Inappropriate Prescription of Allopurinol in a Teaching Hospital
Siriporn Athisakul MD*, Suparaporn Wangkaew MD*, Worawit Louthrenoo MD*
Affiliation : * Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai
Background : Allopurinol is a drug that is widely used to treat hyperuricemia, but it is often prescribed
inappropriately.
Objective : The authors conducted a study to look for the appropriate allopurinol prescription and diagnosis
of gout in the out-patient clinics at a university hospital.
Materials and Methods : One hundred and forty-five patients who were newly prescribed allopurinol (128
males and 17 females, mean + SD age of 58.5 +14.1 years) were enrolled in this study.
Result: Only 77 (53.1%) received allopurinol with appropriate indications. Thirty-eight patients (26.2%) did
not have allopurinol dose adjustment according to the patients’ creatinine clearance. Among 131 patients,
prescribed allopurinol for the diagnosis of gout, only 55 (42.0%) were diagnosed in accordance with the
American Rheumatism Association criteria.
Conclusion : Inappropriate use of allopurinol (both the indication and prescribed dosage) and inappropriate
diagnosis of gout are major problems even in a large teaching hospital. An educational campaign program is
warranted for achieving appropriate diagnosis of gout, and eliminating the inappropriate use of allopurinol.
Keywords : Allopurinol, Drug prescription, Gout, hyperuricemia, inappropriate use of drug
