Ciploric 100mg

Description

“Ciploric 100mg” refers to a tablet containing 100mg of Allopurinol. Allopurinol is a medication used to lower uric acid levels in the blood, making it a cornerstone in the long-term management of gout and certain other conditions associated with high uric acid. It belongs to a class of drugs called xanthine oxidase inhibitors.

Active Ingredient:

• Allopurinol 100mg: This is a purine analogue that acts as an enzyme inhibitor.

Mechanism of Action: Allopurinol works by:

• Inhibiting Xanthine Oxidase: It blocks the activity of xanthine oxidase, an enzyme responsible for converting purines (compounds found naturally in the body and in certain foods) into uric acid.
• Reducing Uric Acid Production: By inhibiting this enzyme, allopurinol significantly reduces the amount of uric acid produced in the body.
• Lowering Blood Uric Acid Levels: This reduction in uric acid helps prevent the formation and deposition of uric acid crystals in joints, kidneys, and other tissues, thereby treating and preventing gout attacks and related complications.

Key Uses: Ciploric 100mg (Allopurinol) is primarily used for:

1. Chronic Management of Hyperuricemia in Patients with Gout: This is its main indication. Gout is a painful type of arthritis caused by the accumulation of uric acid crystals. Allopurinol helps to keep uric acid levels low to prevent future gout attacks and the long-term joint damage that can occur.
2. Prevention of Uric Acid Nephrolithiasis (Kidney Stones): In individuals with high uric acid levels in their urine, it can prevent the formation of uric acid kidney stones.
3. Management of Hyperuricemia Secondary to Chemotherapy: In certain cancer patients undergoing chemotherapy, rapid breakdown of cancer cells can lead to a sudden and significant increase in uric acid levels (known as tumor lysis syndrome), which can harm the kidneys. Allopurinol helps prevent this.
4. Other conditions: It can also be used in some rare enzyme disorders that lead to overproduction of uric acid.

Side Effects

Allopurinol is generally well-tolerated, especially at lower doses. However, like all medications, it can cause side effects. Some are common and mild, while others are serious and require immediate medical attention.

Common Side Effects (usually mild and may subside over time):

• Gout flares: Paradoxically, when starting allopurinol, existing uric acid crystals can be mobilized, potentially leading to an increase in gout attacks (flares) during the first few weeks or months of treatment. This is a sign the medication is working. Your doctor may prescribe an NSAID or colchicine during this initial period to prevent flares.
• Skin rash (mild, often itchy)
• Nausea, vomiting, stomach upset, diarrhea
• Drowsiness, dizziness
• Headache
• Abnormal liver function test results (elevated liver enzymes)

Less Common / Potentially More Serious Side Effects (seek medical attention if experienced):

• Severe Skin Reactions (Allopurinol Hypersensitivity Syndrome – AHS, Stevens-Johnson Syndrome – SJS, Toxic Epidermal Necrolysis – TEN): These are rare but potentially life-threatening allergic reactions. Symptoms include a severe, widespread rash, blistering, peeling of the skin (including inside the mouth, eyes, or genitals), fever, swollen lymph nodes, and involvement of internal organs (e.g., liver, kidneys). If any severe skin rash develops, stop the medication immediately and seek urgent medical help.
• Liver Problems: Symptoms like persistent nausea/vomiting, dark urine, yellowing of the skin or eyes (jaundice), light-colored stools, or severe stomach pain.
• Bone Marrow Depression: Rare, but can lead to a decrease in blood cell counts (anemia, increased risk of infection, easy bruising/bleeding).
• Kidney problems or worsening of existing kidney disease.
• Hair loss or discoloration.
• Changes in taste, blurred vision.
• Swollen lymph glands.

Precautions

It is crucial to use Ciploric 100mg under the strict supervision of a healthcare professional.

1. Initial Gout Flares: Be aware that gout attacks may increase when you first start taking Ciploric. Do not stop the medication if this occurs, as it means the drug is working to dissolve existing crystals. Your doctor will likely prescribe an anti-inflammatory medication (like NSAIDs or colchicine) to be taken concurrently during the initial weeks to months.
2. Allergic Reactions: Allopurinol is known to cause severe hypersensitivity reactions (AHS, SJS/TEN).
   • Stop the medication immediately and seek urgent medical help if you develop any skin rash (even mild), itching, blistering, peeling skin, fever, or swelling of the face, lips, or throat.
   • The risk of these severe reactions is higher in patients with kidney impairment and those of certain genetic backgrounds (e.g., specific HLA-B*5801 allele).
3. Kidney and Liver Impairment: Use with caution if you have kidney or liver disease. Dose adjustments may be necessary. Regular monitoring of kidney and liver function tests is essential.
4. Concomitant Medications: Inform your doctor about ALL other medications (prescription, over-the-counter), herbal products, and supplements you are taking. Significant interactions include:
   • Mercaptopurine or Azathioprine: Allopurinol can drastically increase the levels and toxicity of these immunosuppressant/chemotherapy drugs. Concomitant use is generally contraindicated or requires very significant dose reduction of these drugs under strict monitoring.
   • Warfarin (blood thinner): Allopurinol can enhance the effect of warfarin, increasing bleeding risk. Close monitoring of INR is needed.
   • Theophylline (for asthma/COPD): Allopurinol can increase theophylline levels, leading to toxicity.
   • Ampicillin/Amoxicillin: Increased risk of skin rash when taken with allopurinol.
   • Thiazide Diuretics: May increase the risk of allopurinol toxicity.
   • Cyclosporine: Allopurinol may increase cyclosporine levels.
5. Pregnancy and Breastfeeding: Ciploric 100mg is generally not recommended during pregnancy or breastfeeding due to limited safety data and potential risks to the fetus or infant. Discuss the risks and benefits with your doctor.
6. Alcohol: Limiting or avoiding alcohol is often recommended while on allopurinol, as alcohol can increase uric acid levels and potentially trigger gout attacks.
7. Hydration: Drink plenty of fluids (2-3 liters of water daily) unless advised otherwise by your doctor. This helps to prevent the formation of kidney stones.
8. Driving/Operating Machinery: Ciploric can cause drowsiness or dizziness. Avoid driving or operating heavy machinery until you know how the medication affects you.
9. Asymptomatic Hyperuricemia: Allopurinol is generally not recommended for lowering uric acid in individuals who have high uric acid levels but no symptoms of gout or kidney stones.
10. Regular Monitoring: Your doctor will regularly monitor your serum uric acid levels, liver function, kidney function, and possibly complete blood counts during treatment.

Prescription Information

• Availability: Ciploric 100mg is a prescription-only medication in Nepal and most other countries. It should only be used under the supervision of a qualified healthcare professional.
• Dosage: The dosage of allopurinol is highly individualized and depends on the specific condition, severity, and patient’s response.
  • For Gout: Treatment often starts with a low dose, such as 100mg once daily, and may be gradually increased by 100mg increments at weekly or bi-weekly intervals until the desired serum uric acid level (usually below 6 mg/dL) is achieved. The maximum daily dose can go up to 800mg, but higher doses are often divided.
  • Administration: Take the tablet orally, usually after a meal or with food to minimize stomach upset. Swallow the tablet whole with a glass of water. It’s often recommended to take it at the same time each day for consistency.
• Consistency: Take the medication regularly as advised by your physician, even if you are not experiencing gout attacks, to maintain low uric acid levels and prevent long-term complications. This is a long-term treatment.
• Missed Dose: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.
• Overdose: An overdose requires immediate medical attention. Symptoms may include nausea, vomiting, diarrhea, and dizziness.
• Storage: Store at room temperature (typically below 30°C), away from direct sunlight, heat, and moisture. Keep out of reach of children. Do not use after the expiry date.