Crystal Induced Arthropathy

Allopurinol Use with Chronic Renal
Failure
Half life of allopurinol and oxypurinol increased with
decrease in renal function
Initial dose should be reduced based on Cr. Cl.
Goal for uric acid is still < 6 mg./dl.
If level not achieved, trial of Febuxostat
If Febuxostat not effective or available, consider
slowly increasing allopurinol dose, i.e. 50 mg every 3
to 4 weeks, with careful monitoring of
Creatinine
Uric acid
Liver enzymes.