Allopurinol interactions
Full monograph for AllopurinolCheck it against another medicine
Medicines
588 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Amlodipine Besilate + Benazepril Hydrochloride | Major | Others · Unknown | Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions…2 documented mechanisms | 9 sources — open the full entry |
| Azathioprine | Major | Metabolism | Allopurinol may potentiate the pharmacologic effects of orally administered thiopurines. Severe bone marrow suppression and other toxicity have been associated… | 18 sources — open the full entry |
| Captopril | Major | Others | Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions… | 9 sources — open the full entry |
| Deferiprone | Major | Synergy | Coadministration of deferiprone and other drugs that can cause neutropenia or agranulocytosis may increase the risk and/or severity of hematologic toxicity… | 5 sources — open the full entry |
| Enalapril Maleate | Major | Others | Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions… | 9 sources — open the full entry |
| Lisinopril | Major | Others | Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions… | 9 sources — open the full entry |
| Mercaptopurine | Major | Metabolism | Allopurinol may potentiate the pharmacologic effects of orally administered thiopurines. Severe bone marrow suppression and other toxicity have been associated… | 18 sources — open the full entry |
| Perindopril + Indapamide | Major | Excretion · Others | Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions…2 documented mechanisms | 14 sources — open the full entry |
| Perindopril Arginine | Major | Others | Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions… | 9 sources — open the full entry |
| Perindopril Arginine + Amlodipine | Major | Others · Unknown | Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions…2 documented mechanisms | 9 sources — open the full entry |
| Ramipril | Major | Others | Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions… | 9 sources — open the full entry |
| Ramipril + Hydrochlorothiazide | Major | Excretion · Others | Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions…2 documented mechanisms | 14 sources — open the full entry |
| Aluminium Hydroxide + Magnesium Hydroxide | Moderate | Absorption | INTERVAL: Aluminum-containing oral medications may decrease the absorption of allopurinol and reduce its therapeutic effect. | 2 sources — open the full entry |
| Aluminium Hydroxide + Magnesium Hydroxide + Simethicone | Moderate | Absorption | INTERVAL: Aluminum-containing oral medications may decrease the absorption of allopurinol and reduce its therapeutic effect. | 2 sources — open the full entry |
| Atenolol + Chlorthalidone | Moderate | Excretion · Unknown | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may…2 documented mechanisms | 5 sources — open the full entry |
| Azilsartan Medoxomil + Chlorthalidone | Moderate | Excretion | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may… | 5 sources — open the full entry |
| Bendamustine | Moderate | Synergy | Coadministration of bendamustine with allopurinol may increase the risk of severe skin reactions. The potential mechanism of interaction has not been… | 2 sources — open the full entry |
| Bisoprolol Fumarate + Hydrochlorothiazide | Moderate | Excretion · Unknown | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may…2 documented mechanisms | 5 sources — open the full entry |
| Candesartan Cilexetil + Hydrochlorothiazide | Moderate | Excretion | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may… | 5 sources — open the full entry |
| Chlorthalidone | Moderate | Excretion | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may… | 5 sources — open the full entry |
| Cyclophosphamide | Moderate | Metabolism | Allopurinol may enhance the myelosuppressive side effects of cyclophosphamide. It is suspected that the mechanism is either induction of hepatic metabolism of… | 3 sources — open the full entry |
| Cyclosporine (Oral) | Moderate | Synergy | Concomitant administration of allopurinol may increase cyclosporine blood concentrations. The mechanism is unknown. The risk of cyclosporine-induced… | 15 sources — open the full entry |
| Diroximel Fumarate | Moderate | Synergy | The use of fumaric acid esters in combination with medications that can cause nephrotoxicity (e.g., aminoglycosides, diuretics, nonsteroidal anti-inflammatory… | 7 sources — open the full entry |
| Entecavir Monohydrate | Moderate | Excretion | Coadministration of entecavir with another drug that is also eliminated by active tubular secretion may result in increased plasma concentrations of one or… | 2 sources — open the full entry |
| Hydrochlorothiazide | Moderate | Excretion | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may… | 5 sources — open the full entry |
| Indapamide | Moderate | Excretion | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may… | 5 sources — open the full entry |
| Indapamide + Amlodipine | Moderate | Excretion · Unknown | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may…2 documented mechanisms | 5 sources — open the full entry |
| Irbesartan + Hydrochlorothiazide | Moderate | Excretion · Unknown | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may…2 documented mechanisms | 5 sources — open the full entry |
| Losartan Potassium + Hydrochlorothiazide | Moderate | Excretion · Unknown | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may…2 documented mechanisms | 5 sources — open the full entry |
| Magaldrate | Moderate | Absorption | INTERVAL: Aluminum-containing oral medications may decrease the absorption of allopurinol and reduce its therapeutic effect. | 2 sources — open the full entry |
| Magaldrate + Simethicone | Moderate | Absorption | INTERVAL: Aluminum-containing oral medications may decrease the absorption of allopurinol and reduce its therapeutic effect. | 2 sources — open the full entry |
| Metolazone | Moderate | Excretion | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may… | 5 sources — open the full entry |
| Nebivolol + Hydrochlorothiazide | Moderate | Excretion | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may… | 5 sources — open the full entry |
| Olmesartan Medoxomil + Hydrochlorothiazide | Moderate | Excretion | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may… | 5 sources — open the full entry |
| Pemetrexed | Moderate | Excretion | Coadministration with drugs that are eliminated by active tubular secretion may delay and/or decrease the clearance of pemetrexed. The mechanism is competitive… | 1 sources — open the full entry |
| Sucralfate | Moderate | Absorption | INTERVAL: Aluminum-containing oral medications may decrease the absorption of allopurinol and reduce its therapeutic effect. | 2 sources — open the full entry |
| Telmisartan + Hydrochlorothiazide | Moderate | Excretion · Unknown | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may…2 documented mechanisms | 5 sources — open the full entry |
| Triamterene + Hydrochlorothiazide | Moderate | Excretion | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may… | 5 sources — open the full entry |
| Valsartan + Hydrochlorothiazide | Moderate | Excretion · Unknown | Serious hypersensitivity reactions to allopurinol have been well-documented in the medical literature. Case reports have suggested that thiazide diuretics may…2 documented mechanisms | 5 sources — open the full entry |
| Warfarin Sodium | Moderate | Metabolism | Allopurinol may inhibit the metabolism of warfarin, possibly enhancing its anticoagulant effect. Allopurinol may interact in a similar manner with other oral… | 43 sources — open the full entry |
| Aminophylline | Minor | Metabolism | Allopurinol may inhibit the metabolism of the xanthines, possibly increasing serum concentrations and the risk of toxicity. This interaction may be more likely… | 6 sources — open the full entry |
| Amoxicillin + Clavulanic Acid | Minor | Synergy | Coadministration of allopurinol with ampicillin or amoxicillin may increase the risk of skin rash. The mechanism of interaction is unknown, and it is unclear… | 4 sources — open the full entry |
| Amoxicillin Trihydrate | Minor | Synergy | Coadministration of allopurinol with ampicillin or amoxicillin may increase the risk of skin rash. The mechanism of interaction is unknown, and it is unclear… | 4 sources — open the full entry |
| Ampicillin Sodium | Minor | Synergy | Coadministration of allopurinol with ampicillin or amoxicillin may increase the risk of skin rash. The mechanism of interaction is unknown, and it is unclear… | 4 sources — open the full entry |
| Esomeprazole + Amoxicillin + Clarithromycin | Minor | Synergy · Unknown | Coadministration of allopurinol with ampicillin or amoxicillin may increase the risk of skin rash. The mechanism of interaction is unknown, and it is unclear…2 documented mechanisms | 4 sources — open the full entry |
| Fosphenytoin Sodium | Minor | Others | Limited clinical data suggest that allopurinol may increase phenytoin serum concentrations. The mechanism is unknown and causality is unclear. It is not known… | 17 sources — open the full entry |
| Lansoprazole + Amoxicillin + Clarithromycin | Minor | Synergy · Unknown | Coadministration of allopurinol with ampicillin or amoxicillin may increase the risk of skin rash. The mechanism of interaction is unknown, and it is unclear…3 documented mechanisms | 4 sources — open the full entry |
| Phenytoin Sodium | Minor | Others | Limited clinical data suggest that allopurinol may increase phenytoin serum concentrations. The mechanism is unknown and causality is unclear. It is not known… | 17 sources — open the full entry |
| Rabeprazole + Amoxicillin + Clarithromycin | Minor | Synergy · Unknown | Coadministration of allopurinol with ampicillin or amoxicillin may increase the risk of skin rash. The mechanism of interaction is unknown, and it is unclear…3 documented mechanisms | 4 sources — open the full entry |
| Rifampicin + Isoniazid + Pyrazinamide + Ethambutol | Minor | Excretion · Unknown | Pyrazinamide may render allopurinol less effective. Allopurinol inhibits the renal excretion of pyrazinamide metabolites, which, in turn, inhibit uric acid…4 documented mechanisms | 1 sources — open the full entry |
Conditions
Conditions in which Allopurinol needs care, as documented in this source.
Bone Marrow Failure Disorders
ModerateBone marrow suppression has been reported in patients receiving allopurinol; however, most of these patients were receiving concomitant medications with the known potential to cause such an effect. The suppression has occurred from as early as 6 weeks to as long as 6 years after the initiation of allopurinol therapy. Therapy with allopurinol should be administered cautiously to patients with or predisposed to bone marrow suppression.
1 source
- "Product Information. Zyloprim (allopurinol)." Glaxo Wellcome (2022):
Dehydration
ModerateAdequate hydration is necessary during therapy with allopurinol to prevent both the formation of xanthine calculi and renal precipitation of urates when concomitant uricosuric agents are given. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluid. In general, fluid intake sufficient to yield a daily urinary output of at least 2 liters is recommended. Maintenance of a slightly alkaline or neutral urine is also desirable.
4 sources
- Landgrebe AR, Nyhan WL, Coleman M "Urinary-tract stones resulting from the excretion of oxypurinol." N Engl J Med 292 (1975): 626-7
- Stote RM, Smith LH, Dubb JW, Moyer TP, Alexander F, Roth JL "Oxypurinol nephrolithiasis in regional enteritis secondary to allopurinol therapy." Ann Intern Med 92 (1980): 384-5
- McInnes GT, Lawson DH, Jick H "Acute adverse reactions attributed to allopurinol in hospitalized patients." Ann Rheum Dis 40 (1981): 245-9
- "Product Information. Zyloprim (allopurinol)." Glaxo Wellcome (2022):
Kidney Diseases
ModeratePatients with decreased renal function require lower dosages of allopurinol than normal to control serum urate levels. Therapy should be initiated at reduced dosages with smaller incremental changes in such patients. Additionally, individuals with preexisting renal disease or poor urate clearance have demonstrated a rise in BUN during therapy with allopurinol. Renal failure has also been observed among some with hyperuricemia secondary to neoplastic diseases. Renal function should be monitored during the initial stages of therapy, and the dosage reduced or the drug withdrawn if necessary.
3 sources
- Hande K, Reed E, Chabner B "Allopurinol kinetics." Clin Pharmacol Ther 23 (1978): 598-605
- Hande KR, Noone RM, Stone WJ "Severe allopurinol toxicity: description and guidelines for prevention in patients with renal insufficiency." Am J Med 76 (1984): 47-56
- "Product Information. Zyloprim (allopurinol)." Glaxo Wellcome (2022):
Liver Diseases
ModerateThe use of allopurinol has infrequently been associated with asymptomatic elevations of serum transaminase and alkaline phosphatase levels. Isolated cases of cholestatic jaundice, hepatic necrosis, granulomatous hepatitis, and hepatomegaly have also been reported. Therapy with allopurinol should be administered cautiously in patients with liver disease. Periodic monitoring of liver function tests is recommended in these patients during the early stages of therapy.
4 sources
- Al-Kawas FH, Seeff LB, Berendson RA, Zimmerman HJ, Ishak KG "Allopurinol hepatotoxicity." Ann Intern Med 95 (1981): 588-90
- Raper R, Ibels L, Lauer C, Barnes P, Lunzer M "Fulminant hepatic failure due to allopurinol." Aust N Z J Med 14 (1984): 63-5
- Ohsawa T, Ohtsubo M "Hepatitis associated with allopurinol." Drug Intell Clin Pharm 19 (1985): 431-3
- "Product Information. Zyloprim (allopurinol)." Glaxo Wellcome (2022):
Therapeutic duplication
Drug classes that overlap with Allopurinol, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
anti-gout agents
The recommended maximum number of medicines in the 'anti-gout agents' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anti-gout agents' category.
Example product in the source data (US market): Probenecid and colchicine