Drug-induced hyperuricemia.

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Drug-induced hyperuricemia (common agents) This document Copyright © 2003 D.McAuley, GlobalRPh Inc. All Rights Reserved.
Uric acid is the end-product of purine metabolism and is primarily removed by the kidney. The process of excretion involves filtration, secretion, and reabsorption. Many drugs have been found to alter these processes and induce a state of hyperuricemia. Diuretic-induced hyperuricemia is probably the single most common form of hyperuricemia seen in clinical practice. In most cases, the uric acid level returns to normal after the removal of the offending drug provided there has not been any drug-induced renal injury.
Alcohol	Amiloride
Bumetanide	Chorthalidone
Cisplatin	Cyclophosphamide
Cyclosporine	Ethacrynic acid
Ethambutol	Furosemide
Hydrochlorothiazide	Indapamide
Isotretinoin	Ketoconazole
Levodopa	Metolazone
Pentamidine (renal damage)	Phencyclidine
Pyrazinamide	Salicylates
Theophylline	Thiazide diuretics (in addition to the ones listed above)
Vincristine
References: 1. Faller J, Fox IH. Ethanol induced alterations of uric acid metabolism. Adv Exp Med Biol. 1984;165 Pt A:457-62. 2. Greenberg A. Diuretic complications. Am J Med Sci. 2000 Jan;319(1):10-24. Review. 3. Hosoya T, Ikeda H, Ichida K, Tabe A, Sakai O. [Drug-induced hyperuricemia with decreased renal excretion of urate]. Nippon Rinsho. 1991 May;49(5):1060-4. Review 4. Hutchison JC, Wilkinson WH, McMahon FG. Drug-induced hyperuricemia prevented by probenecid. J Med. 1971;2(1):45-59. 5. Iwaki K, Yonetani Y. Decreased renal excretion of uric acid following diuretic administration in rats. Jpn J Pharmacol. 1984 Apr;34(4):389-96. 6. Laine J, Holmberg C. Mechanisms of hyperuricemia in cyclosporine-treated renal transplanted children. Nephron. 1996;74(2):318-23. 7. Lieber CS. Alcohol and the liver: metabolism of alcohol and its role in hepatic and extrahepatic diseases. Mt Sinai J Med. 2000 Jan;67(1):84-94. 8. Morita Y, Nishida Y, Kamatani N, Miyamoto T. Theophylline increases serum uric acid levels. J Allergy Clin Immunol. 1984 Nov;74(5):707-12. 9. Package Inserts. 10. Paton RR, Kane RE. Long-term diuretic therapy with metolazone of renal failure and the nephrotic syndrome. J Clin Pharmacol. 1977 Apr;17(4):243-51. 11. Postlethwaite AE, Bartel AG, Kelley WN. Hyperuricemia induced by ethambutol. Adv Exp Med Biol. 1974;41:763-7. 12. Sloan RW. Hyperuricemia and gout. J Fam Pract. 1982 May;14(5):923-6, 930-1, 934. 13. Wexler BC. Furosemide-induced hyperuricemia, hyperglycemia, hypertension and arterial lesions in nonarteriosclerotic and arteriosclerotic rats. Atherosclerosis. 1981 May;39(2):253-66. 14. Yonetani Y, Ishii M, Iwaki K. Hyperuricemia induced by some antihypertensives and uricosuric drugs in oxonate-treated rats. Jpn J Pharmacol. 1980 Dec;30(6):829-40.

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