Is Allopurinol and Lesinurad affected by genetics?
Partially. 1 of 2 ingredients has pharmacogenetic evidence.
Allopurinol and lesinurad contains 2 active ingredients, and 1 of them has published pharmacogenetic guidelines. The relevant gene is ABCG2. Your genotype can change how that ingredient behaves in your body, while the other ingredients aren't affected by genetics in any clinically established way. The strongest evidence level on this page is Moderate, from the published guidelines shown below.
Pharmacogenetic guidelines are written for one ingredient at a time, so the guidance below is for each ingredient on its own. What your genes mean for a combination product is less clear, because the dose and the other ingredients can change things. If you take Allopurinol and lesinurad, it's worth talking over with your prescriber or pharmacist. How we handle combination products.
What's in Allopurinol and lesinurad
Allopurinol Affected by ABCG2
Affected by ABCG2. Guidance from DPWG, moderate evidence.
Read the full allopurinol genetics guideLesinurad No known pharmacogenetics
No strong published pharmacogenetic guideline currently applies to lesinurad.
Allopurinol phenotype recommendations
Published guidance from DPWG on how allopurinol should be dosed or substituted based on your ABCG2 phenotype.
| Phenotype | What it means | Recommendation | Evidence |
|---|---|---|---|
| Normal FunctionABCG2 | Your ABCG2 genotype does not change how you respond to allopurinol; standard dosing applies. | DPWG Use standard allopurinol dosing. |
Moderate |
| Decreased FunctionABCG2 | This drug may lower your uric acid a little less than usual. You may need a somewhat higher dose. | DPWG Use 1.25 times the standard allopurinol dose. Equivalent titration schedule: 100, 200, 400, 500 mg/day instead of the usual 100, 200, 300, 400 mg/day. |
Moderate |
| Poor FunctionABCG2 | This drug may lower your uric acid less than usual. You may need a higher dose to reach your target level. | DPWG Use 1.4 times the standard allopurinol dose. Equivalent titration schedule: 100, 300, 400, 600, 700 mg/day instead of the usual 100, 200, 300, 400, 500 mg/day. |
Moderate |
| IndeterminateABCG2 | We couldn't read your ABCG2 result, so we can't say how this drug will work for you. | DPWG Use standard allopurinol dosing and titrate to target uric acid concentration. |
Not rated |
| Not availableABCG2 | We do not have an ABCG2 result for you, so we cannot personalize guidance for allopurinol. | DPWG Use standard allopurinol dosing and titrate to target uric acid concentration. |
Not rated |
Source: DPWG
The gene behind the guidance
ABCG2 ATP-Binding Cassette Subfamily G Member 2 (BCRP)
ABCG2 is a transporter that moves urate and several drugs out of cells. The Q141K variant (rs2231142) is common, particularly in East Asian populations, and reduces transporter function. Carriers tend to have higher serum urate and respond less to allopurinol, and the Dutch Pharmacogenetics Working Group advises a higher allopurinol dose for them. ABCG2 also affects how quickly the body clears rosuvastatin.
The DPWG advises 1.25 times the standard allopurinol dose for one copy of Q141K and 1.4 times for two.
See all drugs affected by ABCG2Browse the full drug class: Gout treatment.
Find out how your genetics affect Allopurinol and lesinurad
Informational only, not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.