Should a patient starting a 'brutunib also take Allopurinol?

[DRM18]

Just curious.

I know Allopurinol is a required pre-treatment for V+O, but I can't find any mention of it being required for Acalabrutunib or Zanubrutunib, ... yet I read about many BTKi patients who take it?

Thanks,

--Dave!

[Justasheet1]

Dave,

I was on allopurinol before the ibrutinib because Dr Wierda gave me obinatuzamab first which brought my WBC count down rapidly. Like from 265,000 to 6 in one day and he didn’t want any issues.

I think the allo is given for rapid cell death and ibrutinib works slowly so I wouldn’t think it’s given but I was given and continue to take Valacyclovir to prevent shingles daily even though I had the Shingrix vaccine.

Jeff

[DRM18 in reply to Justasheet1]

Thanks, Jeff, that helps.

But I wonder if you'd have been given Allopurinol were you not also getting the Obinutuzimab?

--Dave!

[Justasheet1 in reply to DRM18]

Dave,

That’s a conversation you should have with your Doc.

Allopurinol is a pretty benign drug and time limited usually. It never bothered me during chemotherapy during my first treatment or with the ibrutinib for my second.

Jeff

[DRM18 in reply to Justasheet1]

Hi Jeff,

It didn't bother me three years ago. Renal labs were never out of range.

Just curious because I see that Allo kinda standard for Ibru, less so for Acala, so I guess it largely depends on the patient.

--DRM

[Jm954 Administrator in reply to DRM18]

Your doctor will make a judgement call based on your tumour load and the treatment that you're having but no harm in asking

Jackie

[KatieBlue in reply to DRM18]

I was given allopurinol for a short time when I started ibrutinib in fall of ‘18.

[Moma64 in reply to KatieBlue]

Me, too,

[Emgeegee]

I was on Allipurinol for the first few months of taking ibrutunib - while my lymphocyte numbers were rising and until they fell to a reasonable number.

[DRM18 in reply to Emgeegee]

Thanks, MGG!

That’s useful information.

Dave!

[Kwenda]

Allopurinol added to the Acalabrutinib but only for the first month. Once the white cell count came down, stopped the Allopurinol and not required to drink as much water.

Dick

[dogsrule70 in reply to Kwenda]

Same for me.

[Savagebikenut in reply to dogsrule70]

Same for me too. First 30 days only

[meganbo]

I had to take it last year for a month when I started Venclexta. One of the possible side effects in ramp up is tumor lybosis or gout. Luckily I did have either. No issues for me to take it for a month.

This is unrelated but my husband had an attack of gout 2 years ago as it apparently runs in the family. He said it was extremely painful on his foot and Allopurinol was what they gave him it helped a lot. Hope that is helpful and good luck.

[Cindi73]

I've been on Ibrutnib for 5 yrs. I was suffering from bone pain. My rheumatologist checked my uric acid level,it was a little on the high side. She put me on allopurinol and it helped with that side effect. Been on it since. I would check in with your specialist. Cindi

[beechykeen3936]

I took ONE pill of allopurinol when I started on Ibrutinib in April 2020. Had horrific allergic reaction, rash all over, couldn't get rid of it for ages. Had to delay the Ibrutinib until it resolved. I did fine with the Ibrutinib without it.

[Big_Dee]

Hello DRM18

I have never been treated with BTKi drugs and was on B+R and now V&O. My uric acid has been checked through both treatments. While on V&O treatment I was prescribed Allopurinol to control uric acid levels. After end of Oblin treatment I was taken off Allopurinol and retested for uric acid later, uric acid spiked and went back to Allopurinol. Allopurinol protects your kidneys. Blessings.

[Pogee]

For what it's worth, I had a horrible reaction to allopurinol. I took it for two days, and for nearly two weeks thereafter I felt like jumping out a window. * If I were you, I'd research clinical subject reactions, speak with my oncologist about it, find out if it's absolutely necessary, and suggest taking a lower dosage to start with—if the drug is required to begin with. Wish I had done all that to begin with!

[bayside64]

I also had a terrible reaction to Allopurinol, rash all over body. The alternate was Februxostat.