Allopurinol is a commonly prescribed agent in the urologic population for the prevention of urinary stones. Although generally well-tolerated, several serious potential side effects can occur with its use. Allopurinol hypersensitivity syndrome (AHS), in particular, is a relatively rare but potentially life-threatening complication. With the observed increase in urinary stone disease, especially those of uric acid composition, it is likely that the use of allopurinol will increase. Urologists play an important role in the assessment and medical management of patients with urinary stones, thus a greater awareness of the potential adverse events associated with allopurinol use, especially AHS, is important, as well as strategies that can minimize such risks. In this report we review the potential adverse effects of allopurinol. In addition, the results of a comprehensive review of the current literature on AHS will be presented, highlighting those patients at highest risk, reviewing the genetic susceptibility testing currently available, and providing guidance on best practices when allopurinol therapy is being considered.
Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2024 Jan 30 [Epub ahead of print]
Tariq Alotaibi, Jennifer Bjazevic, Richard Kim, Steven Gryn, Nabil Sultan, George Dresser, Hassan Razvi
Division of Clinical Pharmacology, Department of Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada., Division of Urology, Department of Surgery, Schulich School of Medicine and Dentistry, London, ON, Canada., Division of Nephrology, Department of Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada.