Milurit – indications, contraindications, dosage and side effects

Proven content

Milurit is a medicinal preparation intended for the treatment of hyperuricemia, i.e. excessively high levels of uric acid in the blood. This drug is available in pharmacies only on prescription. What is the composition and action of the drug Milurit? When is it worth reaching for it, and in what cases is it not advisable? How to dose Milurit? Can its use cause side effects? How much does Milurit cost and can you expect a refund? Are there any substitutes for this preparation?

Milurit – general characteristics of the drug

Milurit is a drug that is used primarily in such fields of medicine as urology, rheumatology and orthopedics. Milurit is available in pharmacies with a prescription that is usually given to patients suffering from gout.

The active ingredient of Milurit is allopurynolis an organic chemical compound that reduces the production of uric acid. One tablet of Milurit may contain 100, 200 or 300 mg of allopurinol.

Milurit is available as white or gray tablets. They are round, flat and have no rounded edges. Milurit tablets do not give off any odor. The tablet is engraved with “E351” or “E352” on one side and a score line on the other. Thanks to this line, the tablet can be easily divided into two equal doses.

A pack of Milurit may contain a different number of tablets, depending on the dose of allopurinol contained in the tablet. For a dose of 100 mg, packs of 40, 50, 60, 70, 80 and 120 tablets are available. In turn, the formulation with a dose of 300 mg of allopurinol is available in packs of 30, 40, 60, 70, 80 and 120 tablets.

PROTERAPIA is the entity responsible for the production and distribution of Milurit. The company also manufactures such medicinal products as: Cardilopin, Egiramlon, Explemed, Ketilept, Nitromint, Tisercin and Vivacor.

What is Allopurinol and when should it be used? Read on: Allopurinol – composition, action, indications, contraindications and side effects

Milurit – composition and action of the drug

The active substance in Milurit is an organic chemical compound allopurynol. This compound is a drug, an inhibitor of xanthine oxidase, an enzyme that is involved in the conversion of hypoxanthine to xanthine and xanthine to uric acid.

Uric acid is produced in the human body through several stages. The primary substrate for the synthesis of uric acid are the so-called purine bases, i.e. chemical compounds that are present in high concentrations, for example, in high-protein foods. One of the end products of changes taking place in the body is hypoxanthine, which is oxidized to uric acid. In an acidic environment, when the uric acid concentration is too high, sparingly soluble crystals are formed, which accumulate in organs and tissues causing persistent pain.

Allopurinol reduces the body’s production of xanthines and uric acid. The active substance works by blocking the activity of xanthine oxidase. The end result is that the risk of the formation and accumulation of calcium oxalate and stones in the urinary tract is significantly reduced.

The active substance of the drug Milurit after oral administration is absorbed 67-90%. However, the maximum concentration in the blood occurs approximately one and a half hours after taking the drug. The effect of the drug can be observed from the 4th day of treatment. This is when uric acid levels in the blood begin to drop. The maximum effect of allopurinol is achieved after about 2 weeks of using the preparation. The biological half-life of allopurinol is 1-2 hours, and that of the hepatic metabolite of oxypurinol is 13-30 hours. This compound is excreted from the body primarily in the urine and less than 20% in the faeces.

The total composition of the drug Milurit it differs depending on the dose of active substance contained in the preparation.

Excipients in a tablet of 100 mg:

1. lactose jednowodna;
2. potato starch;
3. powidon K-25;
4. talk;
5. magnesium stearate;
6. sodium carboxymethyl starch (type A).

Excipients in a tablet of 100 mg:

1. microcrystalline cellulose;
2. sodium carboxymethyl starch (type A);
3. gelatine;
4. colloidal anhydrous silica;
5. magnesium stearate.

What does the presence of uric acid in the blood mean? Read on: Uric acid – the norm of serum testing

Milurit – indications for use

Milurit is a preparation that is used primarily in the diagnosis of high levels of uric acid in the blood. Your doctor may recommend this medication, especially for the treatment of:

1. primary and secondary gout;
2. secondary hyperuricaemia caused by chemotherapy and radiation therapy for certain types of cancer (acute tumor lysis syndrome);
3. recurrent nephrolithiasis with mixed calcium-oxalate kidney stones;
4. in the Lesch-Nyhan syndrome;
5. to reduce the risk of build-up of urate stones in the urinary tract. 

Milurit may also be prescribed by your doctor in the case of cancer and myeloproliferative syndromes with rapid cell turnover, in which the elevated urate levels occur spontaneously or due to cytotoxic treatment.

An indication for the use of Milurit is also disturbances in the activity of certain enzymes, leading to the overproduction of urate, for example:

1. hypoxanthine-guanine phosphoribosyltransferase;
2. glucose-6-phosphatase (e.g. glycogen storage disease); 
3. Phosphoribosyl pyrophosphate synthetase; 
4. phosphoribosyl pyrophosphate amidotransferase;
5. adenine phosphoribosyltransferase.

Access to professional medical care will facilitate the purchase of an annual extended medical subscription. Thanks to this, you will gain quick access to many medical services without queues and the need to have a referral.

How to recognize and treat gout? Read on: Gout – where does it come from? How does it manifest itself and how to treat gout? [WE EXPLAIN]

Milurit – contraindications to the use of the drug

The drug Milurit, despite its effectiveness in reducing high levels of uric acid in the blood, cannot be used by every patient struggling with this type of ailments.

Contraindications to the use of Milurit are:

1. allergy to allopurinol or other ingredients of the drug;
2. history of severe skin changes;
3. asymptomatic increases in blood uric acid levels;
4. an acute attack of gout.

What should you know about drug hypersensitivity? Check: Drugs also cause allergies

Any doubts related to the use of the preparation should be consulted immediately with your family doctor. Visit under NFZ contracts via the halodoctor.pl portal.

Milurit – precautions

Before and during the use of Milurit, follow the precautions contained in the package leaflet.

Always consult your doctor before starting Milurit. Particular caution, but also strict medical supervision may be necessary in the following cases:

1. the subject is of the Han ethnic group from China, or is of Thai or Korean origin;
2. you have liver or kidney disease;
3. you have heart disease or high blood pressure and are taking diuretics and / or medicines to lower blood pressure called ACE inhibitors;
4. you are currently having a gout attack;
5. you or a close relative have haemochromatosis, a rare disease characterized by abnormally high absorption of iron from the gastrointestinal tract, leading to excess iron storage, especially in the liver;
6. the patient has thyroid disease;
7. you are being treated with azathioprine, a medicine used to suppress the immune response, an immunosuppressant, or mercaptopurine, which is a medicine used to treat leukemia;
8. the patient reports the occurrence of severe skin rashes – hypersensitivity syndrome, Stevens-Johnson syndrome, toxic epidermal necrolysis;
9. the patient is taking other preparations containing allopurinol; 

Also note that Milurit should not be used after the expiry date which is stated on the carton. The expiry date refers to the last day of that month. Expired medicine should not be disposed of via wastewater or household waste. It’s best to ask your pharmacist how to dispose of medicines you no longer use.

What should you know about proper drug storage? Check: Medications that are stored wrongly are poisonous

Milurit – method of use and dosage

Always use Milurit exactly as described in the package leaflet or as directed by your doctor or pharmacist.

Administration of Milurit Always start with a low dose, e.g. 100 mg daily. This will help to reduce the risk of side effects. This starting dose is only increased if the effect of the effect on serum urate is not satisfactory.

Particular care should be taken when selecting the dose of Milurit in patients with renal insufficiency. According to the recommendations, in light states, from 100 mg to 200 mg of the drug is administered. In moderately severe conditions, the dose may vary between 300 and 600 mg per day. However, in diagnosed severe conditions, doses between 700 and 900 mg of the drug per day should be administered.

In cases where it is necessary to calculate the dose of the drug per kilogram of body weight, the range is from 2 to 10 mg of the drug per kilogram of body weight of the patient per day. For children and adolescents under 15 years of age, this range is between 10 and 20 mg per kilogram body weight per day, with the maximum dose being 400 mg per day taken in three divided doses. It should be noted that in younger patients, the use of the drug is usually limited to specific diseases, including cancer (mainly leukemia) and certain enzyme disorders.

Dosage of the drug in patients with impaired renal function, due to the possible increase in the effect of the preparation, it should be properly adjusted by a doctor. If the creatinine clearance is greater than 20 ml / min, the standard dosage will be used. If the creatinine clearance is in the range of 10-20 ml / min, 100-200 mg of the drug is used daily. In severe renal insufficiency (creatinine clearance less than 10 ml / min), doses lower than 100 mg per day or 100 mg are administered at intervals longer than 24 hours.

How to take medication correctly? Check: How to take medications effectively?

Milurit – side effects

The drug Milurit, like any other drug, may cause side effects in patients. It is important to report any suspected adverse reactions after authorization of the medicinal product so that the benefit / risk balance of the medicinal product can be monitored.

The frequency classification of adverse body reactions (ADRs) is based on the following principles: very common (≥1 / 10), common (≥1 / 100 to <1/10), uncommon (≥1 / 1 to <000/1), rare (≥ 100 / 1 to <10 / 000), very rare (<1 / 1), not known (cannot be estimated from the available data).

The most commonly reported side effects of using Milurit are:

1. skin reactions manifested by a rash;
2. increase in serum TSH concentration.

Uncommon side effects after taking Milurit (may affect up to 1 in 100 people) are allergic reactions such as:

1. skin rash;
2. peeling of the skin;
3. ulceration of the lips and mouth;
4. swelling of the face, hands, lips, tongue or throat;
5. difficulty swallowing or breathing;
6. sudden wheezing;
7. palpitations or tightness in the chest;
8. nausea, vomiting and diarrhea;
9. abnormal liver function tests;
10. collapse.

Rare side effects after the use of the drug Milurit (may affect up to 1 in 1000 people):

1. fever and chills;
2. headaches;
3. muscle aches (flu-like symptoms) and generally feeling unwell;
4. skin lesions – ulcers in the mouth, throat, nose, genitals;
5. conjunctivitis (red and swollen eyes);
6. diffuse blisters or peeling of the epidermis;
7. severe hypersensitivity reactions with fever, skin rash, joint pain, and abnormal blood tests and liver function tests (these may be signs of multi-organ hypersensitivity);
8. joint pain or painful swelling in the groin, armpits or neck area;
9. jaundice (yellowing of the skin and whites of the eyes);
10. liver disorders such as hepatitis;
11. kidney disease;
12. the formation of stones in the urinary tract.

Very rare side effects of Milurit (may affect up to 1 in 10 people:

1. serious allergic reaction which causes swelling of the face or throat;
2. bruising more easily than usual;
3. kidney failure;
4. vomiting blood;
5. high level of fat in the blood;
6. general malaise;
7. numbness in the hands or feet;
8. lack of balance;
9. tingle;
10. inability to move muscles (paralysis) or loss of consciousness;
11. headaches;
12. dizziness;
13. drowsiness or visual disturbances;
14. pain in the chest;
15. high blood pressure or slow heart rate;
16. male infertility or the inability to achieve or maintain an erection;
17. breast enlargement in men and women;
18. a change in the rhythm of bowel movements;
19. the presence of fat in the stool;
20. taste disturbance;
21. cataracts (clouding of the lens of the eye);
22. macular disease of the eye;
23. hair loss or change in color;
24. seizures;
25. depression;
26. fluid retention leading to swelling, especially around the ankles
27. increased thirst;
28. weight loss;
29. a severe, potentially life-threatening allergic reaction.

What side effects can occur after taking medications? Check: Adverse drug reactions

Milurit – interactions with other drugs

Before starting treatment with Milurit, please inform your doctor or pharmacist about all the medicines you are taking or have recently taken. You should also inform what medications the patient plans to take in the near future.

Milurit should not be combined with:

1. 6-Mercaptopurine and azathioprine – azathioprine is metabolised to 6-mercaptopurine which is inactivated by xanthine oxidase. Milurit is an inhibitor of xanthine oxidase. Simultaneous administration of Milurit with 6-mercaptopurine or azathioprine extends the duration of action of these drugs. The serum concentrations of these medicinal products may become toxic, unless the dose is appropriately reduced;
2. vidarabine (adenine arabinoside) – the presence of allopurinol increases the half-life of vidarabine. In case of simultaneous administration of both drugs, careful observation of the patient is necessary for signs of increased toxicity;
3. salicylates and uricosuric agents – Oxipurinol, which is the major metabolite of allopurinol and has a therapeutic effect, is excreted by the kidneys in a similar way to urate. Therefore, uricosuric drugs such as probenecid or high doses of salicylates may accelerate the excretion of oxipurinol, which may reduce the effectiveness of Milurit;
4. chlorpropamidem – in patients with impaired renal function who are co-administered with Milurit and chlorpropamide, there may be a greater risk of prolonging the hypoglycaemic effect;
5. anticoagulants – coumarin derivatives;
6. phenytoin – allopurinol may inhibit hepatic oxidation of phenytoin, but the clinical relevance of this reaction has not been demonstrated;
7. theophylline – inhibition of the metabolism of theophylline has been described. The mechanism of this interaction may be explained by the fact that in humans, xanthine oxidase is involved in the biotransformation of theophylline;
8. ampicillin or amoxicillin – there was an increase in the incidence of skin rashes in patients taking either ampicillin or amoxicillin and allopurinol, compared to patients not taking both drugs simultaneously;
9. cytostatics – blood dyscrasias are more common when allopurinol is given together with cytostatics than when these active substances are given separately;
10. aluminum hydroxide – if you take aluminum hydroxide at the same time, allopurinol may be less effective;
11. cyclosporin – it has been shown that the plasma concentration of cyclosporin may be increased with the concomitant administration of allopurinol;
12. didanosine – concomitant use of allpurinol (at a dose of 300 mg daily) in healthy volunteers and in HIV-infected patients receiving didanosine doubling the plasma Cmax and the AUC of didanosine, without affecting the elimination half-life;
13. ACE inhibitors – simultaneous use with allopurinol is associated with an increased risk of leukopenia, especially in patients with impaired renal function;
14. diuretics – there is an interaction between allopurinol and furosemide, leading to an increase in the serum urate and oxypurinol levels. 

Which drugs should never be combined with each other? Check: Dangerous interactions

Milurit and pregnancy and breastfeeding

The use of any medications or dietary supplements during pregnancy requires consultation with the attending physician. If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking Milurit.

Milurit should only be used during pregnancy when there is no safer alternative and the disease itself carries a risk for the mother or the unborn child.

In a woman taking allopurinol 300 mg daily, food concentrations of allopurinol and oxipurinol were 1,4 mg / L and 53,7 mg / L, respectively. Therefore, the use of allopurinol during breastfeeding is not recommended.

What is worth knowing about proper supplementation during pregnancy? Check: Conscious choices. Diet and supplementation in pregnancy

Milurit — dinner

The price of the drug Milurit may differ depending on the city in which the antibiotic will be purchased or the pharmacy chosen by the patient. The price of the product also depends on the manufacturer of the dose of the drug and the number of tablets contained in the package. For 50 100 mg tablets you should pay about PLN 8-9, while after the refund the price is 3,20. 30 tablets of 200 mg cost about PLN 16. On the other hand, the price of 30 300 mg tablets is about PLN 15, and after reimbursement, PLN 3,20.

How much money does the average Pole spend on treatment? Check: The Pole is not expected to see a doctor

Milurit – replacements

Products that have the same international name and appear in the same form are not always substitutes, because the content of the active substance, i.e. the dose of the drug, determines the use of a given drug.

It should be remembered that even when the dose of the active substance is similar, the patient may not always use the substitute, because he may be allergic to any of the other excipients of the drug.

Therefore, before using a substitute for Milurit, read the package leaflet or consult your doctor or pharmacist.

The preparations containing the same active substance as the drug Milurit and showing similar properties include:

1. Allupol – the manufacturer of the drug is Gedeon Richter;
2. of Argadop – the manufacturer of the drug is Sandoz.