Pyrazinamide Allopurinol

ALLOPURINOL PYRAZINAMIDE i efficacy of antigout drugs Pyrazinamide can induce hyperuricaemia Pyrazinamide should not be used in patients with gout... 

Pyrazinamide commonly causes hyperuricaemia and may therefore reduce the uricosuric effect of benzbromarone and probenecid. Allopurinol is unlikely to be effective against pyrazinamide-induced hyperuricaemia, and may exacerbate the situation, whereas benzbromarone may have modest efficacy in reducing hyperuricaemia caused by pyrazinamide. 

It is thought that pyrazinamide is hydrolysed in the body to pyrazinoic acid, which appears to be responsible for the hyperuricaemic effect of pyrazinamide. Pyrazinoic acid is oxidised by the enzyme xanthine oxidase to 5-hydroxypyrazoic acid. Since allopurinol is an inhibitor of xanthine oxidase, its presence increases pyrazinoic acid concentrations thereby probably worsening the pyrazinamide-induced hyperuricaemia. Allopurinol would therefore appear to be unsuitable for treating pyrazinamide-induced hyperuricaemia. 

Lacroix C, Guyonnaud C, Chaou M, Duwoos H, Lafont O. Interaction between allopurinol and pyrazinamide. EurRespirJ (19SS) 807-11. 

The investigation was conducted with the voluntary cooperation of 10 normal males (mean age, 33 years) who were placed on an essentially purine-free diet during the study. Renal handling of uric acid was examined by means of the pyrazinamide (PZA) and probenecid (PB) tests, performed in three uricemia states normouricemia 3.6 to 6.4 mg/dl), allopurinol-induced hypouricemia (under 3.5 mg/dl), and hyperuricemia after oral administration of RNA monosodium salt (over 6.5 mg/dl). 

Class 1 (High Permeability, High Solubihty) Albuterol, Allopurinol, Amlodipine (Amlo), AmoxicilUn, Antipyiine, Dexamethasone, Diltiazem, Zidovudine, Isosoibide mononitrate, Ketoprofen, Lamivudine, Levonoigestiel, Levofloxa-cin. Metronidazole, Midazolam, Minocycline, Morphine, Nifedipine, Ofloxacin, Prednisolone, Propylthiouracil, Stavudine, Phenobaibital, Fluconazole, Chiiiin, Enalapril, Acetaminophen, Diazepam, Lsoniazid, Levodopa, Metoprolol, Paracetamol, Pyrazinamide, Salicylic add, Ethirtylestradiol. ... 

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