UK Clinical Pharmacy Association

Allopurinol

Issues for surgery

For gout – risk of perioperative flare if omitted.

For renal stones – risk of recurrence / exacerbation if omitted.

Advice in the perioperative period

Elective and emergency surgery 

Continue.

Post-operative advice

Restart post-operatively as soon as next dose is due.

Ensure adequate fluid intake (2-3 litres per day).

Monitor renal function – dose reduction may be necessary if renal function is impaired (consult current product literature).

Interactions with common anaesthetic agents

None.

Interactions with other common medicines used in the perioperative period

Amoxicillin

Concomitant administration of amoxicillin with allopurinol is associated with an increased incidence of skin rash. Manufacturer advises consider alternatives but no strong evidence for avoiding concomitant use.

Whilst single surgical prophylactic doses should not pose a problem, monitor for rash with continued post-operative treatment.

Further information

None relevant.

References

Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 24th January 2024]

Summary of Product Characteristics – Allopurinol 100mg tablets. Amarox Limited. Accessed via www.medicines.org.uk 24/01/24 [date of revision of the text November 2022]

Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 24th January 2024]