Allopurinol Low Start CKD — SCE Rheumatology MCQ

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EasyCrystal ArthropathyAllopurinol Low Start CKDSCE Rheumatology

A 60-year-old man with gout and CKD stage 3 asks why Allopurinol was started at 50 mg. What is the rationale?

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Correct answer: B — Reduced renal clearance of oxypurinol increases toxicity risk; low start with slow uptitration allows safe dose finding

Oxypurinol renally cleared. CKD reduces clearance increasing dose-dependent toxicity including hypersensitivity. BSR 2017/NICE 2022: 50mg in CKD 3-5 monthly uptitration to target. Stamp et al 2017 confirmed safety.

Reference: BSR 2017; Stamp LK et al 2017