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Allopurinol severe rash — GPhC CRA MCQ

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EasyAdverse Drug Reactions and SafetyAllopurinol severe rashGPhC CRA

A 62-year-old woman started allopurinol two weeks ago and now has a widespread blistering rash, fever and sore eyes. She has CKD stage 3 and recently increased the dose from 100mg to 300mg daily. What is the most appropriate action?

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Correct answer: E — Stop supply and arrange emergency medical assessment for severe cutaneous reaction

Blistering rash with fever and mucosal symptoms suggests a severe cutaneous adverse reaction such as Stevens-Johnson syndrome or toxic epidermal necrolysis. Allopurinol is a recognised trigger, and renal impairment increases risk. Emergency assessment is required and further doses should not be supplied pending urgent care. Symptomatic OTC treatment would be unsafe.

Reference: BNF; MHRA safety advice