It can also happen if allopurinol is stopped suddenly for a few days and then restarted at the same dose as before. Carnovale  RM, This helps prevent joints becoming swollen and painful. A unique drug-injury relief system in Taiwan: comparing drug-injury compensation in different countries. Methods

Thus, even though there are guidelines to prevent this from … Extra vigilance for the signs of hypersensitivity syndrome or SJS/TEN is required and the patient should be informed of the need to stop treatment immediately and permanently at the first appearance of symptoms (see section 4.8)The HLA-B*5801 allele has been shown to be associated with the risk of developing allopurinol related hypersensitivity syndrome and SJS/TEN. presence of the HLA-B*58:01 allele, most commonly found in patients of Asian  PP, Goicoechea  et al; American College of Rheumatology.  M, There is not enough evidence to say that it's safe.Talk to a doctor if you're thinking about trying for a baby. Clinical Utility Allopurinol hypersensitivity is strongly associated with the presence of the HLA-B*58:01 allele, most commonly found in patients of Asian and African ancestry. It causes flu-like symptoms, followed by a red or purple rash that spreads and forms blisters.  JY.  WH, Chang Málek  WJ, Jones  MG, 1966 Nov 26; 95 (22):1120–1127.  R, Eickman
On Allopurinol Hypersensitivity Allopurinol is the most commonly prescribed drug to treat gout, a disease characterized by the buildup of uric acid crystals in certain body tissues, as well as hyperuricemia. Pacher  M, Allopurinol in dermatology.

 WY, Lee  PB, The presentation, risk factors and mechanisms of allopurinol-induced hypersensitivity are the focus of this Review, as well as strategies to avoid or minimize such reactions.  IV. The curve represents the annual incidence of allopurinol hypersensitivity in the new users, which increased from 3.71 per 1000 new users in 2005 to 6.12 per 1000 new users in 2011. Markel  EE, Saokaew This may decrease the therapeutic effect of allopurinol, but the significance needs to be assessed in each case.To prevent acute uric acid nephropathy in neoplastic conditions, treatment with allopurinol should precede treatment with cytotoxic drugs.Since allopurinol and its metabolites are excreted via the kidney, impairment of renal function may lead to retention of the drug and its metabolites with consequent prolongation of action. In this case, the risk of increased activity of these drugs must be recognised. To examine the accuracy of the data, we retrieved the medical records of patients with allopurinol hypersensitivity from the largest medical center in Taiwan and confirmed the consistency of the results between the nationwide data set and the hospital system–based medical records. Tissue concentrations of allopurinol have not been reported in humans, but it is likely that allopurinol and oxipurinol will be present in the highest concentrations in the liver and intestinal mucosa where xanthine oxidase activity is high.Approximately 20% of the ingested allopurinol is excreted in the faeces.  BG, Nuki Allopurinol and oxipurinol are not bound to plasma proteins.  JT, Thirumoorthy A doctor may prescribe a lower dose of allopurinol.Allopurinol does not affect any type of contraception including the But if allopurinol makes you vomit, your contraceptive pills may not protect you from pregnancy. Screening for HLA-B*5801 should be considered before starting treatment with allopurinol in patient subgroups where the prevalence of this allele is known to be high. Allopurinol in dermatology. The 95% CIs and Based on the information retrieved from the national database, we identified 1 613 719 patients receiving 9 721 780 allopurinol prescriptions between 2005 and 2011 (The national database reported 8817 new users and 33 cases of allopurinol hypersensitivity from the Chang Gung Memorial Hospital Health System between 2009 and 2011.
 U,  BB, Bourg  LH, Liu

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