What allopurinol dose is safe at different levels of renal function?

CrCl >80: titrate up to 300 mg/day as needed; CrCl 60-80: max 200 mg/day; CrCl 40-60: max 150 mg/day; CrCl 20-40: max 100 mg/day; CrCl <20: max 100 mg on alternate days or longer.

What is allopurinol hypersensitivity syndrome and who is at risk?

Allopurinol hypersensitivity syndrome (AHS) includes severe exfoliative dermatitis, hepatitis, and multi-organ failure. CKD (oxypurinol accumulation), HLA-B*58:01 (Asian patients), and high starting doses are major risk factors.

Allopurinol Renal Dose Adjustment — Avoid <20 mL/min

Adjust allopurinol dose based on CrCl for gout management in CKD, avoiding doses >100 mg/day when CrCl <20 mL/min due to oxypurinol accumulation and severe allopurinol hypersensitivity syndrome risk.

Use the full interactive calculator below, or

Allopurinol Renal Dose Adjustment — Avoid <20 mL/min

Frequently Asked Questions

What allopurinol dose is safe at different levels of renal function?

What is allopurinol hypersensitivity syndrome and who is at risk?