OVERVIEW
Allopurinol
- It is an purine and non selective inhibitors of xanthine oxidase
- It is used for the treatment of slowing down the progression of renal disease,Hyperuricemic states,proteinuria which can probably lead to chronic kidney diseases ,preventing renal calculi(calcium oxalate )
- It is considered as one of the most effective and safest drug to use in renal impaired patients
- Dosage need to be uptitrated and available in form of tablets with dose of 100 mg and 300 mg
- The minimally effective dosage is 100 mg
- The dosage adjustments taken in to consideration in renal patients
- Initially 100 mg of allopurinol is given and it is increased at weekly intervals by 100mg until the uric acid levels are less than 6 mg/dl is obtained
- The mode of elimination is through kidneys
- The adverse effects associated with allopurinol is rashes, diarrhea,nausea,Liver Functional tests abnormalities
Febuxostat
- It is a non purine and selective inhibitors of xanthine oxidase
- It is used as the chronic treatment options for slowing down the progression of renal disease,Hyperuricemic condition,proteinuria which can probably lead to chronic kidney diseases similar to that of allopurinol
- It is considered as one of the most effective and safest drug to use in renal impaired patients when compared with allopurinol
- Dosage need not to be titrated and available in form of tablets with dose of 40 mg and 80 mg
- The minimally effective dosage is 40 mg,effective at low doses only
- Initiate 40 mg/dl ,may increase up to 80 mg/dl id serum uric acid is greater than 6 mg/dl after 2 weeks
- The dosage adjustments are not taken in to consideration in renal patients with mild to moderate renal insufficiency
- The mode of elimination is through kidneys and liver
- The adverse effects associated with it is rashes,arthralgias,liver functional test abnormalities
FREQUENTLY ASKED QUESTIONS
Is there any therapeutic advantage of Febuxostat over allopurinol
There are no quite therapeutic advantages of one over the other ,they both serve the action of controlling the uric acid levels and no occurrence of any cardiovascular risks .
Febuxostat at 80 mg or 120 mg was more effective than 300 mg allopurinol
When do you use allopurinol instead of Febuxostat
It is particularly used in patients who are intolerant or having skin reactions or allergic to allopurinol
Moreover also for those who requires no dose limitation in stages 1–3 chronic kidney diseases
Can I switch from allopurinol to Febuxostat
It is possible to switch from allopurinol to Febuxostat in chronic kidney disease patients which it significantly reduces the serum uric acid after an year
In hemodialysis receiving patients had greater tolerability and efficacy towards the switched drug
Usually physicians consider allopurinol over Febuxostat
Can Febuxostat damage kidneys
Yes, according to few studies cited in certain cases both the Febuxostat and allopurinol can cause damage to the kidneys leading to acute kidney injury
Which tablet is best for uric acid
Despite of the side effects from the Drugs such as allopurinol and Febuxostat they are excellent medications for the reduction of uric acid levels In renal impaired patients with certain dosage or no dosage restrictions
Do i have to take Febuxostat forever
Febuxostat is a long term medication until and unless the presence of side effects affecting the individual’s health .
Because this drug is used to treat the Hyperuricemic and kidney related issues which probably might end up in increased risk in case of irregular usage of Febuxostat
Which has more side effects allopurinol or Febuxostat
Allopurinol is known to have more side effects when compared with Febuxostat but the cardiovascular risk is higher in Febuxostat leading to death of the patients
What are the dangers of allopurinol
The dangers associated with allopurinol is trouble breathing ,edema of feet and hands,face,skin allergic reactions including redness,peeling, sensitivity due to ulcers and sores
Sometimes it is much severe leading to skin conditions such as steven johnsons syndrome(SJS),toxic epidermal necrolysis(TEN).
Is allopurinol toxic to kidneys
Allopurinol is not nephrotoxic and it is safest to consider in renal patients and also in hemodialysis patients when used within the prescribed limits of dosages.
Its mode of action is by decreasing the C reactive protein in chronic Kidney disease patients and which further slows the progression .
Who should not take Febuxostat
There is a predictable risk of usage of Febuxostat in cardiovascular diseased patients who had the history of cardiac arrest,heart attack or stroke or any other cardiac related issues .
This drug is not considered in therapy without a physician prescription or isn’t recommended at all.
Can Febuxostat reduce creatinine
Yes, Febuxostat lowers the serum creatinine levels .The value is known to be about 0.03mg/dL
What is an alternative to allopurinol
The alternative option for treatment of gout and allopurinol is Febuxostat which also belongs to the class of xanthine oxidase inhibitors.
Does dialysis remove allopurinol
As the mode of elimination of allopurinol is through kidneys ,the drug allopurinol for sure is removed through the process of dialysis
Does allopurinol need renal dosing
Initiate the dosage of 50 mg daily then increased by 50 mg by every 2-5 weeks until the desired Serum UA levels are achieved
When is allopurinol best taken
It is usually available in form of tablets as mentioned above
The mode of administration is through orally , once or twice a day preferably after meals.