Allopurinol pills 100 mg 50 pcs
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Active ingredients
Allopurinol
Release form
Pills
Composition
on 1 tablet: Active substances: allopurinol - 100 mg. Auxiliary substances: lactose monohydrate - 50 mg, potato starch - 32 mg, povidone K25 - 6.5 mg, talc - 6 mg, magnesium stearate - 3 mg, sodium carboxymethyl starch (type A) - 2.5 mg.
Pharmacological effect
Allopurinol is a structural analogue of hypoxanthine. Allopurinol, as well as its main active metabolite, oxypurinol, inhibits xanthine oxidase, an enzyme that converts hypoxanthin to xanthine, and xanthine to uric acid. Allopurinol reduces the concentration of uric acid in the serum and in the urine. Thus, it prevents the deposition of uric acid crystals in the tissues and (or) contributes to their dissolution. In addition to suppressing the catabolism of purines in some (but not all) patients with hyperuricemia, a large amount of xanthine and hypoxanthine becomes available for the re-formation of purine bases, which leads to a de novo suppression of purine biosynthesis, which is mediated by inhibition of the hypoxanthine-guanine phosphoribosyl enzyme -transferase. Other metabolites of allopurinol are allopurinol-riboside and oxypurinol-7 riboside.
Pharmacokinetics
Absorption Allopurinol is active when taken orally. It is rapidly absorbed from the upper GI tract. According to pharmacokinetic studies, allopurinol is determined in the blood within 30-60 minutes after administration. The bioavailability of allopurinol varies from 67% to 90%. Cmax drug in the blood plasma is usually recorded approximately 1.5 hours after oral administration. Then the concentration of allopurinol rapidly decreases. After 6 h after administration, only the trace concentration of the drug is determined in the blood plasma. Cmax of the active metabolite, oxypurinol, is usually recorded 3-5 hours after oral administration of allopurinol. The level of oxypurinol in plasma decreases much more slowly. Distribution Allopurinol almost does not bind to plasma proteins, so changes in the level of protein binding should not have a significant effect on the clearance of the drug. The apparent Vd of allopurinol is approximately 1.6 l / kg, which indicates a fairly pronounced absorption of the drug into tissues.The content of allopurinol in various human tissues has not been studied, but it is highly likely that allopurinol and oxypurinol accumulate in maximum concentration in the liver and intestinal mucosa, where high xanthine oxidase activity is detected. Oxypurinol inhibits the activity of xanthine oxidase. However, oxypurinol is not a powerful inhibitor of xanthine oxidase, compared with allopurinol, but its T1 / 2 is much higher. Due to these properties, after taking a single daily dose of allopurinol, effective suppression of the activity of xanthine oxidase is maintained for 24 hours. In patients with normal kidney function, the content of oxypurinol in the blood plasma increases slowly until Css is reached. After taking allopurinol in a dose of 300 mg / day, the concentration of allopurinol in the blood plasma, as a rule, is 5-10 mg / l. Other allopurinol metabolites include allopurinol-riboside and oxipurinol-7-riboside. Withdrawal Approximately 20% of allopurinol taken per os is excreted in feces unchanged. About 10% of the daily dose is excreted by the glomerular apparatus of the kidney as unchanged allopurinol. Another 70% of the daily dose of allopurinol is excreted in the urine in the form of oxypurinol. Oxypurinol is excreted by the kidneys in unchanged form, however, due to tubular reabsorption, it has a long T1 / 2. T1 / 2 of allopurinol is 1-2 hours, while T1 / 2 of oxypurinol varies from 13 to 30 hours. Such significant differences are probably due to differences in the structure of studies and / or creatinine clearance in patients. Patients with impaired renal function In patients with impaired renal function, excretion of allopurinol and oxypurinol can slow down significantly, which with prolonged therapy leads to an increase in the concentration of these compounds in the blood plasma. In patients with impaired renal function and CC 10-20 ml / min after long-term therapy with allopurinol at a dose of 300 mg / day, the concentration of oxypurinol in the blood plasma reached approximately 30 mg / l. Such a concentration of oxypurinol can be determined in patients with normal renal function during therapy with allopurinol in a dose of 600 mg / day.Therefore, in the treatment of patients with impaired renal function, the dose of allopurinol should be reduced. Older patients In elderly patients, significant changes in the pharmacokinetic properties of allopurinol are unlikely. The exception is patients with comorbid pathology of the kidneys (see Pharmacokinetics section in patients with impaired renal function).
Indications
Suppression of the formation of uric acid and its salts with confirmed accumulation of these compounds (for example, gout, skin tophus, nephrolithiasis) or the perceived clinical risk of their accumulation (for example, treatment of malignant neoplasms may be complicated by the development of acute uric acid nephropathy). accumulation of uric acid and its salts, include: - idiopathic gout; - urolithiasis (formation of uric acid calculi); - acute uric acid nephros ropathy; - tumor diseases and myeloproliferative syndrome with a high rate of cell population renewal when hyperuricemia occurs spontaneously or after performing cytotoxic therapy; - certain enzymatic disorders accompanied by hyperproduction of uric acid salts, for example, reduced hypoxanthine-guanine-phosphoribosyltransferase syndrome (including Naihan), decreased glucose-6-phosphatase activity (including glycogenoses), increased phosphoribosyl-pyrophosphate synthetase activity, Reduced activity of phosphoribosyl-pyrophosphate-amido-transferase, reduced activity of adenine-phosphoribosyltransferase. Treatment of urolithiasis, accompanied by the formation of 2,8-dihydroxyadenine (2,8-DHA) calculi due to adenine-phosphoribosyltransferase, 2.8-DHA) calculi due to adenine-phosphoribosyltransferase, 2.8-DHA) calculi due to adenine-phosphoribosyltransferase, 2.8-DHA) calculi due to adenine-phosphoribosyltransferase, 2.8-DGA accompanied by the formation of mixed calcium-oxalate stones on the background of hyperuricuria, when diet and increased fluid intake were unsuccessful.
Contraindications
- hypersensitivity to allopurinol or any of the excipients that make up the drug; - liver failure; - chronic renal failure (azotemia stage); - primary hemochromatosis; - asymptomatic hyperuricemia; - acute gout attack; - children up to 3 years old ( taking into account the solid dosage form); - pregnancy, breastfeeding period (seesection Use during pregnancy and breastfeeding). — Patients with rare hereditary diseases such as galactose intolerance, lactase deficiency or glucose-galactose malabsorption should not take the drug (lactose monohydrate is part of the drug). With caution: abnormal liver function, hypothyroidism , diabetes mellitus, arterial hypertension, concomitant use of ACE inhibitors or diuretics, children's age (up to 15 years old is prescribed only during cytostatic therapy of leukemia and other cancers diseases, as well as symptomatic treatment of enzyme disorders), old age.
Use during pregnancy and lactation
Pregnancy Currently, there are insufficient data on the safety of therapy with allopurinol during pregnancy, although this drug has been widely used for a long time without obvious adverse effects. Pregnant women should not take Allopurinol-Egis pills, except when there is no less dangerous alternative treatment and the disease poses a greater risk for the mother and fetus than taking the drug. Breastfeeding periodAccording to existing reports, allopurinol and oxypurinol are excreted in breast milk. In women taking allopurinol in a dose of 300 mg / day, the concentration of allopurinol and oxypurinol in breast milk reached, respectively, 1.4 mg / l and 53.7 mg / l. However, there is no information on the effect of allopurinol and its metabolites on breastfed infants. Thus, Allopurinol-Egis pills are not recommended during breastfeeding.
Dosage and administration
Inside The drug should be taken 1 time / day after meals, drinking plenty of water. If the daily dose exceeds 300 mg or there are symptoms of intolerance from the gastrointestinal tract, then the dose should be divided into several doses. Adult patients In order to reduce the risk of side effects, it is recommended to use allopurinol in the initial dose of 100 mg 1 time / day. If this dose is not enough to properly reduce the concentration of uric acid in the serum, then the daily dose of the drug can be gradually increased to achieve the desired effect.Special care should be taken when kidney function is impaired. With an increase in the dose of allopurinol every 1-3 weeks, it is necessary to determine the concentration of uric acid in the blood serum. When dosing the drug, it is recommended to use the following dosing regimens (depending on the selected dosing regimen, 100 mg or 300 mg pills are recommended). The recommended dose is: 100 - 200 mg / day for mild disease; 300-600 mg / day for moderate flow; 700-900 mg / day for severe course. If based on the patient's body weight, the dose of allopurinol should be from 2 to 10 mg / kg / day. Children and adolescents under 15 years old Recommended dose for children with 3 up to 10 years: 5-10 mg / kg / day. For low doses, 100 mg pills are used, which with the help of the risks can be divided into two equal doses of 50 mg. The recommended dose for children from 10 to 15 years is 10-20 mg / kg / day. The daily dose of the drug should not exceed 400 mg. Allopurinol is rarely used for pediatric therapy. Exceptions are malignant oncological diseases (especially leukemia) and some enzymatic disorders (for example, Lesch-Nyhan syndrome). Elderly patientsSince there are no special data on the use of allopurinol in the elderly population, the minimum dose should be used to treat these patients, ensuring sufficient reduction serum uric acid concentration. Particular attention should be paid to recommendations on the selection of a dose of the drug for patients with impaired renal function (see Special Instructions section). Renal dysfunctions As allopurinol and its metabolites are excreted by the kidneys, impaired renal function can lead to a delay of the drug and its metabolites in the body, followed lengthening the half-life of these compounds from plasma. In severe renal insufficiency, it is recommended to use allopurinol in a dose below 100 mg / day, or use single doses of 100 mg with an interval of more than one day. If conditions allow you to control the concentration of oxypurinol in the blood plasma, then the dose of allopurinol should be adjusted so that The blood plasma was below 100 µmol / L (15.2 mg / L). Allopurinol and its derivatives are removed from the body by hemodialysis.If hemodialysis sessions are held 2-3 times a week, then it is advisable to determine the need to switch to an alternative therapy regimen - receiving 300-400 mg of allopurinol immediately after completing the hemodialysis session (the drug is not taken between hemodialysis sessions). In patients with impaired renal function, combination of allopurinol with Thiazide diuretics should be carried out with extreme caution. Allopurinol should be prescribed in the lowest effective doses with careful monitoring of renal function (see the section on Interaction with Other Drugs). Liver Disorders In the event of impaired liver function, the dose of the drug should be reduced. In the early stage of therapy, it is recommended to monitor the laboratory parameters of liver function. Conditions accompanied by increased exchange of uric acid salts (eg, tumor diseases, Lesch-Nyhan syndrome) Before starting therapy with cytotoxic drugs, it is recommended to correct existing hyperuricemia and / or hyperuricuria with allopurinol. Adequate hydration is of great importance, contributing to the maintenance of optimal diuresis, as well as alkalinization of urine, due to which the solubility of uric acid and its salts increases. The dose of allopurinol should be close to the lower limit of the recommended dose range. If renal dysfunction is caused by the development of acute uric acid nephropathy or other renal pathology, treatment should be continued in accordance with the recommendations provided in the section Kidney dysfunction. The described measures can reduce the risk of xanthine accumulation and uric acid, complicating the course of the disease. Recommendations for monitoring To adjust the dose of the drug, it is necessary to estimate the concentration of salt at optimal intervals her uric acid in the serum, as well as the level of uric acid and urate urine.
Side effects
There are no current clinical data to determine the incidence of side effects. Their frequency may vary depending on the dose and on whether the drug was administered as monotherapy or in combination with other drugs. The classification of the incidence of side effects is based on an approximate assessmentfor most side effects there is no data to determine the frequency of their development. The classification of unwanted reactions depending on the frequency of occurrence is as follows: very frequent (≥1 / 10), frequent (from ≥1 / 100 to <1/10), infrequent (from ≥1 / 1000 to <1/100), rare (≥1 / 10 000 to <1/1000), very rare (<1/10 000), frequency unknown (impossible to determine based on available data). Observed in post-registration During the period, adverse reactions associated with allopurinol therapy are rare or very rare. In the general population of patients in most cases are easy. The incidence of adverse events increases with impaired renal function and / or liver. Infections and parasitic diseases: very rare: furunculosis. Disorders of the blood system and lymphatic system: very rare - agranulocytosis, aplastic anemia, thrombocytopenia, granulocytosis, leukopenia, leukocytosis eosinophilia and aplasia, relating only to red blood cells; very rarely were reports of thrombocytopenia, agranulocytosis and aplastic anemia, especially in people with impaired renal and / or liver function, which emphasizes the need for special caution in these groups of patients. Disorders of the immune system: infrequent - hypersensitivity reactions; rare - severe hypersensitivity reactions, including skin reactions with epidermis detachment, fever, lymphadenopathy, arthralgia and (or) eosinophilia (including Stevens-Johnson syndrome and toxic epidermal necrolysis) (see the section on skin and subcutaneous tissue disorders) . Concomitant vasculitis or tissue reactions can have various manifestations, including hepatitis, kidney damage, acute cholangitis, xanthine stones and, in very rare cases, seizures. In addition, the development of anaphylactic shock was very rarely observed. With the development of severe adverse reactions, allopurinol therapy should be immediately stopped and not resumed. With delayed multiorgan hypersensitivity (known as drug hypersensitivity syndrome / DRESS /), the following symptoms may develop in various combinations: fever, skin rash, vasculitis, lymphadenopathy, pseudolymphoma, arthralgia, leukopenia, eosinophilia, hepato-splenomegaly, changes in the effects of sephagia, cramping, changes in the effects of the masters. disappearing bile ducts (destruction or disappearance of intrahepatic bile ducts).With the development of such reactions during any period of treatment, Allopurinol-Egis should be immediately canceled and never renewed. Generalized hypersensitivity reactions developed in patients with impaired renal function and (or) liver. Such cases have sometimes been fatal; very rare - angioimmunoblastic lymphadenopathy. Angioimmunoblastic lymphadenopathy is very rarely diagnosed after a biopsy of the lymph nodes for generalized lymphadenopathy. Angioimmunoblastic lymphadenopathy is reversible and regresses after cessation of allopurinol therapy. Metabolism and nutrition disorders: very rare - diabetes mellitus, hyperlipidemia. Mental disorders: very rare - depression. Nervous system disorders: very rare - coma, paralysis, ataxia , neuropathy, paresthesia, drowsiness, headache, taste perversion. Violations on the part of the organ of vision: very rare - cataract, visual disturbances, macular changes. Violations on the part of the organ of the ha and labyrinth disorders: very rare - dizziness (vertigo). Heart disorders: very rare - angina, bradycardia. Disorders from the vessels: very rare - increase in blood pressure. Disorders from the gastrointestinal tract: infrequent - vomiting, nausea, diarrhea. In earlier clinical studies, nausea and vomiting were observed, however, later observations confirmed that these reactions are not a clinically significant problem and can be avoided by prescribing allopurinol after a meal; very rare - recurrent bloody vomiting, steatorrhea, stomatitis, changes in the frequency of bowel movements; frequency unknown - abdominal pain. Violations of the liver and biliary tract: infrequent - asymptomatic increase in the concentration of liver enzymes (elevated levels of alkaline phosphatase and transaminases in serum); rare - hepatitis (including necrotic and granulomatous forms). Violations of the liver function can develop without obvious signs of generalized hypersensitivity. Violations of the skin and subcutaneous tissues: frequent - rash; rare - severe skin reactions: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEH); very rare - angioedema, local medical rash, alopecia, hair discoloration. In patients taking allopurinol, the most common adverse reactions from the skin. Against the background of drug therapy, these reactions can develop at any time.Skin reactions can occur with itching, maculopapular and scaly rashes. In other cases, purpura may develop. In rare cases, an exfoliative skin lesion is observed (SSD / TEN). With the development of such reactions, therapy with allopurinol must be stopped immediately. If the skin reaction is mild, then after the disappearance of these changes, you can resume taking allopurinol in a lower dose (for example, 50 mg / day). Subsequently, the dose can be gradually increased. When skin reactions recur, allopurinol should be stopped and no longer resumed, because further administration of the drug may lead to more severe hypersensitivity reactions (see Immune system disorders). According to the existing information, during treatment with allopurinol, angioneurotic edema developed in isolation, as well as in conjunction with the symptoms of a generalized hypersensitivity reaction. Disorders of the musculoskeletal and connective tissues: very rare - myalgia. Violation kidney and urinary tract: very rare - hematuria, renal failure, uremia; frequency is unknown - urolithiasis. Disorders of the reproductive system and breast: very rare - male infertility, erectile dysfunction, gynecomastia. General disorders and disorders at the injection site: very rare - edema, general malaise, general weakness, fever. According to existing According to allopurinol therapy, fever developed both in isolation and in combination with symptoms of a generalized hypersensitivity reaction (see Disorders of the immune system). reaktsiyahV possible adverse event of adverse reactions, including not indicated in this manual, the use of the drug should be discontinued. In the post-registration period, any information on possible adverse reactions is important, as these messages help to constantly monitor the safety of the drug. Health officials are required to report any suspicion of adverse reactions to local pharmacovigilance authorities.
Overdose
Symptoms: nausea, vomiting, diarrhea and dizziness.Severe allopurinol overdose can lead to significant inhibition of xanthine oxidase activity. By itself, this effect should not be accompanied by undesirable reactions. An exception is the effect on concomitant therapy, especially on treatment with 6-mercaptopurine and (or) azathioprine. Treatment: the specific antidote of allopurinol is unknown. Adequate hydration, supporting optimal diuresis, promotes the removal of allopurinol and its derivatives with urine. If clinically indicated, hemodialysis is performed.
Interaction with other drugs
6-mercaptopurine and azathioprine Asathioprine is metabolized to form 6-mercaptopurine, which is inactivated by the enzyme xanthine oxidase. In cases where 6-mercaptopurine or azathioprine is combined with allopurinol, patients should be given only one-fourth of the usual dose of 6-mercaptopurine or azathioprine, since the inhibition of xanthine oxidase activity increases the duration of action of these compounds. Vidarabina increases. With the simultaneous use of these drugs, you must be especially wary of the increased toxic effects of therapy. Salicylates and uricosuric drugs. The main active metabolite of allopurinol is oxypurinol, which is excreted by the kidneys like uric acid salts. Therefore, drugs with uricosuric activity, such as probenecid or high doses of salicylates, can enhance the elimination of oxypurinol. In turn, enhanced excretion of oxypurinol is accompanied by a decrease in the therapeutic activity of allopurinol, however, the importance of this type of interaction must be assessed individually in each case. and chlorpropamide compete with each other. Anti-coagulants coumarin derivatives When applied simultaneously With allopurinol, the effects of warfarin and other anticoagulants on coumarin derivatives were enhanced.In this regard, it is necessary to carefully monitor the condition of patients receiving concomitant therapy with these drugs. PhenytoinAllopurinol can suppress the oxidation of phenytoin in the liver, but the clinical significance of this interaction has not been established. TheophyllineIt is known that allopurinol inhibits theophylline metabolism. Such an interaction can be explained by the participation of xanthine oxidase in the theophylline biotransformation process in the human body. Serum theophylline concentration should be monitored at the beginning of concomitant therapy with allopurinol, as well as increasing the dose of the latter. Ampicillin and amoxicillin In patients who simultaneously received ampicillin or amoxicillin and allopurinol, an increased incidence of skin reactions was recorded, compared with patients who did not receive similar concomitant therapy. The cause of this type of drug interaction has not been established. Nevertheless, patients receiving allopurinol, instead of ampicillin and amoxycillin recommended to assign preparaty.Tsitotoksicheskie other antibacterial drugs (cyclophosphamide, doxorubicin, bleomycin, procarbazine, mechlorethamine) In patients suffering from neoplastic diseases (except the leukemia) and receiving allopurinol, observed enhanced suppression activity of the bone marrow cyclophosphamide and other cytotoxic drugs. However, according to the results of controlled studies, in which patients receiving cyclophosphamide, doxorubicin, bleomycin, procarbazine, and (or) mechlorethamine (chlormethine hydrochloride) took part, concomitant therapy with allopurinol did not increase the toxic effect of these cytotoxic drugs. in blood plasma may increase due to concomitant therapy with allopurinol. With the simultaneous use of these drugs, it is necessary to take into account the possibility of increasing the toxicity of cyclosporine. Didanosine in healthy volunteers and HIV-infected patients receiving didanosine, amid concomitant therapy with allopurinol (300 mg / day), showed an increase in Cmax and AUC of didanosine by about 2 times. T1 / 2 didanosine did not change.As a rule, the simultaneous use of these drugs is not recommended. If concomitant therapy is unavoidable, it may be necessary to reduce the dose of didanosine and carefully monitor the patient's condition. APFO inhibitors: simultaneous use of ACE inhibitors with allopurinol is associated with an increased risk of leukopenia, so these drugs should be combined with caution. Thiazide diuretics Simultaneous use of thiazide diuretics, including and hydrochlorothiazide, may increase the risk of side effects of hypersensitivity associated with allopurinol, especially in patients with impaired renal function.
special instructions
Syndrome drug hypersensitivity, SJS and TENN against the background of the use of allopurinol, there have been reports of the development of life-threatening reactions from the skin, such as Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS / TEN). Patients should be informed about the symptoms of these reactions (progressive skin rash, often with blisters and mucosal lesions) and carefully monitor their development. The most common SSD / TEN develop in the first weeks of taking the drug. If there are signs and symptoms of SSD / TEN, Allopurinol-Egis should be immediately canceled and no longer prescribed! The manifestation of hypersensitivity reactions to allopurinol can be very different, including maculopapular exanthema, drug hypersensitivity syndrome (DRESS) and SJS / TEN. These reactions are the clinical diagnosis and their clinical manifestations serve as the basis for making appropriate decisions. Therapy with Allopurinol-Egis should be immediately discontinued when a skin rash or other manifestations of a hypersensitivity reaction appear. It is impossible to resume therapy in patients with hypersensitivity syndrome and SJS / TEN. Corticosteroids can be used to treat skin reactions with hypersensitivity. Chronic renal dysfunction Patients with chronic renal dysfunction have a greater risk of developing hypersensitivity reactions associated with allopurinol, including and SSD / TEN.Allel HLA-B * 5801 It was established that the presence of the HLA-B * 5801 allele is associated with the development of hypersensitivity to allopurinol and SSD / TEN.The frequency of the presence of the HLA-B * 5801 allele is different in different ethnic groups and can reach 20% in the Han Chinese population, about 12% in Koreans and 1-2% in Japanese and Europeans. The use of genotyping for making decisions about allopurinol therapy has not been studied. If it is known that the patient is a carrier of the HLA-B * 5801 allele, then allopurinol should be prescribed only if the benefit of the treatment exceeds the risk. It should be very closely monitor the development of hypersensitivity syndrome and SJS / TEN. The patient should be informed of the need to immediately discontinue treatment at the first appearance of such symptoms. Violation of the liver and kidneys When treating patients with impaired renal or hepatic function, the dose of allopurinol should be reduced. Patients receiving treatment for hypertension or heart failure (for example, patients taking diuretics or ACE inhibitors) may have a concomitant renal dysfunction, so allopurinol in this group of patients should be used with caution. Asymptomatic hyperuricemia itself is not an indication to the use of allopurinol. In such cases, an improvement in the patient's condition can be achieved due to changes in diet and fluid intake, along with the elimination of the underlying cause of hyperuricemia. treatment with allopurinol can trigger an acute attack of gout. In order to avoid this complication, it is recommended to carry out prophylactic therapy with nonsteroidal anti-inflammatory drugs or colchicine for at least one month before the appointment of allopurinol. Detailed information about the recommended doses, cautions and precautions can be found in the relevant literature. If an acute attack of gout develops during therapy with allopurinol, then the drug should be continued in the same dose, and for the treatment of an attack it is necessary to prescribe a suitable non-steroidal anti-inflammatory agent. ,when the formation of uric acid is significantly enhanced (for example, malignant tumor pathology and appropriate antitumor therapy, Lesch-Nyhan syndrome), the absolute concentration of xanthine in the urine in rare cases can increase significantly, which contributes to the deposition of xanthine in the tissues of the urinary tract. The probability of xanthine deposition in tissues can be minimized due to adequate hydration, which ensures optimal dilution of urine. Concretion of uric acid stones Adequate therapy with allopurinol can lead to the dissolution of large stones in uric acid in ureteric stones, the likelihood of penetration of ureteral stones in the renal pelvis to the urethra, however, the likelihood of the ureters in the urethral canals to dissolve large urethral stones from uric acid in the ureters, the likelihood of closure of ureterol in ureteromas can lead to the clumps of uric acid in uric acid. The effect of allopurinol in the treatment of gout is to suppress the activity of the enzyme xanthine oxidase. Xanthine oxidase may be involved in the reduction and elimination of iron deposited in the liver. There are no studies demonstrating the safety of allopurinol therapy in the population of hemochromatosis. Patients with hemochromatosis, as well as their blood relatives, allopurinol should be prescribed with caution. LactoseEach 100 mg tablet of Allopurinol-Egis contains 50 mg of lactose. Consequently, this drug should not be taken by patients with rare hereditary intolerance to galactose, lactase deficiency, and malabsorption syndrome of glucose and galactose. Ability to drive vehicles Against the background of allopurinol therapy, the development of such undesirable reactions as drowsiness, dizziness (vertigo) and ataxia was observed. These adverse effects may affect the ability to