allopurinol / Generic mfg. - LARVOL DELTA

Molecular modelling study on Piper betle phytocompounds to discover the potential active moiety responsible for xanthine oxidase inhibition in avian gout. (PubMed, Br Poult Sci) - "In silico analysis was performed against the active sites of XO using 32 phytocompounds from P. betle along with the known inhibitor allopurinol used in avian gout treatment.2...The MM‑GBSA calculations supported the docking studies.5. The data showed that 4-chromanol and 4-allyl-1, 2-diacetoxybenzene phytocompounds present in P. betle might account for antigout activity through XO inhibition, meaning that these could be developed as potential drug molecules."

Journal • Gout • Inflammatory Arthritis • Rheumatology

Sex-stratified disproportionality signals of adverse events with allopurinol and febuxostat: a retrospective pharmacovigilance analysis of FAERS and EudraVigilance. (PubMed, Clin Rheumatol) - "Notable sex associated safety signals for allopurinol and febuxostat showed directionally consistent patterns across two databases but should be interpreted as hypothesis generating. Allopurinol showed disproportionality signals for haematological irregularities in female reports, while febuxostat showed signals for rhabdomyolysis in male reports. Topiroxostat data were insufficient for analysis. The findings identify exploratory reporting patterns that require confirmation in studies with exposure denominators and adjustment for confounding."

Adverse events • Journal • Retrospective data • Gout • Hematological Disorders • Inflammatory Arthritis • Rheumatology

Allopurinol-induced DRESS syndrome: a clinical entry point towards the diagnosis of hereditary hemochromatosis (EADV 2026) - "Management included the immediate cessation of allopurinol, intravenous methylprednisolone ( [insert value] mg/kg/day), intensive hyperhydration, and antiviral coverage. The inflammatory "flare" of the DRESS syndrome likely accelerated the visible hyperpigmentation and exacerbated the cholestasis. In the context of CKD, oxypurinol accumulation triggered the DRESS syndrome, but the underlying iron-saturated state determined the catastrophic nature of the hepatic and pancreatic outcomes."

Clinical • Cholestasis • Chronic Kidney Disease • Diabetes • Diabetic Retinopathy • Endocrine Disorders • Eosinophilia • Genetic Disorders • Glaucoma • Hematological Disorders • Hepatology • Infertility • Inflammation • Metabolic Disorders • Nephrology • Ophthalmology • Renal Disease • Retinal Disorders • Sexual Disorders • Type 2 Diabetes Mellitus

Allopurinol-Induced DRESS Syndrome A Clinical Gateway to Diagnosing Hereditary Hemochromatosis (EADV 2026) - "Management includedimmediate cessation of Allopurinol, IV methylprednisolone, intensivehyperhydration, and antiviral coverage. Combined with infertility, hypotrichosis, and diabetes, this formed a pathognomonic cluster of systemic iron overload. Clinicians must look beyond toxidermia to identify underlying vulnerabilities, as acute inflammation can reveal long-standing metabolic disorders"

Clinical • Cholestasis • Chronic Kidney Disease • Diabetes • Diabetic Retinopathy • Endocrine Disorders • Eosinophilia • Genetic Disorders • Glaucoma • Hematological Disorders • Hepatology • Infertility • Inflammation • Metabolic Disorders • Nephrology • Ophthalmology • Renal Disease • Retinal Disorders • Sexual Disorders • Type 2 Diabetes Mellitus

Effective Use of 3% Topical Allopurinol in Intractable Granulomatous Tattoo Reaction: Case Report and Review (EADV 2026) - "Prior treatment with oral cephalexin for presumed infection showed no improvement and no clinical evidence of infection was noted on exam. The patient was initially treated with topical clobetasol propionate ointment without improvement. Subsequent bacterial cultures were negative despite empiric treatment with doxycycline and mupirocin...Reported treatments include topical and intralesional corticosteroids, tacrolimus, allopurinol, hydroxychloroquine, topical pimecrolimus 1% cream, JAK1/2 inhibitors such as ruxolitinib 1.5% cream, and photodynamic therapy using topical methyl aminolevulinate, all with reported success.In our case, the patient showed significant improvement one month after starting topical allopurinol, with complete resolution at three months...Although topical allopurinol is not commercially available in the United States, it can be compounded (approximately $55 for a 30-g preparation), providing a safe and affordable treatment option for recalcitrant..."

Case report • Clinical • Review • Atopic Dermatitis • Immunology • Infectious Disease • Sarcoidosis • Steven-Johnson Syndrome

Common dermatology medication triggers a dermatological emergency: Stevens-Johnson Syndrome caused by doxycycline (EADV 2026) - "In this context, she required monitoring in the intensive care unit and simultaneously developed a complication due to sepsis from bacteremia with isolation of Escherichia coli and Staphylococcus epidermidis, which were managed with cefepime and linezolid. Owing to the described body surface involvement, treatment was initiated with prednisone pulses and subsequently at a dose of 50 mg/day. However, in the absence of a clinical response, cyclosporine (100 mg/day) and topical corticosteroids were administered, resulting in a favorable response within 2 weeks...The medications most frequently associated with SJS/TEN include antibiotics (28% of cases) from the sulfonamide and aminopenicillin groups, nonsteroidal anti-inflammatory drugs, and anticonvulsants such as phenytoin, lamotrigine, carbamazepine, and allopurinol...Management should be multidisciplinary and include intensive support, pain control, skin barrier care measures, monitoring for infectious complications and..."

Acne Vulgaris • Dermatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Rosacea • Septic Shock • Sjogren's Syndrome • Steven-Johnson Syndrome

Is Eosinophilia Mandatory in DRESS? A Case Series Evaluating Peripheral and Tissue Eosinophilia and Their Correlation with Severity of Transaminitis (EADV 2026) - "The most common culprit drug was sulfasalazine (n=5). Other implicated drugs included leflunomide, carbamazepine, lamotrigine, allopurinol, vancomycin, piperacillin-tazobactam, and co-trimoxazole, with one case attributed to each...Furthermore, it does not reliably correlate with the severity of transaminitis, as significant hepatic involvement may occur even in its absence. Therefore, eosinophil count alone is an unreliable marker for both diagnosis and assessment of hepatic injury severity, and its absence should not preclude early recognition of DRESS syndrome."

Clinical • Eosinophilia • Hepatology • Immunology • Liver Failure

Determinants of the Severity of Lyell Syndrome: Epidemiological and Clinical Profile, Role of the Implicated Molecule, and Time to Onset (EADV 2026) - "The most frequently implicated drugs were allopurinol (30%), lamotrigine (12.5%), NSAIDs (10%), paracetamol (10%), and amoxicillin–clavulanic acid (10%). The most severe forms occur more frequently when the time to onset is 7–28 days and after exposure to certain drug classes, particularly antibiotics and NSAIDs. Early identification of these factors remains essential to optimize prognostic assessment and patient management."

Clinical • Conjunctivitis • Keratitis • Ocular Infections • Ocular Inflammation • Ophthalmology • Steven-Johnson Syndrome

EPIDEMIOLOGICAL, CLINICAL, AND BIOLOGICAL CHARACTERISTICS OF DRESSSYNDROME IN ELDERLY PATIENTS: A RETROSPECTIVE STUDY OF 21 CASES (EADV 2026) - "Allopurinol was the most frequently implicated drug (85.7%)...Other drugs included phenobarbital, an antibiotic, and aspirin (4.7% each)...Overall, DRESS in elderly patients shows clinical features similar to those in younger adults but appears to be associated with a higher frequency of visceral involvement, particularly renal. These findings highlight the need for careful prescribing practices and increased vigilance in elderly patients, as well as further studies focusing on this population."

Retrospective data • Cardiovascular • Diabetes • Eosinophilia • Gout • Hypertension • Inflammatory Arthritis • Metabolic Disorders

Whole-genome sequencing and studies using AlphaFold suggest that HLA-B*13:01 may be a universal biomarker associated with drugs that frequently cause drug eruptions (EADV 2026) - "Results The drugs most frequently reported to cause drug eruptions, in descending order, were carbamazepine, lamotrigine, and allopurinol. Furthermore, drugs that readily bind to HLA-B*13:01 were found to share common chemical structural formulas. Conclusions This study demonstrated through whole-genome sequencing analysis and AlphaFold-based research that HLA-B*13:01 is a universal biomarker for drugs prone to causing drug eruptions."

Biomarker • Whole genome sequencing • Immunology • Steven-Johnson Syndrome • HLA-B

Drug Rash with Eosinophilia and Systemic Symptoms Associated with Brentuximab Vedotin: A Rarely Reported Case in the Literature (EADV 2026) - "Following the diagnosis, chemotherapy with adriamycin, bleomycin, vinblastine, and dacarbazine was initiated...In consensus with the hematologydepartment, it was decided to continue brentuximab treatment, initiate systemic methylprednisolone at a dose of 32 mg/day, apply mometasone furoateointment to the erythematous maculopapular lesions on the arms and legs, and closely monitor liver and kidney function tests as well as hemogramparameters...It typically develops 2–6 weeks after exposure to the offending drug, with antiepileptics, antibiotics, NSAIDs, and allopurinol being the most frequently implicated agents...Although brentuximab vedotin is known to cause various cutaneous adverse reactions, DRESS associated with this agent has been reported only rarely. This case highlights the importance of recognizing DRESS in patients receiving brentuximab vedotin who develop fever, rash, and systemic involvement, emphasizing the need for early diagnosis and prompt treatment to..."

Clinical • Cardiovascular • Cutaneous T-cell Lymphoma • Eosinophilia • Hematological Malignancies • Immunology • Lymphoma • T Cell Non-Hodgkin Lymphoma • TNFRSF8

When Two High-Risk Drugs Collide: Allopurinol-Induced DRESS Syndrome Exacerbated by Cotrimoxazole (EADV 2026) - "The progression was marked by a flu-like syndrome followed by tonsillitis and a urinary tract infection, which prompted the intake of several antibiotics, including amoxicillin-clavulanic acid, ciprofloxacin, cotrimoxazole (Bactrim), and pristinamycin . Allopurinol is a primary cause, and its presentation can be worsened by cotrimoxazole . Early recognition is essential for a favorable outcome ."

Cardiovascular • Cholestasis • Eosinophilia • Gout • Hepatology • Hypertension • Immunology • Infectious Disease • Inflammatory Arthritis • Nephrology • Otorhinolaryngology

Type 3c Diabetes Mellitus Presenting as Acquired Reactive Perforating Collagenosis (EADV 2026) - "Additional therapeutic options include topical retinoids, keratolytics, topical or systemic corticosteroids, tetracyclines, rifampicin, narrowband UVB phototherapy, PUVA phototherapy, oral acitretin, and allopurinol...Optimisation of glycaemic control, combined withdermatological management including topical clobetasol propionate, oral chlorphenamine,and narrowband UVB phototherapy, led to some clinical improvement...This case highlights the importance of thorough evaluation, including random blood glucose testing, in patients with atypical pruritic dermatoses. While perforating collagenosis is usually reported in individuals with established diabetes, it can also present as an initial cutaneous manifestation, revealing previously undiagnosed diabetes."

Addiction (Opioid and Alcohol) • Chronic Kidney Disease • Diabetes • Endocrine Disorders • Fibromyalgia • Fibrosis • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Metabolic Disorders • Musculoskeletal Pain • Nephrology • Obesity • Pancreatitis • Renal Disease

Reactive Perforating Collagenosis Successfully Treated with Low-Dose Colchicine: A Case Report (EADV 2026) - "Conclusion RPC is often refractory to conventional therapies, including phototherapy and systemic agents such as allopurinol. Colchicine, through its anti-inflammatory effects and inhibition of neutrophil chemotaxis, may represent an effective therapeutic alternative.This case highlights a favorable response to low-dose colchicine, supporting its use as a safe and accessible option, particularly in patients with metabolic comorbidities."

Case report • Clinical • Chronic Kidney Disease • Diabetes • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Comparison of the Effect of Allopurinol Versus Febuxostat on Serum Uric Acid in Patients With Chronic Kidney Disease Associated With Hyperuricemia (clinicaltrials.gov) - P=N/A | N=66 | Active, not recruiting | Sponsor: Nishtar Medical University

New trial • Chronic Kidney Disease • Nephrology • Renal Disease

Toxic Epidermal Necrolysis with Epiglottitis: A Rare Airway Challenge (ASA 2026) - "Evaluation revealed toxic epidermal necrolysis (TEN) triggered by allopurinol, with extensive mucosal as well as ocular involvement requiring sutured amniotic membrane placement under anesthesia. This case examines the unique airway management challenges posed by concurrent epiglottitis and diffuse edematous mucosal sloughing in the setting of TEN."

Cardiovascular • Chronic Kidney Disease • Chronic Obstructive Pulmonary Disease • Gout • Hypertension • Immunology • Inflammatory Arthritis • Respiratory Diseases • Steven-Johnson Syndrome

Tirzepatide-Associated Drug-Induced Liver Injury in a Liver Transplant Recipient: A Case Report (ACG 2026) - "She has been on 5 mg of extended-release tacrolimus (envarsus) daily with stable therapeutic trough levels. Review of other medications was notable for allopurinol, escitalopram, and glipizide, which were long-term with stable dose...Figure: Table 1. Liver Enzyme Trends During Tirzepatide Exposure and Following Discontinuation"

Case report • Clinical • Diabetes • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Metabolic Disorders • Metabolic Dysfunction-Associated Steatohepatitis • Obesity • Transplantation • Type 2 Diabetes Mellitus

CHOLESTATIC LIVER INJURY ASSOCIATED WITH COLCHICINE IN FAMILIAL MEDITERRANEAN FEVER: A CASE REPORT (UEGW 2026) - "Medications included colchicine (1 mg/day), perindopril, amlodipine, indapamide, and allopurinol. This case suggests that cholestatic liver injury in FMF may be associated with colchicine therapy and that ascites may occur outside acute FMF attacks."

Case report • Clinical • Amyloidosis • Cardiovascular • Chronic Kidney Disease • Fibrosis • Genetic Disorders • Gout • Hepatology • Immunology • Inflammatory Arthritis • Liver Failure • Nephrology • Pruritus • Renal Disease • Xerostomia • MUC16

Ultrasound-Assisted Ternary Deep Eutectic Solvent Extraction of Total Flavonoids from Artemisia argyi: GA-ANN Optimization, Greenness Assessment, and In Vitro Bioactivity Evaluation. (PubMed, Antioxidants (Basel)) - "As an in silico probe, the predominant quantified flavonoid eupatilin (3.64 mg/g) docked to xanthine oxidase (-7.78 kcal/mol vs. allopurinol -6.86), offering a structural hypothesis for XO interaction without attributing mixture bioactivity to a single compound. This TDES-based platform offers a scalable, green route to valorize A. argyi for functional food and nutraceutical applications."

Journal • Preclinical

Rapid Clinical Improvement Temporally Associated with Off-Label LetiFend® Vaccination in Canine Leishmaniasis: A Case Report. (PubMed, Vaccines (Basel)) - "Domperidone was subsequently introduced as long-term immunomodulatory follow-up, and allopurinol was temporarily reintroduced after transient laboratory deterioration in 2024; the dog remained clinically healthy through July 2026. The close temporal association is clinically noteworthy but cannot establish causality. This hypothesis-generating observation supports controlled investigation of therapeutic vaccination as a potential complementary approach in canine leishmaniasis."

Journal • Hematological Disorders • Infectious Disease • Thrombocytopenia

Study on renal protective effect of serum urate lowering therapy (clinicaltrials.gov) - P=N/A | N=90 | Recruiting | Sponsor: Tokushukai Medical Corporation Shonan Kamakura General Hospital (Clinical Research Center) | N=150 ➔ 90

Enrollment change • FGF23

A Phase 2 Study of Minimal Residual Disease (MRD)-Adapted Front Line Venetoclax and Obinutuzumab in Fit Patients with Chronic Lymphocytic Leukemia (CLL): Effect of Obinutuzumab on Tumor Lysis Syndrome (TLS) Risk and Safety of Outpatient Venetoclax Dose Escalation (ASH 2023) - P2 | "For pts who remained high TLS risk at the time of V initiation, TLS ppx throughout dose escalation included allopurinol to start at least 3 days prior to V initiation, sevelamer to start 12 hours prior to V initiation, and oral intake of ≥2 L water daily. On days of dose escalation, ppx additionally included kayexalate, rasburicase, and IV normal saline on D1 and D2 of each dose escalation... A single cycle of O effectively reduced TLS risk prior to introduction of V escalation with most pts achieving low or med TLS risk by C1D22. Notably, 90% of pts with high pre-tx TLS risk converted to low or med risk following C1 of O allowing for outpatient V escalation per FDA label. Further, we demonstrate that V dose escalation can be safely accomplished in the outpatient setting with close monitoring regardless of TLS risk."

Clinical • Minimal residual disease • P2 data • Residual disease • Chronic Lymphocytic Leukemia • Hematological Disorders • Hematological Malignancies • Leukemia • Neutropenia • Oncology • Thrombocytopenia

Evaluation of ventoclax initiation prophylaxis and monitoring outcomes at each dose level and time point in patients with chronic lymphocytic leukemia: A real-world experience (ASH 2025) - "Background : Venetoclax (VEN)+obinutuzumab (VO) is an effective therapy for CLL/SLL requiring regularmonitoring for tumor lysis syndrome (TLS) during VEN ramp-up...Adult pts with CLL/SLL were eligible if they: (1) startedVO per-label outside of a clinical trial in 1L, or immediately after exposure in 1L to agents with differentmechanisms of action (i.e., BTKi, anti-CD20 only) of <30 days; (2) prior to VEN start, had either (i) lowphysician-determined tumor burden (TB) (i.e., all lymph nodes [LN] <5 cm and ALC <25 x 109/L), or (ii)medium physician-determined TB (i.e., any LN ≥5-<10 cm or ALC ≥25 x 109/L) with creatinine clearance≥80 mL/min; (3) had no strong CYP3A inhibitors or prophylactic rasburicase from 3 days prior to VENstart until end of VEN ramp-up; and (4) had VEN ramp-up in an outpatient setting.TB-related labs/imaging was assessed from 2 months prior to obinutuzumab initiation (i.e., index date)until VEN start...Prior to VEN ramp-up, all pts..."

Clinical • Real-world • Real-world evidence • Chronic Lymphocytic Leukemia • Diabetes • Hematological Disorders • Hematological Malignancies • Leukemia • Neutropenia • IGH • TP53

Non-Cirrhotic Hyperammonemic Encephalopathy in a Critically Ill Patient (ACG 2026) - "Case Description/ A 36-year-old female with a history of gastric bypass who presented with leg ulcers and oral mucosal lesions was found to have TEN likely from allopurinol use for gout...Data points indicate concurrent interventions: no intervention (gray X), lactulose alone (blue circles), continuous renal replacement therapy (CRRT, red squares), and L-carnitine with CRRT (purple triangles)...Ammonia levels declined to within normal range (10â28 µmol/L, green shaded area) by day 29 following CRRT discontinuation. Error bars represent same-day repeated measurements."

Clinical • Autoimmune Hepatitis • Cardiovascular • CNS Disorders • Fibrosis • Gout • Hepatology • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Metabolic Disorders • Nephrology • Portal Hypertension • Renal Disease • Septic Shock • Steven-Johnson Syndrome

Proton Pump Inhibitors and H2-Receptor Blockers as Culprit Agents in Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis: A Systematic Review of Case Reports (ACG 2026) - "While antibiotics, anticonvulsants, and allopurinol are well-established culprits, proton pump inhibitors (PPIs) and H2-receptor blockers (H2RBs), among the most widely prescribed drug classes globally, are underrecognized triggers...PPIs were implicated in 62% of cases; lansoprazole, omeprazole, and pantoprazole were most frequent. H2RBs accounted for 38%, with ranitidine and cimetidine most common... Twenty studies met inclusion criteria, including one two-patient case series, yielding 21 cases (10 TEN, 11 SJS). Median age was 50 years; 62% were female. Median latency to onset was 10 days."

Case report • Clinical • Review • Acute Respiratory Distress Syndrome • Cardiovascular • Infectious Disease • Renal Disease • Respiratory Diseases • Septic Shock • Steven-Johnson Syndrome