Febuxostat (Uloric)
Febuxostat is a medication that helps prevent attacks of gout.
Febuxostat reduces the body’s production of uric acid by inhibiting an enzyme called xanthine oxidase. Buildups of excess uric acid can lead to gout and kidney stones.
Febuxostat belongs to a class of medications called xanthine oxidase inhibitors.
Taking Febuxostat
Febuxostat is available in 40, 80, and 120 mg tablets. Only the 80 mg dose is available in Canada.
The usual dose for Febuxostat is one tablet (either a 40mg or 80mg dose) taken daily.
It takes time for Febuxostat to work, and it can sometimes cause gout to flare when a patient starts on it. It is important for patients to understand that this is common, and to continue taking the medication as prescribed by their doctor. Over time, Febuxostat will work to reduce the frequency of flares.
If gout flares while taking Febuxostat, patients should see their doctor so that it can be treated with a different medicine.
Important Tests and Risks
Patients taking Febuxostat should have their blood tested every month or two, as advised by their doctor. It is important to make sure the medication is not irritating the liver.
Drinking alcohol is known to cause flares of gout. Patients taking Febuxostat are advised to avoid alcohol completely.
Patients should not take the medicines azathioprine, mercaptopurine, or theophylline while taking Febuxostat.
Science
Febuxostat works by inhibiting an enzyme called Xanthine oxidase.
Xanthine Oxidase is a crucial part of a chemical reaction that produces uric acid in the body. By inhibiting this enzyme, Febuxostat’s effect on the body is that it starts producing less uric acid.
Gout, the most common type of inflammatory arthritis, occurs when excess uric acid in the body builds up and starts to form into crystals in the joints, tendons, and surrounding tissues. The crystals can trigger a response by the immune system, and its attack results in the painful symptoms seen in a flare of gout.
Febuxostat helps prevent flares (attacks) of gout by reducing the amount of uric acid in the body. As the accumulation of crystals is reduced, the body’s immune response is reduced.
A person’s gout will usually become less severe over time as they continue to take this medication.
Safety
When Febuxostat is first started, it can increase gout flares. It is important for patients to keep taking this medicine because in time it will help prevent flares. New flares that happen after starting Febuxostat can be treated with a different medicine.
Patients taking Febuxostat should have their blood tested every month or two so their doctor can make sure that it isn’t irritating their liver.
Other side-effects of Febuxostat include:
- Joint pain – Febuxostat can rarely cause aching in the joints
- Nausea – While Febuxostat agrees with most people it can rarely cause an upset stomach
- Rash – Febuxostat can rarely cause a rash. Patients who experience a rash should stop taking this medicine and tell their doctor
- Drug interactions – Febuxostat should not be taken with azathioprine, mercaptopurine, or theophylline.
- Heart attack and stroke – All patients with gout and those taking Febuxostat should be aware of the risk of heart attack and stroke and discuss these risks with their doctor.
Patients should talk to their doctor if they are concerned about any side effects.
Febuxostat can safely be stopped without needing to be weaned off. Patients should advise their doctor if they stop taking this medicine.
Febuxostat has not been studied for safety in pregnancy. Patients should let their doctor know if they are planning to get pregnant or if they are breastfeeding.
Patients who should NOT be taking Febuxostat include:
- Patients who have had a previous reaction to Febuxostat
- Patients taking azathioprine, mercaptopurine, or theophylline
Patients who become pregnant while taking Febuxostat should notify their doctor immediately.
Patients taking Febuxostat should call their doctor if they feel sick and want to stop, or they are concerned about any side effects.
Other reasons to call a doctor while taking Febuxostat include:
- Developing a Rash
- Flare of gout
- Becoming pregnant or planning pregnancy
Video
Watch Canadian rheumatologist Dr. Andy Thompson introduce Febuxostat in this short video: