Lesinurad Allopurinol Brand Name– DUZALLO
What is Lesinurad Allopurinol
Lesinurad, a uricosuric agent that is an urate transporter (URAT1) inhibitor, and allopurinol, a xanthine oxidase inhibitor (XOI), are used in combination to treat hyperuricemia due to gout in patients who have not achieved target serum uric acid levels with a medically appropriate daily dose of allopurinol alone.
The product labeling carries a boxed warning regarding the risk of acute renal failure; this product should not be used if a patient has persistent renal impairment, as defined by a creatinine clearance of less than 45 mL/minute. Therapy requires close monitoring for rash or other serious hypersensitivity reactions to allopurinol.
For chronic gout management, the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) guidelines recommend urate lowering therapy (ULt) to achieve a target serum uric acid (sUA) level of less than 6 mg/dL to prevent the formation of crystals and to eliminate crystal deposition, thereby dissolving tophi.
A lower target (less than 5 mg/dL) is recommended for patients with severe disease.
Treatment guidelines recommend combination therapy (e.g., an XOI plus lesinurad) when treatment goals are not met with initial monotherapy; the use of pegloticase is usually reserved for severe, refractory chronic gout.
Indications
- gout
- gouty arthritis
- hyperuricemia
For the treatment of hyperuricemia due to gout (gouty arthritis) in patients not achieving target serum uric acid levels with allopurinol alone
Side Effects
- abdominal pain
- agranulocytosis
- alopecia
- amblyopia
- amnesia
- anemia
- anorexia
- aplastic anemia
- arthralgia
- asthenia
- azotemia
- bradycardia
- bronchospasm
- bullous rash
- cataracts
- confusion
- conjunctivitis
- depression
- diarrhea
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysgeusia
- dyspepsia
- ecchymosis
- elevated hepatic enzymes
- eosinophilia
- epistaxis
- erythema multiforme
- exfoliative dermatitis
- fever
- gastritis
- gastroesophageal reflux
- GI bleeding
- gynecomastia
- headache
- hematuria
- hemolytic anemia
- hepatic necrosis
- hepatitis
- hepatomegaly
- hyperbilirubinemia
- hypercalcemia
- hyperhidrosis
- hyperlipidemia
- impotence (erectile dysfunction)
- influenza
- insomnia
- iritis
- jaundice
- leukocytosis
- leukopenia
- libido decrease
- lichen planus-like eruption
- lymphadenopathy
- lymphocytosis
- maculopapular rash
- malaise
- myocardial infarction
- myopathy
- nausea
- nephrolithiasis
- neuritis
- onycholysis
- optic neuritis
- pancreatitis
- pancytopenia
- paresthesias
- pericarditis
- peripheral neuropathy
- peripheral vasodilation
- pharyngitis
- proteinuria
- pruritus
- purpura
- rash
- renal failure (unspecified)
- rhinitis
- sialadenitis
- Stevens-Johnson syndrome
- stomatitis
- stroke
- thrombocytopenia
- tinnitus
- toxic epidermal necrolysis
- urticaria
- vasculitis
- vomiting
Monitoring Parameters
- CBC with differential
- LFTs
- serum creatinine/BUN
- serum uric acid
Contraindications
- anticoagulant therapy
- bone marrow suppression
- breast-feeding
- children
- dialysis
- driving or operating machinery
- hepatic disease
- hepatotoxicity
- infants
- kidney transplant
- Lesch-Nyhan syndrome
- pregnancy
- renal disease
- renal failure
- renal impairment
- serious rash
- tumor lysis syndrome (TLS)
Interactions
- Abiraterone
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Alfentanil
- Alfuzosin
- Aliskiren
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Aluminum Hydroxide
- Aluminum Hydroxide; Magnesium Carbonate
- Aluminum Hydroxide; Magnesium Hydroxide
- Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
- Aluminum Hydroxide; Magnesium Trisilicate
- Amiodarone
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amoxicillin
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amoxicillin; Clavulanic Acid
- Ampicillin
- Ampicillin; Sulbactam
- Aprepitant, Fosaprepitant
- Artemether; Lumefantrine
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
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- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
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- Elagolix; Estradiol; Norethindrone acetate
- Elvitegravir
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- Enalapril; Felodipine
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- Ethinyl Estradiol; Desogestrel
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- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
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- Ethinyl Estradiol; Norgestimate
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- Lidocaine
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- Loperamide; Simethicone
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- Lumateperone
- Lurasidone
- Macitentan
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- Mephobarbital
- Mercaptopurine, 6-MP
- Mestranol; Norethindrone
- Methohexital
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- Methoxsalen
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- Nanoparticle Albumin-Bound Paclitaxel
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