Febuxostat (branded as Uloric) is a newer-generation xanthine oxidase inhibitor that lowers uric acid levels in patients with gout and provides an important alternative for patients who cannot tolerate allopurinol.
Febuxostat works by inhibiting xanthine oxidase, the enzyme responsible for producing uric acid in the body. By lowering uric acid production, it helps prevent the formation of uric acid crystals in joints that cause gout attacks.
While it has a similar mechanism of action to allopurinol, febuxostat is more selective in targeting xanthine oxidase and is metabolized differently, making it suitable for some patients who cannot take allopurinol.
Febuxostat is typically started at a lower dose and may be increased if needed to reach target uric acid levels:
Like all uric acid-lowering therapies, febuxostat should be taken consistently for maximum effectiveness. Regular monitoring of uric acid levels is important to ensure the medication is working properly.
While febuxostat is effective, there are important side effects and risks to consider:
Important FDA Warning:
In 2019, the FDA added a Boxed Warning to febuxostat due to an increased risk of heart-related death compared to allopurinol. This medication should generally be used only when allopurinol is not tolerated or is ineffective.
Despite the cardiovascular concerns, febuxostat remains an effective option for managing gout in certain patients:
Febuxostat, like allopurinol, lowers uric acid—but it does it in a slightly different way. It's often used when allopurinol doesn't work well or causes side effects.
For some people, yes. Febuxostat may lower uric acid more aggressively, but it's not always the first pick due to heart risk concerns.
If allopurinol causes rashes, stomach issues, or just doesn't do the job, febuxostat might be your Plan B.
There's a small increased risk of heart-related death in some studies, which led to an FDA warning. It's a "talk-with-your-doctor" decision.
Yes—but don't start it during a flare. If you're already on it, keep going. Stopping could backfire.
Most people start at 40 mg daily, with some going up to 80 mg if needed. It's a once-a-day thing.
You might see drops within a week, but steady control takes a few months. It's a long game, not a quick fix.
Fewer food issues than allopurinol, but it can interact with drugs like azathioprine. Always double-check your meds.
Often yes, though some plans prefer generics like allopurinol first. Expect a prior auth dance.
A safety study found more heart-related deaths in febuxostat users compared to allopurinol. It's still approved—just with caution.
This website uses cookies to improve your experience and analyze site traffic.
By clicking "Accept", you consent to our use of cookies.
