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Allopurinol Tablets and Prestalia

Determining the interaction of Allopurinol Tablets and Prestalia and the possibility of their joint administration.

Check result:
Allopurinol Tablets <> Prestalia
Relevance: 04.07.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Talk to your doctor before using allopurinol together with perindopril. Combining these medications may increase the risk of severe allergic reactions and infections. You should seek immediate medical attention if you develop shortness of breath; throat tightness; swelling of the face, lips, or tongue; itching; rash; fever; and/or muscle pain or weakness. Also let your doctor know if you notice signs of infection or experience fever, chills, sore throat, fatigue, body aches, or other flu-like symptoms. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR CLOSELY: Coadministration of allopurinol with angiotensin converting enzyme (ACE) inhibitors has been associated with a risk of severe hypersensitivity reactions, neutropenia, agranulocytosis, and serious infections. The mechanism of interaction is unknown, but impaired renal function may be a predisposing factor. Case reports, albeit rare, have mostly involved captopril. Fever, myalgia, arthralgia, exfoliative dermatitis, and Stevens-Johnson syndrome (including one fatality) have been reported, with the latter occurring 3 to 5 weeks after initiation of allopurinol. In an isolated case involving enalapril, a man who had been receiving enalapril without incident developed generalized pruritus, urticaria, severe chest pain, severe nausea, peripheral cyanosis, hypotension, sinus tachycardia, and mild bronchospasm approximately 20 minutes after the first dose of allopurinol 100 mg prescribed for acute gout. Serial electrocardiograms and cardiac enzyme studies revealed evidence of acute myocardial infarction. Following recovery, the patient continued to take enalapril uneventfully without allopurinol. No pharmacokinetic interactions have been reported between allopurinol and ACE inhibitors. In a study of 12 healthy volunteers, allopurinol had no significant effect on the bioavailability of captopril.

MANAGEMENT: Caution is advised if allopurinol is prescribed in combination with an ACE inhibitor, particularly in the elderly and patients with renal impairment. Periodic monitoring of white blood cell counts is recommended. Patients should be advised to promptly discontinue these medications and seek medical attention if they develop dyspnea; throat constriction; swelling of the face, lips, or tongue; urticaria; rash; fever; arthralgia; or myalgia. Patients should also contact their physician if they notice signs of infection or experience fever, chills, sore throat, lethargy, body aches, or other flu-like symptoms.

References
  • Pennell DJ, Nunan TO, O'Doherty MJ, Croft DN "Fatal Stevens-Johnson syndrome in a patient on captopril and allopurinol." Lancet 1 (1984): 463
  • Ahmad S "Allopurinol and enalapril: drug induced anaphylactic coronary spasm and acute myocardial infarction." Chest 108 (1995): 586
  • EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports. Available from: URL: http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid."
  • Duchin KL, McKinstry DN, Cohen AI, Migdalof BH "Pharmacokinetics of captopril in healthy subjects and in patients with cardiovascular diseases." Clin Pharmacokinet 14 (1988): 241-59
  • "Product Information. Zyloprim capsules (allopurinol)." Glaxo Wellcome, Research Triangle Park, NC.
  • Samanta A, Burden AC "Fever, myalgia, and arthralgia in a patient on captopril and allopurinol." Lancet 1 (1984): 679
Allopurinol Tablets

Generic Name: allopurinol

Brand name: Zyloprim, Lopurin, Aloprim

Synonyms: Allopurinol

Prestalia

Generic Name: amlodipine / perindopril

Brand name: Prestalia

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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