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What Factors Affect a Sufficient Allopurinol Dose?

By S. Berger
Updated May 17, 2024
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The medication known as allopurinol is normally used as a gout treatment, and it helps to lower uric acid levels in the blood stream. It may also be used to treat other conditions like congestive heart failure, and as a therapy before bypass surgery. Many factors can affect an allopurinol dose, including the reason for taking the medication, whether the dose is for an adult or a child, and extant damage to the kidneys.

Patients with relatively mild cases of gout usually only have to take 200 to 300 milligrams (mg) of this medication each day, orally. For more severe gout, however, standard the allopurinol dose is 400 to 600 mg each day. There is a risk of side effects with this drug, and in order to minimize these effects, dosages above 300 mg are usually taken as smaller doses, twice a day. The manufacturers of this medication recommend that doses do not go over 800 mg per day.

Occasionally, uric acid can concentrate in the blood after surgery. The allopurinol dose used in this case is 200 to 400 mg a day if it is given intravenously, and 600 to 800 mg orally per day, for the first three days. Dosages taken orally should be taken with at least 2 liters (L) of water to avoid dehydration. An oral dose of 200 mg a day may be taken after three days, until the doctor feels that the patient is no longer at risk.

Congestive heart failure is one way that allopurinol is being used experimentally. For this study, patients are taking an allopurinol dose of 300 mg each day for one month. This treatment has not been approved for use in all patients, however. Another experimental use is for bypass surgery, where 600 mg is given to the patient one day before surgery, and another 600 mg given the day of the surgery.

Children less than ten years old are sometimes given this drug as a treatment for uric acid levels. A standard allopurinol dose for this condition is 100 mg a day orally, taken twice a day. In older children, it may be given in 100 to 200 mg doses, one to three times each day.

Kidney damage can slow metabolism of this drug, so the allopurinol dose is usually reduced for patients with renal damage. Depending on the extent of the damage, these doses can range from 200 mg each day to 100 mg every three days. For intravenous administration, the doses are reduced as well, ranging from 100 mg administered throughout the day, to 200 mg a day.

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