What are the ACR guidelines for the use of allopurinol ULT in gout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
  • Print
Answer

Allopurinol:

  • Testing for the HLA–B*5801 allele prior to starting allopurinol is conditionally recommended for patients of Southeast Asian descent (eg, Han Chinese, Korean, Thai) and for African-American patients, over not testing for the HLA–B*5801 allele. Universal testing for the HLA–B*5801 allele prior to starting allopurinol is conditionally recommended against in patients of other ethnic or racial background over testing for the HLA–B*5801 allele.
  • Starting allopurinol in daily doses of ≤100 mg (and lower doses in patients with CKD) is strongly recommended over starting at a higher dose.
  • Allopurinol desensitization is conditionally recommended for patients with a prior allergic response to allopurinol who cannot be treated with other oral ULT agents.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!