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Allopurinol Interactions and Toxicities

  • Hypersensitivity
  • Decrease dose with renal insufficiency
  • Interaction w/ Dicumarol (prolonged PT)
  • Thiazide diruretics (increased allopurinol toxicity)
  • Ampicillin/amoxicillin (skin rashes)
  • Chlorpropamide (increased hypoglycemia)
  • Cyclophosphamide and other cytotoxic agents (bone marrow suppression);
  • the allopurinol hypersensitivity syndrome is characterized by fever, eosinophilia, leukocytosis, impaired renal function, hepatocellular injury and rash;
  • these reactions are severe and may be fatal;
  • allopurinol should be used carefully with those w/ renal insufficiency, a h/o uric acid stones and those with a 24 hour urinary acid excretion over 1,100 mg