Hydrochlorothiazide Allopurinol

A 66-year-old man had taken trovafloxacin 100 mg/day for 4 weeks for refractory chronic sinusitis (10). For several years he had also taken allopurinol, doxepin, hydrochlorothiazide, losartan, metoprolol, and nabumetone. He developed nausea, vomiting, malaise, and abdominal distension. His white cell count was 8000 x 10 /1 with 16% eosinophils his serum aspartate transaminase was 537 IU/1, alanine transaminase 841 IU/1, direct bilirubin 17 pmol/l total bilirubin 27 pmol/l, alkaline phosphatase 111 IU/1 blood urea nitrogen 5 pmol/l and creatinine 190 pmol/l. Tests for hepatitis A, B, and C were negative. A biopsy of the liver showed centrilobular and focal periportal necrosis and eosinophilic infiltration the sinusoids were dilated and contained lymphocytes and eosinophils many hepatocytes were undergoing mitosis. After withdrawal of trovafloxacin and treatment with prednisone, his hepatic and renal function returned to normal, and the eosinophilia gradually resolved. 

A 45-year-old white man, who had taken losartan, hydrochlorothiazide, allopurinol, and colchicine for 9 months, developed facial urticaria, eyelid swelling, shortness of breath, and upper chest tightness, which resolved quickly with famotidine, methylprednisolone, and adrenaline. He had a recurrence 7 hours later, not having taken another dose of losartan. The patient had no history of allergy and was well after losartan withdrawal. 

Two of nine patients with drug-induced toxic epidermal necrolysis were taking hydrochlorothiazide, one with triamterene and allopurinol, the other with reserpine and hydralazine both died (28). 

Cronqvist, J. Nilsson-Ehle, I. Determination of acyclovir in human serum hy hi -performance liquid chromatography. J.Liq.Chromatogr., 1988, 11, 2593-2601 [serum non-interfering acetaminophen, allopurinol, baclofen, carbacholine, cefuroxime, chlorpropamide, cilastatin, cloxacillin, diazepam, di-cumarol, digoxin, flucloxacillm, furosemide, fusidic acid, fusidic, glipizide, heparin, hydrochlorothiazide, imipenem, insulin, isoniazid, ketoprofen, metronidazole, naproxen, perphenazine, phenytoin, prednisolone, propranolol, p3razinamide, p3ridoxine, ranitidine, rifampicin, rifampin, spironolactone, streptomycin, sulfamethoxazole, trimethoprim, warfarin]... 

Noninterfering acebutolol, acetazolamide, acetophenetidin, aldosterone, allopurinol, caffeine, cephalothin, chlorothiazide, cotinine, ephedrine, furosemide, hydrochlorothiazide, nicotine, pheniramine, phenylephrine, phenytoin, primidone, quinine, triamcinolone... 

Noninterfering acetaminophen, allopurinol, amikacin, amoxapine, amytal, bretylium, caffeine, carbamazepine, carisoprodol, chloramphenicol, chlordiazepoxide, chlorpropamide, clonazepam, codeine, diazepeun, disop30 amide, droperidol, ethinamate, ethinamate, etho-suximide, fluphenazine, flurazepam, furosemide, gentamicin, haloperidol, hydrochlorothiazide, hydro yzine, ibuprofen, kanamycin, lidocaine, loxapine, meperidine, mepho-barbital, meprobamate, methaqualone, methotrexate, morphine, nafcUlin, naloxone, neomycin, perphenazine, phenacetin, phenobarbital, phenytoin, prazepam, primidone, procaine, propoxyphene, reserpine, salicylamide, salicylic acid, secobarbital, spironolactone, theophyUine, thiopental, thioridazine, tobramycin, valproic acid, verapeunil... 

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