plasma concentration of urates. This effect is important in terms of prevention of exacerbations of gout at different stages of its development. Although the application during the current gouty exacerbation of the drug "Allopurinol" reviews are ambiguous. In general, the drug has a proven clinically important effect, although it has its own characteristics.
Systemic characteristics of the drug
Allopurinol is a representative of the group of arthritic drugs. It refers to uricostatic agents that lead to inhibition of the synthesis of uric acid. For this purpose, it is used in rheumatology and therapy. Moreover, "Allopurinol" for gout is appointed only to reduce the number of exacerbations during the year.Also, the use of the drug can weaken the clinical manifestations of gout, reduce the size of tophi, the degree of joint damage and shorten the time of exacerbation of the disease.
The latter effect allows you to quickly interrupt the period of temporary disability due to exacerbation of the disease. Reviews about the drug "Allopurinol" reviews do not confirm its therapeutic value precisely in the exacerbation of gout. This drug only reduces the amount of newly formed uric acid, but does not affect its excretion. But if during the period of remission, in addition to the diet, the patient took the drug, then the time of exacerbation and the period of disability will be much shorter.
Features of therapeutic use for gout
Applying "Allopurinol" for gout, the clinician expects a certain therapeutic effect. In the case of this pathology, a reduction in the amount of newly formed uric acid, which provokes exacerbation, is required. Basic therapy is designed to reduce the number of such exacerbations of the disease.Then gout is well controlled, although it requires constant adherence to a specific diet.
In assessing the effectiveness of the drug "Allopurinol" reviews of doctors are the most revealing. Characteristics are subject to clinical effects and cases of combined medicinal organ damage. Due to the fact that the medicinal substance affects the course of biochemical reactions, its side effects should theoretically be significantly greater than that of receptor-dependent agents. However, Allopurinol is distinguished by a small number of clinically important side effects, and its therapeutic value is quite high.
The cure for gout "Allopurinol", reviews of which positively characterize its therapeutic value, is taken orally. The initial adult dose is 100 mg per day, and the drug should be taken in the case when an increase in the plasma concentration of uric acid above 500 µmol / L is reliably detected. The average daily dose is 300 mg. Available in the drug tablets solid dosage form.
Basic treatment of gout begins with an empirically prescribed dose. It is determined by the doctor based on the plasma and urinary concentrations of urate. In patients taking "Allopurinol" for gout, the reviews are mainly related to the regimen. It must be constant, and the changing dose may be made by the attending physician. Based on data on the concentration of uric acid after 1-3 weeks from the start of treatment, the dosage may undergo changes.
Special instructions when taking the drug
Drug "Allopurinol", instructions for use, reviews and clinical recommendations which confirm its effectiveness, has a number of special instructions for use. They are aimed at optimizing the uricostatic effect and achieving the result of prescribed therapy in the minimum allowable concentration. Also, the drug "Allopurinol", reviews of doctors about which prove the safety of the active ingredient, requires an explanation of the possible clinically important side effects. Theses of practical application are as follows:
- the drug is recommended to be used after meals, which somewhat reduces the likely risk of damage to the epithelium of the stomach;
- "Allopurinol" can not be taken by pregnant women during breastfeeding;
- Medication should be monitored by persons whose professional activity is related to controlling mechanisms or increased concentration of attention.
- The drug is not recommended for use in the treatment of children under 15 years old (the only exception is secondary gout when using cytotoxic drugs).
You also need to pay attention to the possible effects of joint use of the drug with other medicinal substances. Although patient reviews about Allopurinol medication suggest that it is safe and well tolerated, the likelihood of undesirable drug interactions is high.
Use in associated diseases and conditions
The reviews of experts on the drug Allopurinol illustrate its use in case of gout-related diseases. Theoretically, only kidney and liver diseases require abandoning the use of a drug or reducing its dosage. If you identify an allergy to additional components or the active ingredient of the drug, desensitization or refusal to use “Allopurinol” is required.
During pregnancy and breastfeeding the use of the drug is contraindicated. In case of renal insufficiency of different origin, complete cancellation is not required. The drug can be administered in doses that depend on the glomerular filtration rate. With creatinine clearance less than 20 ml / min, only 200 mg of the drug per day is allowed. For GFR less than 10 ml / min, only 100 mg of allopurinol is used per day. If a patient with gout is on dialysis, then the use of 200-400 mg per day on which the session was conducted is allowed.
Features of the liver metabolism of the drug
In case of liver diseases, the drug is not used only in the case of pronounced cytolysis syndrome, associated both with a medicinal lesion of the organ and with a toxic one. Considering that only 20% of Allopurinol is metabolized by liver cells, its use does not require a significant dose reduction. Its average value is 300 mg per day, although the amount of the drug used should decrease with a significant increase in markers of cytolysis in response to uricostatic therapy.
Joint pharmacological effects
The drug "Allopurinol", reviews of which indicate its high efficacy as a basic anti-gout drug, is characterized by numerous drug interactions. This in particular:
- the proven effect of increasing the duration of action of indirect anticoagulants (requires dose adjustment of the latter);
- substances of the salicylate group significantly reduce the effectiveness of "Allopurinol";
- uricosuric drugs weaken the effect of uricostatic substances;
- "Allopurinol" enhances the action of cystostatic drugs, provoking an increase in myelotoxic effect;
- "Mercaptopurin" and "Azathioprine" lead to a significant increase in the activity of "Allopurinol", provoke the effects of the accumulation of purines.
It is obvious that all the effects of interaction with drugs are not limited to the above. There are also experimental drugs that will soon be introduced into therapeutic practice. Therefore, the feedback on the use of the drug "Allopurinol EGIS" will be visual aids on side effects. The same is typical for drugs from other manufacturers.Moreover, the most complete information about the possible drug interactions and the use of a number of combined pathologies should be found out from your doctor.
Interaction "Allopurinol" and alcohol derivatives
In assessing the interaction of substances such as "Allopurinol" and alcohol, patient feedback is not indicative. They have no statistical significance and are subject to subjective attitude. At the same time, examples of the interaction of "Allopurinol" and alcohol in medical practice are not uncommon. Although their identification is difficult to interrupt the observation of the attending physician for the patient during remission of gout.
Regarding the drug "Allopurinol" instruction, reviews and reports of rheumatologists are very categorical. In particular, they contain instructions about the impossibility of the joint use of the drug and alcoholic beverages. Based on the data on toxic liver damage induced by Allopurinol and the proven hepatotropic effect of alcohol, it is logical to conclude that the damaging effect is enhanced when used together.
Proven effects of a combination of alcohol and drug
The drug "Allopurinol" with gout at a dosage of 300-600 mg per day mediates a slight damaging effect on the liver. However, with chronic alcohol intoxication, this effect is exacerbated and can manifest hepatic cytolysis syndrome. Therefore, the joint continuous use of these substances is unacceptable.
Information based on specific studies designed to prove the safety of occasional alcohol intake during treatment with Allopurinol is also not available. Therefore, during basic therapy, it is completely forbidden to take alcohol. Also, the rejection of its use is one of the basic requirements of a diet that is prescribed for gout. In case of violation of the diet, including associated with the consumption of alcohol, the frequency of exacerbations of gout increases significantly.
Allopurinol generic drugs: reviews of clinical use
Allopurinol is a medicinal substance that is included in a number of drugs. The latter are produced by more than ten companies under their trade names. Often in the state and commercial pharmacy network are Russian and Ukrainian generics, which are produced by Borschagovsky HFZ, Organika, JSC, Akrihin, JSCDanish company Nicomed and Hungarian EGIS.
About generics of the drug "Allopurinol" reviews of patients and doctors do not differ. The reason for this is the simple chemical structure of the drug and its simple synthesis. From the point of view of pharmacological production, this aspect is extremely important, because it allows you to minimize the number of by-products of the synthesis that have no therapeutic value. Therefore, the clinical efficacy of all drugs of allopurinol is about the same.
Generic Safety Feature
Similar is the safety of the drug "Allopurinol", reviews of patients about which very indicatively characterize its therapeutic properties. Since the same technologies are used in the manufacture of solid dosage forms by different companies, the preparations by different manufacturers cannot differ in their bioavailability, pharmacodynamics, or safety. And this thesis is confirmed by the analysis of the composition of the tablet "Allopurinol" specified in the accompanying instructions.