People with chronic kidney or heart diseases should refrain from taking allopurinol — the most common drug used to treat high uric acid levels — with more than 20 people dying each year due to severe allergic reactions to the drug, the Linkou Chang Gung Memorial Hospital said yesterday.
“Allopurinol was approved by the US Food Drug Administration as a drug to treat gout, cancer or chemotherapy-induced hyperuricemia, but it is one of the most common medications that can trigger potentially fatal allergic reactions,” the hospital’s Drug Hypersensitivity Clinical and Research Center director Chung Wen-hung (鐘文宏) said.
Chung said about 0.4 percent of patients taking the drug experienced severe allergic responses, such as drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome and toxic epidermal necrolysis, which has a mortality rate of between 18 and 32 percent.
To better understand the health risks of allopurinol, the center, in cooperation with the National Health Insurance Administration (NHIA), conducted a study of people who took the medication from 2005 to 2011.
“The study found that each year, 4.68 of every 1,000 individuals who took the drug suffered from allergic reactions, of whom 2.02 were admitted into hospitals and 0.39 died because of its side effects,” Chung said.
Chung said the research also found that people aged 60 and above, have impaired kidney functions or cardiovascular diseases were at a higher risk for allopurinol-induced allergic reactions.
People with both kidney and heart illnesses faced an ever greater risk of experiencing the potentially deadly side effects and a higher death rate, the study suggested.
As the medication is mainly excreted via the kidney, Chung said people with chronic renal diseases who take the drug are more likely to suffer from kidney and heart failure, or even sepsis, if they experience allergic reactions.
“Over the past decade, more than 20 people died each year because of the medication,” Chung said, urging physicians to avoid prescribing the drug to hyperuricemia patients who also have chronic kidney or heart diseases.
In the past, allopurinol was the only choice of drug for reducing uric acid levels, Chung said.
However, with the NHIA’s coverage of a new antihyperuricemic drug last year, the number of people suffering from allopurinol’s harmful side effects is expected to drop, he said.
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