Dosing & Uses
Dosage Forms & Strengths
powder for injection
Mild: 100 mg/day PO initially; increased weekly to 200-300 mg/day
Moderate to severe: 100 mg/day PO initially; increased weekly to 400-600 mg/day
PO: 600-800 mg divided q8-12hr, starting 1-2 days before chemotherapy
Minimum PO dosage: 100-200 mg/day
Maximum PO dosage: 800 mg/day
- CrCl 10-20 mL/min: 200 mg/day
- CrCl 3-10 mL/min: 100 mg/day
- CrCl <3 mL/min: 100 mg/day at extended intervals
Dosage Forms & Strengths
powder for injection
Serious - Use Alternative
Significant - Monitor Closely
Renal failure (1.2%)
Frequency Not Defined
Decrease in libido
Kidney function abnormality
Hypersensitivity to allopurinol
Discontinue at first sign of allergic reactions (first sign of rash, vasculitis, or Stevens-Johnson syndrome)
Myelosuppression reported; use caution when administering other drugs known to cause myelosuppression
Hepatotoxicity (reversible) reported
Not for treatment of asymptomatic hyperuricemia
Use with caution in renal impairment
Risk of hypersensitivity increased in patients treated with angiotensin-converting emzyme (ACE) inhibitors
When taken with amoxicillin or ampicillin, may increase risk of skin rash
During concomitant treatment, reduce dosages of azathioprine and mercaptopurine to 25-33% of usual
Risk of hypersensitivity may increase with concomitant administration of thiazides
Maintain fluid intake necessary to yield urine output of at least 2 L/day in adults
Pregnancy & Lactation
Pregnancy category: C
Lactation: Agent is distributed into breast milk; use with caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Xanthine oxidase inhibitor; inhibits conversion of hypoxanthine to xanthine to uric acid; decreases production of uric acid without disrupting synthesis of vital purines
Onset: 2-3 days
Peak plasma time: 0.5-2 hr
Time to peak effect: 7-14 days
Protein bound: <1%
Vd: 1.6-2.4 L/kg
Metabolized in liver
Metabolites: Oxypurinol (active), allopurinol riboside (activity unknown)
Half-life: Parent drug, 1-3 hr; active metabolite, 15-20 hr
Dialyzable: Yes (both hemodialysis and peritoneal dialysis)
Renal clearance: 30 mL/min
Total body clearance: 16 mL/min/kg
Excretion: Urine (80%), feces (10-20%)
Y-site (partial list): Acyclovir, calcium gluconate, cefazolin, ceftriaxone, carboplatin, cisplatin, cyclophosphamide, dactinomycin, doxorubicin liposomal, fluorouracil, ifosfamide, mesna, metronidazole, mitoxantrone, morphine sulfate, potassium chloride, thiotepa, vancomycin
Y-site: Amikacin, amphotericin B, carmustine, cefotaxime, chlorpromazine, cimetidine, clindamycin, cytarabine, dacarbazine, daunorubicin, diphenhydramine, doxorubicin, doxycycline, droperidol, floxuridine, gentamicin, haloperidol, hydroxyzine, idarubicin, imipenem-cilastatin, mechlorethamine, meperidine, methylprednisolone sodium succinate, metoclopramide, minocycline, nalbuphine, netilmicin, ondansetron, prochlorperazine, promethazine, sodium bicarbonate, streptozocin, tobramycin, vinorelbine
Reconstitute with 25 mL SWI
Dilute to desired concentration with NS or D5W; do not use sodium bicarbonate-containing solutions; final concentration of ≤6 mg/mL is recommended
Store solution at 20-25°C (do not refrigerate), and use within 10 hours after reconstitution
In both adults and children, daily dose can be given as single infusion or in equally divided infusions q6hr, q8hr, or q12hr
Whenever possible, administration should be initiated 1-2 days before start of chemotherapy known to cause tumor cell lysis (including adrenocorticosteroids)
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
Select a box to add or remove a plan.
Select a class to view formulary status for similar drugs