Starting from scratch: Allopurinol prescribing for the non-adherent

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In print

Pharmacotherapy

Starting from scratch: Allopurinol prescribing for the non-adherent

1 March 2023

Leanne Te Karu

Wednesday 1 March 2023, 12:30 AM

Gout flares when initiating allopurinol are a common reason for people to fall into a stop-start cycle of administration [Asm Arif on Pexels]

Pharmacist prescriber Leanne Te Karu explains that repeat prescriptions for allopurinol sometimes require the same approach as for allopurinol naive people

Key points, In a person who has become non-adherent to allopurinol (even for one month), do not automatically restart at a previous dose – re-titration is require, Pract Green w Pale Yellow

Rheumatology

References

Yue TF, Gutman AB. Effect of allopurinol (4-hydroxypyrazolo-(3,4-d)pyrimidine) on serum and urinary uric acid in primary and secondary gout. Am J Med 1964;37:885–98.
Borstad GC, Bryant LR, Abel MP, et al. Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis. J Rheumatol 2004;31(12):2429–32.
Stamp LK, Taylor WJ, Jones PB, et al. Starting dose is a risk factor for allopurinol hypersensitivity syndrome: a proposed safe starting dose of allopurinol. Arthritis Rheum 2012;64(8):2529–36.
Medsafe. Re-ad-DRESS-ing the risk of DRESS with cautious titration. Prescriber Update 2022;43(3):38–40.

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