A patient who is taking azathioprine [Imuran] to prevent rejection of a renal transplant develops gout and the provider orders allopurinol. The nurse will contact the provider to discuss:
a. decreasing the allopurinol dose.
b. decreasing the azathioprine dose.
c. increasing the allopurinol dose.
d. increasing the azathioprine dose.
B
Allopurinol delays conversion of mercaptopurine to inactive products and increases the risk of azathioprine toxicity. Patients taking the two concurrently should have an approximate 70% re-duction in the azathioprine dose. Altering the allopurinol dose is not indicated.
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