Posted on April 28th, 2009 by
Class: Supportive Care
Generic Name: allopurinol (al-oh-PYOOR-in-ol)
Trade Name: Aloprim®, Zyloprim®
For which conditions is this drug approved? Allopurinol is FDA approved for management of patients with leukemia, lymphoma, and cancers who are receiving cancer therapy that causes elevations of uric acid levels in association with tumor lysis syndrome.
What is the mechanism of action? Allopurinol works by reducing the formation of uric acid.
Tumor lysis syndrome (TLS) is the development of electrolyte and metabolic disturbances that may occur following the treatment of cancer and can result in life-threatening complications if not managed appropriately. TLS is caused by the sudden, rapid death of cells, particularly cancer cells in patients with leukemia or lymphoma, in response to cancer therapies. TLS may occur spontaneously, although this is uncommon. When cancer cells are killed by therapy, they spill their inner (intracellular) contents, which accumulate in the body faster than can be eliminated. These intracellular contents cause the metabolic and electrolyte disturbances that result in TLS. Hyperuricemia is a component of TLS and refers to excess uric acid in the blood. Uric acid is the end product of the digestion of certain proteins and is normally eliminated through the urine. When excess uric acid is present, it is converted to crystals formed of sodium urate. These crystals may deposit in the tiny tubes that are part of the kidney and cause acute kidney damage, which can ultimately lead to kidney failure.
How is allopurinol typically given (administered)? Allopurinol is usually given orally as a tablet, but also may be given intravenously (into a vein). Patients taking the oral tablet will take the tablet after a meal and with plenty of fluid. Patients may have an allergic-type reaction to treatment with allopurinol, although this is uncommon. Patients should tell their healthcare provider immediately at the first signs of a rash or other skin abnormalities, as more severe side effects may follow.
How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with allopurinol. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy. In addition, levels of electrolytes and products of metabolism will be measured frequently to monitor the possibility of developing TLS. Patients will also be monitored for allergic-type reactions that may occur with treatment with allopurinol, including skin abnormalities and liver dysfunction.
What are the most common side effects associated with treatment with allopurinol?
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
Are there any special precautions patients should be aware of before starting treatment?
When should patients notify their physician?
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
Last updated on 09/16.
Important Limitations of Use
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