中文通用名称: 别嘌醇
英文通用名称: Allopurinol
其 它 名 称: 异嘌呤醇,痛风立克,痛风宁,痛风平,赛洛克,赛来力,赛洛力,全嘌呤,华风痛,柴罗列克,别嘌呤,别嘌呤醇,Zyloprim,Zyloric,Valeric,Milurit,Lopurim,Lopurin,Isopurinol,Adenock,Anzief,维洛林,路必利,Lupuric,Progout,别嘌醇片,ALLOPURINOL Tablets,Aloprim,别嘌呤醇片,Allopurinol SR Microgranules,Lopuric,别嘌醇缓释片,别嘌醇颗粒,奥迈必利,别嘌醇缓释胶囊,易达通,Allopurinol Sustained Release Capsules,Allopurinol Sustained Release Tablets
产 品 分 类: 西药\代谢及内分泌系统用药\抗痛风药\其它抗痛风药
适应症
1.原发性和继发性高尿酸血症,尤其是尿酸生成过多者,也用于伴有肾功能不全的高尿酸血症。
2.用于治疗痛风,适合于反复发作或慢性痛风患者。
用法用量
成人
·常规剂量
·口服给药
1.痛风:初始剂量50mg,一日1-2次,一周可递增50-100mg,至一日200-300mg,分2-3次服,或一次300mg,一日1次。每2周测血液和尿液的尿酸水平,如已达正常水平,则不再增量,如测定值仍高,可再增加剂量。一日最大用量不宜超过600mg。
2.尿酸结石:一次100-200mg,一日1-4次。或者一次300mg,一日1次。
·肾功能不全时剂量
肌酐清除率为10-20ml/min时,一日用量为200mg;为3-10ml/min时,为100mg;低于3ml/min时,用量为一次100mg,给药间隔至少24小时。
儿童
·常规剂量
·口服给药继发性高尿酸血症:
(1)6岁以下儿童,一次50mg,一日1-3次。
(2)6-10岁儿童,一次100mg,一日1-3次;或一次300mg,一日1次。给药48小时后,根据病人反应调整用量。
给药说明
1.本药对痛风急性发作无效,必须在痛风性关节炎的急性炎症症状消失后(一般在发作后两周左右)方开始应用。痛风急性期服用,会造成尿酸结晶迁延和痛风性关节炎持续。
2.本药必须由小剂量开始,逐渐递增至有效量维持正常血尿酸和尿尿酸水平,以后逐渐减量,用最小有效量维持较长时间。
3.服药期间应大量饮水,并维持尿液呈中性或弱碱性,以降低黄嘌呤结石及肾脏内尿酸沉积的风险。
4.在治疗的最初几个月内,痛风的急性发作可能更频繁,因此应同时服用预防量的秋水仙碱;而在用本药治疗期间出现痛风急性发作时,应及时给予足量的秋水仙碱。
5.本药用于血尿酸和24小时尿尿酸过多,或有痛风石或泌尿系结石,以及不宜用排尿酸药者。当从排尿酸药换成本药时,排尿酸药的用量应在数周内逐渐减少,本药用量逐渐增多,直到能维持正常血尿酸浓度。
6.本药有致眩晕的危险,用药期间不宜驾车及操作机器。
7.用药期间出现任何血液系统不良反应时,均应考虑停药。
8.如皮疹广泛而持久,经对症处理无效并有加重趋势时,必须停药。
不良反应
1.过敏反应皮疹发生率为3%-10%,可呈瘙痒性丘疹或荨麻疹,也可为水疱性反应等。尚可见过敏性血管炎,极罕见剥脱性皮炎和表皮坏死(Lyell综合征)。严重者可出现全身过敏性反应,甚至可导致死亡。
2.血液可有白细胞、血小板减少及贫血,甚至全血细胞减少。
3.胃肠道可有恶心、呕吐、腹泻、腹痛、食欲减退、口腔溃疡等,发生率为1%-3%。
4.肝脏可有血氨基转移酶升高,可引起肝肉芽肿形成伴胆囊炎、胆管周围炎、过敏性肝坏死等,甚至出现肝功能衰竭。
5.泌尿生殖系统可见肌酐清除率降低及少尿,可出现间质性肾炎,甚至发生进行性肾衰竭。长期用药可出现黄嘌呤肾病或结石。
6.代谢/内分泌系统可出现糖耐量减低(或出现糖尿病症状)。在治疗期间,从肌肉活检中发现次黄嘌呤、黄嘌呤及羟嘌呤醇结晶,临床上出现肌肉疼痛(这种情况并不多见,而且存在有诱因或肾脏疾病)。
7.神经系统常见头痛、头晕,罕见手脚麻木感、疼痛(如刺痛)、乏力等,停药后则恢复。
8.其它可有脱发、发热、淋巴结肿大等,有导致白内障的报道。国外曾报道数例患者在服用本药期间发生原因未明的突然死亡。
注意事项
1.禁忌症
(1)对本药过敏者。
(2)严重肝肾功能不全。
(3)明显血细胞低下者。
(4)孕妇。
(5)哺乳期妇女。
2.慎用
(1)肝、肾功能不全者。
(2)有特发性血色素沉积症病史者(国外资料)。
(3)有骨髓抑制者(国外资料)。
3.药物对老人的影响老年人应谨慎用药,并应减少用量。
4.药物对妊娠的影响孕妇禁用本药,美国药品和食品管理局(FDA)对本药的妊娠安全性分级为C级。
5.药物对哺乳的影响本药及氧嘌呤醇都可分泌入乳汁中,哺乳期妇女禁用。。
6.用药前后及用药时应当检查或监测用药期间应定期检查血常规、肝肾功能以及血尿酸及24小时尿尿酸水平。
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原产地英文商品名:
ZYLOPRIM(Known as Aloprim) 300mg/Tab 100Tabs/bottle
原产地英文药品名:
ALLOPURINOL
中文参考商品译名:
ZYLOPRIM(相当于Aloprim)300毫克/片 100片/瓶
中文参考化合物名称:
别嘌醇
生产厂家中文参考译名:
PROMETHEUS LABS
生产厂家英文名:
PROMETHEUS LABS
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原产地英文商品名:
ZYLOPRIM(Known as Aloprim) 100mg/Tab 100Tabs/bottle
原产地英文药品名:
ALLOPURINOL
中文参考商品译名:
ZYLOPRIM(相当于Aloprim)100毫克/片 100片/瓶
中文参考药品译名:
别嘌醇
生产厂家中文参考译名:
PROMETHEUS LABS
生产厂家英文名:
PROMETHEUS LABS
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原产地英文商品名:
ALLOPURINOL 300mg/tab 30Tablets/bottle
原产地英文药品名:
ALLOPURINOL
中文参考商品译名:
别嘌醇 300毫克/片 30片/瓶
中文参考药品译名:
别嘌醇
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原产地英文商品名:
ALLOPURINOL 100mg/tab 30Tablets/bottle
原产地英文药品名:
ALLOPURINOL
中文参考商品译名:
别嘌醇 100毫克/片 30片/瓶
中文参考药品译名:
别嘌醇
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BRAND NAME: Zyloprim, Aloprim
DRUG CLASS AND MECHANISM: Allopurinol is used for treating gout caused by excessive levels of uric acid in the blood (hyperuricemia). Uric acid is a by product from the breakdown of certain proteins (purines) in the body. Hyperuricemia occurs when the body produces more uric acid than it can eliminate. The uric acid forms crystals in joints (gouty arthritis) and tissues, causing inflammation and pain. Elevated blood uric acid levels also can cause kidney disease and stones. Allopurinol prevents the production of uric acid by blocking the activity of the enzyme that converts purines to uric acid. Uric acid levels usually begin to fall within 2-3 days of starting treatment and return to their original levels within 7-10 days after allopurinol is stopped. It may take several months of therapy before attacks of gout are controlled. The FDA approved allopurinol prior to 1982.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 100, 300 mg; Powder for injection: 500 mg
STORAGE: Tablets should be stored at room temperature between 15 to 25 C (59-77 F) and in a moisture proof, light- resistant container. Powder should be stored between 20 and 25 C (68-77 F) and not refrigerated.
PRESCRIBED FOR: Allopurinol is used for treating acute attacks of gout, erosive destructive gouty joint disease, uric acid deposits in tissues (tophi), gouty kidney disease, and uric acid stones. Allopurinol also is used to prevent elevation of blood uric acid in patients undergoing chemotherapy for the treatment of certain cancers and in patients with recurrent calcium kidney stones and elevated uric acid levels.
DOSING: The dose range of allopurinol is 100-800 mg day. It should be taken with food to avoid irritation of the stomach. In order to avoid formation of kidney stones, patients should drink plenty of fluids while taking allopurinol.
DRUG INTERACTIONS: Allopurinol increases blood levels of oral mercaptopurine (Purinethol) and azathioprine (Imuran) by reducing their breakdown in the body. Therefore, the dose of mercaptopurine and azathioprine should be reduced in order to avoid toxicity. There is an increased risk of skin rash in patients taking allopurinol in combination with penicillins.
PREGNANCY: There are no adequate studies of allopurinol in pregnant women.
NURSING MOTHERS: Allopurinol is excreted in breast milk. To avoid adverse effects in the infant, nursing mothers taking allopurinol should consider not breastfeeding.
SIDE EFFECTS: Common reactions include diarrhea, nausea, rash and itching, and drowsiness. The most frequent side effect to allopurinol is skin rash. Allopurinol should be discontinued immediately at the first appearance of rash, painful urination, blood in the urine, eye irritation, or swelling of the mouth or lips, because these can be a signs of an impending severe allergic reaction that can be fatal. Allopurinol should be avoided by patients with a prior severe reaction to the drug. Allopurinol can cause a flare-up of gouty arthritis during initial therapy. Therefore, colchicine often is used simultaneously to prevent these flares.
Rarely, allopurinol can cause nerve, kidney, and bone marrow damage. Allopurinol can cause a serious allergic liver toxicity that can be fatal. Appetite loss and itching can be signs of liver toxicity. The risk of this reaction increases in patients with kidney impairment. Patients with kidney impairment should receive lower doses of allopurinol.