알로푸리놀

Allopurinol

1,5-dihydro-4H-pyrazolo[3,4-d]pyrimidin-4-one

다른 이름: Zyloprim · Aloprim · Zyloric · Zylapour · allopurinolum · BW-56-158 · HPP · NSC-1390 · oxypurinol (active metabolite) · alloxanthine

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

15 mg/kg PO q12h; only in conjunction with low purine foods.PO· q12h

체중— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
Urate uroliths (dissolution)	15 mg/kg PO q12h; only in conjunction with low purine foods.	PO	q12h	—	🌎 NA
Urate uroliths (prevention)	10-20 mg/kg/day	PO	Daily	—	🌎 NA
Urate uroliths (dissolution and prevention)	7-10 mg/kg PO three times daily	PO	TID	—	🌎 NA
Leishmaniasis (First line treatment)	10 mg/kg PO twice daily	PO	BID	6-12 months	🌎 NA
Leishmaniasis (Second line treatment)	10 mg/kg PO twice daily	PO	BID	6-12 months	🌎 NA
Leishmaniasis	20 mg/kg PO q12h	PO	q12h	9 months	🌎 NA
Leishmaniasis (Alternate protocol alone)	10 mg/kg PO q8h or 10-20 mg/kg PO q12h	PO	q8h or q12h	1-4 months	🌎 NA
Leishmaniasis	10 mg/kg PO twice daily	PO	BID	—	🌎 NA
Leishmaniasis (with renal insufficiency)	5 mg/kg PO twice daily	PO	BID	—	🌎 NA
Leishmaniasis	15 mg/kg PO twice daily	PO	BID	months	🌎 NA
Uric acid urolithiasis (Dissolution)	10 mg/kg p.o. q8h or 15 mg/kg p.o. q12h	PO	q8h or q12h	up to 4 weeks	🌍 EU
Uric acid urolithiasis (Prevention)	10-15 mg/kg	PO	q24h	—	🌍 EU
Leishmaniosis	10 mg/kg	PO	q12h	at least 6-12 months	🌍 EU

Urate uroliths (prevention): Preferable to minimize recurrence with dietary therapy to avoid xanthine uroliths.
Urate uroliths (dissolution and prevention): Goal is to reduce urine urate:creatinine ratio by 50%.
Leishmaniasis (First line treatment): Used plus Meglumine antimoniate 75-100 mg/kg once daily for 4-8 weeks.
Leishmaniasis (Second line treatment): Used plus Miltofosine 2 mg/kg PO once daily for 4 weeks OR allopurinol alone.
Leishmaniasis: With Meglumine antimoniate (100 mg/kg/day SQ) until resolution.
Leishmaniasis: If possible use with meglumine antimoniate, if not, use alone.
Leishmaniosis: Use with meglumine antimonate for 1-2 months, or miltefosine for 1 month (NB: this does not result in complete parasitological cure).

고양이

적응증	용량	경로	빈도	기간	지역
Leishmaniosis	10-20 mg/kg	PO	q12-24h	—	🌍 EU

Leishmaniosis: Has been shown to be effective (although experience is limited in this species).

새

적응증	용량	경로	빈도	기간	지역
Gout (budgies and cockatiels)	Crush one 100 mg tablet into 10 mL of water. Add 20 drops of this solution to one ounce of drinking water.	PO	Continuous in water	—	🌎 NA
Gout (parakeets)	Crush one 100 mg tablet into 10 mL of water. Add 20 drops of this solution to one ounce of drinking water or give 1 drop 4 times daily.	PO	Continuous or QID	—	🌎 NA

파충류

적응증	용량	경로	빈도	기간	지역
Elevated uric acid levels in renal disease (lizards)	20 mg/kg PO once daily	PO	SID	—	🌎 NA
Gout	20 mg/kg PO once daily	PO	SID	—	🌎 NA
Hyperuricemia (green iguanas)	25 mg/kg PO daily	PO	SID	—	🌎 NA

Gout: Suggested dosage based upon human data as dose is not established for reptiles.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

알로푸리놀(Allopurinol)은 수의학에서 널리 사용되는 강력한 크산틴 산화효소 억제제입니다.

주요 임상 적용 분야는 다음과 같습니다:

요산염 요로결석: 주로 개(특히 달마시안과 같은 호발 품종)에서 요산 결석을 용해하고 예방하는 데 사용됩니다. 크산틴 결석 형성을 방지하기 위해 반드시 저퓨린 식단과 병행해야 합니다.
개 리슈만편모충증: 리슈만편모충 증식 억제제로 작용합니다. 장기 관리를 위해 메글루민 안티모니에이트(meglumine antimoniate) 또는 밀테포신(miltefosine)과 병용하는 경우가 많습니다.
조류 및 파충류 의학: 조류와 파충류의 고요산혈증 관리 및 통풍 치료에 사용됩니다.

임상 팁: 알로푸리놀은 크산틴의 요중 배설을 증가시키므로, 식이 퓨린 제한 없이 장기간 고용량으로 투여할 경우 역설적으로 크산틴 요로결석이 형성될 수 있습니다.

작용 기전

Allopurinol and its primary active metabolite, oxypurinol (alloxanthine), competitively inhibit the enzyme xanthine oxidase.

Normal Pathway: Hypoxanthine → xanthine oxidase → Xanthine → xanthine oxidase → Uric Acid
Inhibition: By blocking this enzyme, allopurinol prevents the conversion of oxypurines to uric acid. This decreases serum and urine concentrations of uric acid, while increasing the levels of the more water-soluble precursors (hypoxanthine and xanthine).

In Leishmaniasis: Allopurinol acts as a purine analogue. Leishmania organisms mistakenly incorporate allopurinol metabolites into their RNA, which disrupts protein synthesis and inhibits parasite multiplication.

안전성·주의사항

금기사항

Known hypersensitivity to allopurinol
Red-tailed hawks (anecdotal reports of severe toxicity)

부작용

Xanthine urolithiasis (especially with high doses or non-restricted diets)
Hypersensitivity reactions (rash, erythema)
Lethargy
Gastrointestinal upset
Hepatotoxicity (rare)
Bone marrow suppression (rare)

주의

Prolonged high doses of allopurinol may result in xanthine uroliths; it is highly recommended to use concurrently with a low-purine diet for urolith management. Use with caution and consider dose reduction (e.g., 5 mg/kg PO twice daily) in patients with renal insufficiency.

약물 상호작용

Chlorpropamide

May increase risks for hypoglycemia and hepato-renal reactions

Cyclophosphamide

Increased bone marrow depression may occur

Cyclosporine

Allopurinol may increase cyclosporine levels

Diuretics (Furosemide, Thiazides, Diazoxide) and Alcohol

Can increase uric acid levels, antagonizing allopurinol's effect

Oral Anticoagulants (e.g., Warfarin)

Allopurinol may reduce the metabolism of warfarin thereby increasing its effect

Trimethoprim/Sulfamethoxazole

Thrombocytopenia has occurred in a few human patients when used concurrently

Uricosuric Agents (e.g., Probenecid, Sulfinpyrazone)

May increase the renal excretion of oxypurinol and thereby reduce xanthine oxidase inhibition; additive effects on blood uric acid may be beneficial

Urinary Acidifiers (e.g., Methionine, Ammonium Chloride)

May reduce the solubility of uric acid in the urine and induce urolithiasis

AzathioprineMajor

Allopurinol inhibits the metabolism of azathioprine, leading to severe, potentially fatal myelosuppression.

MercaptopurineMajor

Allopurinol inhibits the metabolism of mercaptopurine, significantly increasing toxicity risk.

Amoxicillin / AmpicillinModerate

Concurrent use increases the risk of cutaneous rash.

TheophyllineModerate

May decrease theophylline clearance, increasing the risk of toxicity.

Thiazide diureticsModerate

May increase the risk of allopurinol hypersensitivity and toxicity.

AmoxicillinMinor

Increased risk of skin rashes when used concurrently.

모니터링

Urine uric acid (for urolithiasis)
Adverse effects (rash, lethargy)
Periodic CBC, liver and renal function tests (e.g., BUN, Creatinine, liver enzymes); especially early in therapy

약동학

흡수

Rapidly absorbed following oral administration.

분포

Widely distributed in tissue fluid; not highly bound to plasma proteins.

대사

Rapidly oxidized to its primary active metabolite, oxypurinol (alloxanthine), which is also a xanthine oxidase inhibitor.

배설

Excreted primarily in the urine as oxypurinol and unchanged allopurinol.

과다투여

Information on acute overdosage in veterinary species is limited. Massive overdoses may cause gastrointestinal distress (vomiting, diarrhea). Treatment should consist of supportive care and monitoring of renal function. Adequate hydration is important to promote diuresis and excretion.

제품

제형

Oral tablets
Powder for injection (lyophilized)
Compounded oral suspension

인용의약품

Allopurinol Oral Tablets: 100 mg & 300 mg; Zyloprim® (Faro); generic
Allopurinol Powder for Injection, lyophilized: 500 mg preservative-free in 30 mL vials; Aloprim® (Nabi); generic (Bedford Labs)

규제 현황

European Union✓ 승인됨처방전의약품EMA

🐕 Dogs

Approved in several EU member states specifically for canine leishmaniosis.

United Kingdom✓ 승인됨처방전의약품VMD

🐕 Dogs

Used under the cascade where specific veterinary licensed products are unavailable.

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Tablets should be stored at room temperature in well-closed containers; stable in light and air. Powder for injection should be stored at 25°C (excursions permitted to 15-30°C). Once diluted to ≤6 mg/mL, store at room temperature and use within 10 hours; do not refrigerate. Compounded oral suspensions (20 mg/mL) in Ora-Plus/Ora-Sweet retain >95% potency for 60 days at 5°C and 25°C and should be protected from light.

보호자 정보

중요: 수의사의 다른 지시가 없는 한, 위장 장애를 최소화하기 위해 이 약은 식후(보통 식후 약 1시간)에 투여하십시오.

식이 관리: 반려동물이 요산 결석 치료를 받고 있다면 수의사가 처방한 저퓨린 식단을 엄격히 따르십시오. 적절한 식단 없이 이 약을 투여하면 다른 종류의 결석(크산틴 결석)이 형성될 수 있습니다.
수의사에게 연락해야 할 때: 반려동물에게 피부 발진이 생기거나, 비정상적으로 무기력해지거나, 아파 보인다면 즉시 수의사에게 알리십시오.
비뇨기계를 씻어내는 데 도움이 되도록 반려동물이 항상 신선한 식수를 충분히 마실 수 있게 해주십시오.

VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.