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Duzallo (allopurinol and lesinurad), for the treatment of hyperuricaemia in gout patients who have not achieved target serum uric acid levels with an adequate dose of allopurinol alone.

Duzallo is a medicine used in adults with gout to reduce high levels of uric acid in the blood. It is used when allopurinol on its own is not able to control uric acid levels sufficiently.

Gout results from a build-up of uric acid crystals in and around the joints, especially in the toes, which causes pain and swelling.

Duzallo contains the active substances allopurinol and lesinurad.

Duzallo is available as tablets containing either 200 or 300 mg of allopurinol in combination with 200 mg of lesinurad. The strength of Duzallo tablet is chosen to match the dose of allopurinol the patient has been taking. The recommended dose is one tablet once daily, in the morning.

Patients should drink plenty of water throughout the day. The medicine can only be obtained with a prescription.

The two active substances in Duzallo work in different ways to prevent the build-up of uric acid:

  • Lesinurad helps to remove uric acid from the body by blocking a protein called ‘uric acid transporter-1’ (URAT1) in the kidneys. URAT1 allows uric acid to return to the blood after the kidneys have filtered it out. By blocking URAT1, more uric acid is passed out in the urine and less remains in the blood.
  • Allopurinol reduces the production of uric acid in the body by blocking an enzyme called xanthine oxidase, which is needed to make uric acid in the body. By reducing the production of uric acid, allopurinol can reduce levels of uric acid in the blood and keep them low, stopping crystals from building up.

The most common side effects with Duzallo (which may affect up to 1 in 10 people) are flu, gastro-oesophageal reflux disease (stomach acid coming back to the mouth), headache and blood tests showing increased blood creatinine levels (a marker of kidney function). The most serious adverse reactions were kidney failure, reduced kidney function, and kidney stones, which affected less than 1 patient in 100. For the full list of side effects reported with Duzallo, see the package leaflet.

Duzallo must not be taken by patients with severely reduced kidney function, including those who have severely impaired kidney function, who are on dialysis or have received a kidney transplant. It must also not be taken in patients with tumour lysis syndrome (a complication due to the rapid breakdown of cancer cells during cancer treatment) or Lesch-Nyhan syndrome (a rare genetic disease).

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