Desensitization to allopurinol in patients with gout and cutaneous reactions

Am J Med. 1992 Sep;93(3):299-302. doi: 10.1016/0002-9343(92)90236-5.


Purpose: To determine the efficacy and safety of slow oral desensitization in the management of allopurinol-related pruritic cutaneous eruptions.

Patients and methods: Nine patients with renal insufficiency and chronic tophaceous gouty arthritis, who had to interrupt their allopurinol therapy because of an allergic-type pruritic maculopapular eruption, were enrolled in an allopurinol oral desensitization protocol using a schedule of gradually increasing doses.

Results: Cautious reinstitution of allopurinol was successfully accomplished in all nine patients, but four individuals required dose adjustment because of development of a mild, recurrent, macular rash early during the protocol at allopurinol doses of less than or equal to 5 mg/d. Transient, postdesensitization cutaneous reactions occurred in two patients, one of whom also had an early rash.

Conclusion: Oral desensitization to the minor rashes induced by allopurinol is a feasible and acceptably safe approach to therapy, particularly for those with renal insufficiency in whom no substitute urate-lowering drug is available.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Allopurinol / administration & dosage
  • Allopurinol / adverse effects*
  • Allopurinol / immunology
  • Chronic Disease
  • Desensitization, Immunologic*
  • Drug Eruptions / etiology
  • Drug Eruptions / prevention & control*
  • Female
  • Gout / complications
  • Gout / drug therapy*
  • Humans
  • Kidney Failure, Chronic / complications
  • Male
  • Middle Aged
  • Pruritus / chemically induced


  • Allopurinol