Usual Adult Dose of Allopurinol for Gout:
Dose will vary with the severity of the disease:
Initial dose: 100 mg orally once a day
-Increase in increments of 100 mg weekly until a serum uric level of 6 mg/dL or less is attained
Mild Gout:
-Average maintenance dose: 200 to 300 mg orally once a day
Moderately Severe Tophaceous Gout:
-Average maintenance dose: 400 to 600 mg orally/day in divided doses
Minimal Effective Dose: 100 to 200 mg per day
Maximum Dose: 800 mg per day
Comments:
-Oral doses in excess of 300 mg/day should be given in divided doses, preferably after meals to minimize gastric irritation.
-A gradual dose titration is recommended to reduce the possibility of acute gouty attacks.
-Normal serum urate levels are usually achieved in 1 to 3 weeks.
Use: For the management of patients with signs and symptoms of primary or secondary gout (acute attacks, tophi, joint destruction, uric acid lithiasis, and/or nephropathy).
Usual Adult Dose of Allopurinol for Hyperuricemia Secondary to Chemotherapy:
Parenteral:
200 to 400 mg/m2/day IV as a single infusion or in equally divided infusions at 6, 8, or 12 hour intervals
Maximum dose: 600 mg/day
Oral:
Initial dose: 600 to 800 mg orally in divided doses
Maintenance: Adjust dose as needed based on serum uric acid levels
Maximum dose: 800 mg per day
Comments:
-When possible, therapy should be initiated 24 to 48 hours before the start of chemotherapy; treatment should be discontinued when the potential for overproduction of uric acid is no longer present.
-Oral doses in excess of 300 mg/day should be given in divided doses, preferably after meals to minimize gastric irritation.
-The dose to lower serum uric acid to normal or near-normal varies with the severity of the disease; the above dosing represents suggested doses; serum uric acid levels should serve as an index.
-Fluid intake should be sufficient to maintain a daily urinary output of at least 2 L; neutral or preferably slightly alkaline urine is desirable.
Use: For the management of patients with leukemia, lymphoma, and malignancies who are receiving cancer therapy which causes elevations of serum and urinary uric acid levels; IV therapy is available for patients who cannot tolerate oral therapy.
Usual Adult Dose of Allopurinol for Calcium Oxalate Calculi with Hyperuricosuria:
200 to 300 mg orally once a day or in divided doses
Comments:
-Carefully assess risk versus benefit when initiating therapy and periodically thereafter.
-Dose adjustments should be based on control of hyperuricosuria based on 24-hour urinary urate determinations.
-Clinical experience suggests these patients may benefit dietary changes in addition to drug therapy.
Use: For the management recurrent calcium oxalate calculi in patients whose daily uric acid excretion exceeds 800 mg/day in males or 750 mg/day in females.
Usual Pediatric Dose for Hyperuricemia Secondary to Chemotherapy:
Parenteral:
Initial dose: 200 mg/m2/day IV as a single infusion or in equally divided infusions at 6, 8, or 12 hour intervals
Maximum dose: 600 mg/day
Oral:
Age: Less than 6 years: 150 mg orally once a day or in divided doses
Age: 6 to 10 years: 300 mg orally once a day or in divided doses
Age: Greater than 10 years: 600 to 800 mg orally per day in divided doses
-After 48 hours, evaluate and adjust dose as needed
Comments:
-Oral doses in excess of 300 mg should be administered in divided doses.
-When possible, therapy should be initiated 24 to 48 hours before the start of chemotherapy; treatment should be discontinued when the potential for overproduction of uric acid is no longer present.
-The dose to lower serum uric acid to normal or near-normal varies with the severity of the disease; the above dosing represents suggested doses in children; serum uric acid levels should serve as an index.
-Fluid intake should be sufficient to maintain a daily urinary output of at least 2 L; neutral or preferably slightly alkaline urine is desirable.
Use: For the management of patients with leukemia, lymphoma, and malignancies who are receiving cancer therapy which causes elevations of serum and urinary uric acid levels.
 Detailed Allopurinol dosage information
What happens if I miss a dose?
Take the allopurinol oral dose as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
Call your doctor for instructions if you miss an injection.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
