drugs

ALLOPURINOLO MOLTENI ® Allopurinol

ALLOPURINOL MOLTENI ® is an allopurinol based drug

THERAPEUTIC GROUP: Anti-gout - Xanthine oxidase inhibitors

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Directions ALLOPURINOLO MOLTENI ® Allopurinol

ALLOPURINOLO MOLTENI ® is indicated in the prophylaxis in the treatment of hyperuricemia, gout, urinary lithiasis and hyperuricemia induced by anticancer chemotherapy.

Mechanism of action ALLOPURINOL MOLTENI ® Allopurinol

Hyperuricemia, a clinical condition characterized by high blood concentrations of uric acid and antechamber of more serious pathologies such as renal calculosis and gout, presents in most cases as a pathogenic mechanism an increased production of urates, generally supported by the increase in enzymatic activity of xanthine oxidase.

This enzyme, belonging to the oxido-reductase family, is in fact able to mediate the transformation of xanthine and hypoxanthine, products of purine derivation whose concentrations increase during hyperprotein diets and chemotherapy, in uric acid, thus causing an accumulation of this substance first in circulation, then in specific sites such as the joints of the lower limbs.

Allopurinol, thanks to the molecular structure similar to hypoxanthine, which makes it a direct competitor, is able to bind xanthine oxidase with greater affinity, inhibiting its action and significantly reducing the synthesis of urates, thus allowing a significant reduction in concentrations blood levels of this product.

The consequent accumulation of xanthine and hypoxanthine completes the therapeutic action of allopurinol, allowing both molecules to re-enter endogenous purine synthesis, thus also contributing to the lowering of blood concentrations of xanthine oxidase substrates.

Studies carried out and clinical efficacy

1.XANTINOSSIDASE AND CARDIOVASCULAR DISEASES

Int Urol Nephrol. 2011 Jun; 43 (2): 441-9. Epub 2011 Mar 10.

Study that seeks to evaluate the potential pathogenic effects exerted by a hyperactivation of xanthine oxidase, limited not only to the increased risk of hyperuricemia but also to an increased risk of developing cardiovascular diseases. These hypotheses, already observed in experimental models, are supported by the increase in reactive oxygen species linked to xanthine oxidase activity.

2.ALLOPURINOL AND ENDOTHELIAL FUNCTION

J Am Soc Nephrol. 2011 Jul; 22 (7): 1382-9. Epub 2011 Jun 30.

Work demonstrating that the administration of allopurinol in patients with chronic nephropathy can significantly improve endothelial function, reducing arterial stiffness and ensuring at the same time a regression of the left ventricular mass.

3. THE EFFECTIVENESS OF ALLOPURINOL IN CLINICAL PRACTICE

Nucleosides Nucleotides Nucleic Acids. 2011 Dec; 30 (12): 1011-7.

Work that has shown the great efficacy of allopurinol in the treatment of gout in young subjects, even when compared to newer drugs such as febuxostat. To give greater therapeutic importance to allopurinol, we also think about the protective effects on the cardiovascular system, described by the numerous studies recently published.

Method of use and dosage

ALLOPURINOLO MOLTENI ®

100 mg or 300 mg tablets of allopurinol;

Despite the range of use of allopurinol, in the prophylaxis and treatment of hyperuricemia, it is very wide and between 100 and 800 mg daily, it is recommended to start the treatment with the lowest possible dosage, gradually adjusting the dose until get the expected results.

The precise dose should be formulated by the doctor based on the patient's clinical picture and the related therapeutic needs.

It is recommended to take ALLOPURINOLO MOLTENI ® after meals, every day and preferably at the same time.

Warnings ALLOPURINOLO MOLTENI ® Allopurinol

The initial phase of drug treatment with allopurinol should include the simultaneous preventive intake of colchicine or non-steroidal anti-inflammatory drugs, in order to reduce the risk of the onset of acute gouty attacks.

Medical supervision is necessary both in the definition phase of the dosage, and during the whole therapeutic procedure to avoid the appearance of side effects, while maintaining high therapeutic efficacy.

Particular attention should be paid to patients suffering from kidney diseases, in which the incidence of adverse reactions is significantly higher than that of the healthy population.

It is also advisable to increase the daily intake of water, in order to facilitate both the urinary excretion of uric acid and that of allopurinol catabolites and to suspend therapy following the possible appearance of skin rashes.

Taking allopurinol could reduce the cognitive abilities of the patient, making it dangerous to use machinery or driving vehicles.

ALLOPURINOLO MOLTENI ® contains lactose, therefore its use is not recommended in patients with lactose intolerance, glucose-galactose malabsorption or lactase enzyme deficiency.

PREGNANCY AND BREASTFEEDING

The intake of allopurinol is not recommended during pregnancy or in the subsequent period of breastfeeding, given the lack of studies regarding the safety profile of the drug with respect to the health of the unborn child and infant.

For this reason the administration of ALLOPURINOL MOLTENI ® should be limited to cases in which it is not possible to foresee other alternative and better characterized therapies.

Interactions

The characteristic metabolic role of allopurinol makes this drug particularly subject to drug interactions, in some cases clinically relevant.

In fact, the simultaneous intake of ALLOPURINOL MOLTENI ® and ACE inhibitors, Amoxicillin, Ampicillin, Antivirals, cytotoxic drugs, Theophylline and Cyclosporine could significantly increase the risk of developing dangerous adverse reactions.

Similarly, the simultaneous administration of oral anticoagulants could expose the patient to an increased risk of bleeding.

A reduction in the therapeutic efficacy of allopurinol, it could be observed instead, following the intake of uricothelics, able to increase the renal clearance of both urates and allopurinol and oxyporinol (active metabolite).

Contraindications ALLOPURINOL MOLTENI ® Allopurinol

The use of ALLOPURINOL MOLTENI ® is contraindicated in patients who are hypersensitive to the active ingredient or to one of its excipients, and as a pharmacological treatment of the acute gout episode.

Undesirable effects - Side effects

Treatment with allopurinol, especially in some categories of patients at risk such as for nephropaths, could lead to the appearance of undesirable effects from the different clinical course.

Hypersensitivity reactions with skin rash, fever, skin exfoliation and vasculitis, gastrointestinal disorders, asthenia, malaise, vertigo, drowsiness, changes in vision and taste, hypertension, alopecia, hepatotoxicity, paresthesia and neuropathies, gynecomastia and haematological disorders, represent the effects most frequently observed collaterals, for which it may be necessary to suspend therapy until the symptoms are completely remitted.

Note

ALLOPURINOLO MOLTENI ® can be sold exclusively with a medical prescription.