Febuxostat
Febuxostat, sold here as Uloric 40 mg tablets, is a xanthine oxidase inhibitor that lowers uric acid in people with chronic Hyperuricaemia causing gout or tophi.
Key points
- Febuxostat is a xanthine oxidase inhibitor used to treat chronic hyperuricaemia in gout and to prevent uric acid build-up in adults at risk of tumour lysis syndrome during chemotherapy.
- The CARES study found more fatal cardiovascular events with febuxostat than allopurinol in people with existing heart disease, though the later FAST study showed no difference, so cardiovascular monitoring is advised if you have a history of heart attack, stroke or angina.
- Rare but serious allergic reactions including Stevens-Johnson Syndrome and anaphylaxis have been reported, most often in the first month, and febuxostat must be stopped immediately if a rash or swelling develops and never restarted.
How does Febuxostat work?
Febuxostat blocks xanthine oxidase, the enzyme your body uses to convert purines into uric acid. With less uric acid produced, levels in the blood fall over days to weeks. The therapeutic target is to keep serum uric acid below 6 mg/dL, and febuxostat works quickly enough that levels can be retested after two weeks to confirm the drop.
Because it acts on the enzyme itself rather than on how the kidneys handle uric acid, febuxostat suits people whose bodies overproduce urate. That includes chronic gout, one of the main reasons it appears in Gout Treatment, and the rapid cell breakdown seen during chemotherapy for blood cancers.