char = A;code = 65
char = ;code = 32
char = c;code = 99
char = r;code = 114
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = p;code = 112
char = p;code = 112
char = r;code = 114
char = a;code = 97
char = i;code = 105
char = s;code = 115
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = d;code = 100
char = o;code = 111
char = s;code = 115
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ,;code = 44
char = ;code = 32
char = s;code = 115
char = a;code = 97
char = f;code = 102
char = e;code = 101
char = t;code = 116
char = y;code = 121
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = e;code = 101
char = f;code = 102
char = f;code = 102
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = c;code = 99
char = y;code = 121
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = h;code = 104
char = y;code = 121
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = e;code = 101
char = m;code = 109
char = i;code = 105
char = a;code = 97
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = g;code = 103
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = .;code = 46
result sql = A critical reappraisal of allopurinol dosing, safety, and efficacy for hyperuricemia in gout.
A critical reappraisal of allopurinol dosing, safety, and efficacy for hyperuricemia in gout.
char = A;code = 65
char = l;code = 108
char = l;code = 108
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ,;code = 44
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = i;code = 105
char = r;code = 114
char = s;code = 115
char = t;code = 116
char = -;code = 45
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = d;code = 100
char = r;code = 114
char = u;code = 117
char = g;code = 103
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = m;code = 109
char = ;code = 32
char = u;code = 117
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = -;code = 45
char = l;code = 108
char = o;code = 111
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = p;code = 112
char = y;code = 121
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = g;code = 103
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = ,;code = 44
char = ;code = 32
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = p;code = 112
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = v;code = 118
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = y;code = 121
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = U;code = 85
char = S;code = 83
char = ;code = 32
char = F;code = 70
char = o;code = 111
char = o;code = 111
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = D;code = 68
char = r;code = 114
char = u;code = 117
char = g;code = 103
char = ;code = 32
char = A;code = 65
char = d;code = 100
char = m;code = 109
char = i;code = 105
char = n;code = 110
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = d;code = 100
char = o;code = 111
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = u;code = 117
char = p;code = 112
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = 8;code = 56
char = 0;code = 48
char = 0;code = 48
char = ;code = 32
char = m;code = 109
char = g;code = 103
char = /;code = 47
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = v;code = 118
char = a;code = 97
char = i;code = 105
char = l;code = 108
char = a;code = 97
char = b;code = 98
char = l;code = 108
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = l;code = 108
char = o;code = 111
char = w;code = 119
char = -;code = 45
char = c;code = 99
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = g;code = 103
char = e;code = 101
char = n;code = 110
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = d;code = 100
char = r;code = 114
char = u;code = 117
char = g;code = 103
char = .;code = 46
char = ;code = 32
char = H;code = 72
char = o;code = 111
char = w;code = 119
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = r;code = 114
char = ,;code = 44
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = j;code = 106
char = o;code = 111
char = r;code = 114
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = r;code = 114
char = i;code = 105
char = p;code = 112
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = d;code = 100
char = o;code = 111
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = <;code = 60
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = =;code = 61
char = ;code = 32
char = 3;code = 51
char = 0;code = 48
char = 0;code = 48
char = ;code = 32
char = m;code = 109
char = g;code = 103
char = /;code = 47
char = d;code = 100
char = ,;code = 44
char = ;code = 32
char = w;code = 119
char = h;code = 104
char = i;code = 105
char = c;code = 99
char = h;code = 104
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = f;code = 102
char = a;code = 97
char = i;code = 105
char = l;code = 108
char = s;code = 115
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = e;code = 101
char = q;code = 113
char = u;code = 117
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = h;code = 104
char = y;code = 121
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = e;code = 101
char = m;code = 109
char = i;code = 105
char = a;code = 97
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = g;code = 103
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = s;code = 115
char = i;code = 105
char = t;code = 116
char = u;code = 117
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = m;code = 109
char = o;code = 111
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = y;code = 121
char = ;code = 32
char = l;code = 108
char = o;code = 111
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char = g;code = 103
char = s;code = 115
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char = a;code = 97
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char = d;code = 100
char = i;code = 105
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char = g;code = 103
char = ,;code = 44
char = ;code = 32
char = n;code = 110
char = o;code = 111
char = n;code = 110
char = -;code = 45
char = e;code = 101
char = v;code = 118
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = -;code = 45
char = b;code = 98
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = g;code = 103
char = u;code = 117
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = r;code = 114
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char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = u;code = 117
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char = e;code = 101
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char = c;code = 99
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char = i;code = 105
char = b;code = 98
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char = a;code = 97
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char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = o;code = 111
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char = r;code = 114
char = e;code = 101
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = f;code = 102
char = u;code = 117
char = n;code = 110
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
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char = ;code = 32
char = (;code = 40
char = a;code = 97
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char = d;code = 100
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char = o;code = 111
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char = y;code = 121
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char = u;code = 117
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char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = s;code = 115
char = );code = 41
char = ;code = 32
char = a;code = 97
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char = d;code = 100
char = ;code = 32
char = d;code = 100
char = e;code = 101
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char = g;code = 103
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char = d;code = 100
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char = t;code = 116
char = ;code = 32
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char = r;code = 114
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char = o;code = 111
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char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = e;code = 101
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char = f;code = 102
char = i;code = 105
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char = a;code = 97
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char = ;code = 32
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char = ;code = 32
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char = l;code = 108
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char = i;code = 105
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char = r;code = 114
char = o;code = 111
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char = e;code = 101
char = .;code = 46
char = ;code = 32
char = S;code = 83
char = e;code = 101
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char = r;code = 114
char = e;code = 101
char = ;code = 32
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char = l;code = 108
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char = o;code = 111
char = l;code = 108
char = ;code = 32
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char = s;code = 115
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char = e;code = 101
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char = ;code = 32
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char = d;code = 100
char = ;code = 32
char = d;code = 100
char = o;code = 111
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char = n;code = 110
char = o;code = 111
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char = r;code = 114
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char = ;code = 32
char = s;code = 115
char = e;code = 101
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char = m;code = 109
char = ;code = 32
char = o;code = 111
char = x;code = 120
char = y;code = 121
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char = u;code = 117
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char = o;code = 111
char = l;code = 108
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = L;code = 76
char = i;code = 105
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
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char = u;code = 117
char = r;code = 114
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char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = d;code = 100
char = o;code = 111
char = s;code = 115
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char = t;code = 116
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char = <;code = 60
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char = o;code = 111
char = r;code = 114
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char = =;code = 61
char = ;code = 32
char = 3;code = 51
char = 0;code = 48
char = 0;code = 48
char = ;code = 32
char = m;code = 109
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char = m;code = 109
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char = l;code = 108
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char = c;code = 99
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = r;code = 114
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char = l;code = 108
char = s;code = 115
char = ;code = 32
char = h;code = 104
char = y;code = 121
char = p;code = 112
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char = r;code = 114
char = i;code = 105
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char = a;code = 97
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char = r;code = 114
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char = d;code = 100
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char = e;code = 101
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char = e;code = 101
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char = f;code = 102
char = ;code = 32
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char = o;code = 111
char = v;code = 118
char = e;code = 101
char = l;code = 108
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char = u;code = 117
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = -;code = 45
char = l;code = 108
char = o;code = 111
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
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char = a;code = 97
char = p;code = 112
char = e;code = 101
char = u;code = 117
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char = i;code = 105
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char = t;code = 116
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char = s;code = 115
char = ;code = 32
char = f;code = 102
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char = b;code = 98
char = u;code = 117
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char = a;code = 97
char = t;code = 116
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char = n;code = 110
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char = e;code = 101
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char = m;code = 109
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char = i;code = 105
char = s;code = 115
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char = ;code = 32
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char = p;code = 112
char = u;code = 117
char = r;code = 114
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char = n;code = 110
char = o;code = 111
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char = ;code = 32
char = d;code = 100
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char = ;code = 32
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char = ;code = 32
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char = ;code = 32
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char = r;code = 114
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = e;code = 101
char = m;code = 109
char = i;code = 105
char = a;code = 97
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = p;code = 112
char = y;code = 121
char = ,;code = 44
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = c;code = 99
char = l;code = 108
char = u;code = 117
char = d;code = 100
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
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char = t;code = 116
char = i;code = 105
char = e;code = 101
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char = t;code = 116
char = s;code = 115
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char = t;code = 116
char = h;code = 104
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char = o;code = 111
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char = c;code = 99
char = ;code = 32
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char = d;code = 100
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char = d;code = 100
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char = e;code = 101
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char = s;code = 115
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result sql = Allopurinol, the first-line drug for serum urate-lowering therapy in gout, is approved by the US Food and Drug Administration for a dose up to 800 mg/d and is available as a low-cost generic drug. However, the vast majority of allopurinol prescriptions are for doses < or = 300 mg/d, which often fails to adequately treat hyperuricemia in gout. This situation has been promoted by longstanding, non-evidence-based guidelines for allopurinol use calibrated to renal function (and oxypurinol levels) and designed, without proof of efficacy, to avoid allopurinol hypersensitivity syndrome. Severe allopurinol hypersensitivity reactions are not necessarily dose-dependent and do not always correlate with serum oxypurinol levels. Limiting allopurinol dosing to < or = 300 mg/d suboptimally controls hyperuricemia and fails to adequately prevent hypersensitivity reactions. However, the long-term safety of elevating allopurinol dosages in chronic kidney disease requires further study. The emergence of novel urate-lowering therapeutic options, such as febuxostat and uricase, makes timely this review of current allopurinol dosing guidelines, safety, and efficacy in gout hyperuricemia therapy, including patients with chronic kidney disease.

Publication: Curr Rheumatol Rep 2009 Apr ;11(2)::135-40.
Publication Date: 2009 Apr
Study Author(s): Chao, Jeannie;Terkeltaub, Robert;
Institution: Department of Rheumatology, VA Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
Shortcut link to this study:
Allopurinol, the first-line drug for serum urate-lowering therapy in gout, is approved by the US Food and Drug Administration for a dose up to 800 mg/d and is available as a low-cost generic drug. However, the vast majority of allopurinol prescriptions are for doses < or = 300 mg/d, which often fails to adequately treat hyperuricemia in gout. This situation has been promoted by longstanding, non-evidence-based guidelines for allopurinol use calibrated to renal function (and oxypurinol levels) and designed, without proof of efficacy, to avoid allopurinol hypersensitivity syndrome. Severe allopurinol hypersensitivity reactions are not necessarily dose-dependent and do not always correlate with serum oxypurinol levels. Limiting allopurinol dosing to < or = 300 mg/d suboptimally controls hyperuricemia and fails to adequately prevent hypersensitivity reactions. However, the long-term safety of elevating allopurinol dosages in chronic kidney disease requires further study. The emergence of novel urate-lowering therapeutic options, such as febuxostat and uricase, makes timely this review of current allopurinol dosing guidelines, safety, and efficacy in gout hyperuricemia therapy, including patients with chronic kidney disease.
PMID: 19296886

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