Long-term use of allopurinol in the treatment of gout.

Allopurinol (Zyloric) was first used in 1963 in the U.S.A. and in 1964 in England by Scott and his colleagues (Hall, Holloway, and Scott 1964; Scott, Hall, and Grahame, 1966) and by the author (Kersley, 1966a, b). The position in 1966 was reviewed together with the American literature by Rundles, Elion, and Hitchings (1966), who concluded that the xanthine oxidase inhibitor, allopurinol, was as effective in gout as the uricosuric agents. In very severe disease, or in cases with impaired renal function or urate stones, its use was of prime importance and often gave the best results in combination with colchicine. It was well tolerated when given in divided doses of up to 1 g./day, but about 3 per cent. of patients developed skin reactions, predominantly pruritic and maculopapular. A few cases have also been reported of fever, malaise, jaundice, and mild leucopenia. Toxic reactions regressed within a few days of the drug being stopped.