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  • Probenecid is not recommended in patients with a creatinine clearance <50 ml/min.???For any patient, the initial dose of allopurinol should be <100 mg/day and <50 mg/day in patients with CKD stage 4 or stage 5.5 Starting at a low dose is a strategy designed to decrease gout flares associated with initiation of ULT and to lessen the risk of allopurinol hypersensitivity and other adverse reactions.6
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