Uses for allopurinol

Allopurinol injection is used to prevent or treat high uric acid levels in the blood that may be caused by cancer medicines. Allopurinol is a xanthine oxidase inhibitor that works by causing less uric acid to be produced by the body.

This medicine is to be given only by or under the direct supervision of a doctor.

Before using allopurinol

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of allopurinol injection in children. Safety and efficacy have been established.

Geriatric

Appropriate studies on the relationship of age to the effects of allopurinol injection have not been performed in the geriatric population.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Didanosine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acenocoumarol
• Azathioprine
• Capecitabine
• Captopril
• Enalapril
• Enalaprilat
• Fluorouracil
• Mercaptopurine
• Methotrexate
• Pegloticase
• Phenprocoumon
• Tegafur
• Warfarin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Cyclosporine
• Vidarabine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Bone marrow problems or
• Liver disease—Use with caution. May make these conditions worse.

• Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper use of allopurinol

A nurse or other trained health professional will give you or your child this medicine in a hospital. This medicine is given through a needle placed in one of your veins.

Drink plenty of liquids while you are receiving this medicine to help prevent kidney stones. Check with your doctor about the amount of liquid you or your child should drink each day.

Precautions while using allopurinol

It is very important that your doctor check you or your child closely while you are receiving this medicine. This is to make sure that the medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Receiving this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine. If you think you have become pregnant while receiving this medicine, tell your doctor right away.

If you or your child develop a skin rash, hives, swelling of the lips or mouth, or any allergic reaction to this medicine, tell your doctor or nurse right away.

This medicine may cause serious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome, and drug reaction with eosinophilia and systemic symptoms (DRESS). Check with your doctor right away if you or your child have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, fever, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness.

Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

Check with your doctor right away if you or your child have chest pain, chills, cough or hoarseness, fever, lower back or side pain, painful or difficult urination, sores, ulcers, or white spots on the lips or in the mouth, swollen glands, unusual bleeding, bruising, tiredness, or weakness. These could be symptoms of bone marrow suppression.

This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.

This medicine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of allopurinol

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

• Agitation
• coma
• confusion
• decreased urine output
• depression
• dizziness
• headache
• hostility
• irritability
• lethargy
• muscle twitching
• nausea
• rapid weight gain
• seizures
• stupor
• swelling of the face, ankles, or hands
• unusual tiredness or weakness

Rare

• Black, tarry stools
• bladder pain
• bleeding gums
• blistering, peeling, loosening of the skin
• blood in the urine or stools
• blurred vision
• changes in skin color
• chest pain or tightness
• chills
• clay-colored stools
• cloudy urine
• cough or hoarseness
• coughing up blood
• dark urine
• diarrhea
• difficult, burning, or painful urination
• difficulty with breathing or swallowing
• difficulty with speaking
• dilated neck veins
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• double vision
• enlarged stomach
• fainting
• fast or slow heartbeat
• feeling of warmth
• fever
• frequent urge to urinate
• inability to move the arms, legs, or facial muscles
• inability to speak
• increased menstrual flow or vaginal bleeding
• increased sweating
• irregular breathing
• irregular heartbeat
• itching, rash
• joint pain, stiffness, or swelling
• lightheadedness
• loosening of the fingernails
• loss of appetite
• loss of strength or energy
• lower back or side pain
• muscle pain or weakness
• nosebleeds
• numbness, tingling, pain, or weakness in the hands or feet
• pain, tenderness, or swelling of the foot or leg
• painful or difficult urination
• paralysis
• pinpoint red spots on the skin
• prolonged bleeding from cuts
• rapid, shallow breathing
• red or black, tarry stools
• red or dark brown urine
• red skin lesions, often with a purple center
• redness of the face, neck, arms, and occasionally, upper chest
• slow speech
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• stomach pain
• sweating
• swelling of the fingers, feet, or lower legs
• swollen glands
• trouble breathing
• unpleasant breath odor
• unusual bleeding or bruising
• unusual weak feeling
• vomiting of blood
• weight gain
• yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Drowsiness
• indigestion
• unusual hair loss

Rare

• Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
• body aches or pain
• congestion
• cracked lips
• difficulty with moving
• hair loss or thinning of the hair
• hives or welts
• muscle stiffness
• pain, redness, swelling, tenderness, or warmth on the skin
• runny nose
• voice changes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.