Allopurinol: Clinical Considerations in the Development and Treatment of Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, and Other Associated Drug Reactions

Authors

Kathryn M. Dillman, LSU Health Sciences Center - New OrleansFollow
Alison M. Hawkins, Louisiana State University Health Sciences Center, Shreveport, LA
Amanda R. Ragland, Louisiana State University Health Sciences Center, Shreveport, LA
Grace C. Wester, Louisiana State University Health Sciences Center, Shreveport, LA
Driskell R. Greene, Louisiana State University Health Sciences Center, Shreveport, LA
Giustino Varrassi, Paolo Procacci Foundation, Rome, ITA
Peyton Moore, Louisiana State University Health Sciences Center, Shreveport, LA
Raju Behara, Louisiana State University Health Sciences Center, Shreveport, LA
Shahab Ahmadzadeh, Louisiana State University Health Sciences Center, Shreveport, LA
Harish Siddaiah, Louisiana State University Health Sciences Center, Shreveport, LA
Sahar Shekoohi, Louisiana State University Health Sciences Center, Shreveport, LA
Alan D. Kaye, Louisiana State University Health Sciences Center, Shreveport, LA

Document Type

Article

Publication Date

7-16-2024

Publication Title

Cureus

Abstract

Allopurinol lowers urate production through the inhibition of xanthine oxidase. It is oxidatively hydroxylated to oxypurinol and is the most prescribed medication for gout treatment. Although it has a beneficial effect in the treatment of this common disease, like many medications, it is also known for having numerous adverse effects. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), diseases that exist on a spectrum, are two of the most dangerous adverse effects associated with allopurinol use. These immune-mediated disease processes involve almost every organ system. They are essential to recognize as early as possible, as they could potentially be deadly, requiring cessation of the medication with initial signs of rash or other early manifestations of SJS/TEN. One major consideration in the increased risk of allopurinol-mediated or modulated SJS/TEN is the need to have a lower dose in the setting of renal disease. The purpose of this review is not only to examine the involvement of allopurinol in SJS/TEN but also to provide detailed information about the drug, allopurinol, and general features and characteristics of SJS/TEN and other associated drug reactions.

PubMed ID

39149682

Volume

16

Issue

7

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Dillman, Kathryn M.; Hawkins, Alison M.; Ragland, Amanda R.; Wester, Grace C.; Greene, Driskell R.; Varrassi, Giustino; Moore, Peyton; Behara, Raju; Ahmadzadeh, Shahab; Siddaiah, Harish; Shekoohi, Sahar; and Kaye, Alan D., "Allopurinol: Clinical Considerations in the Development and Treatment of Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, and Other Associated Drug Reactions" (2024). School of Medicine Faculty Publications. 2928.
https://digitalscholar.lsuhsc.edu/som_facpubs/2928
10.7759/cureus.64654