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Pharmacy and Medications

Febuxostat

07/29/2010

Question:

My dr has suggested Ulril 80 mg tab ( febuxostat ) which according to him is the better over allopurinol. Is this drug advantageous for high uric acid.

Answer:

Thank you for contacting Net Wellness. Febuxostat (UloricĀ®) is a xanthine oxidase inhibitor that works to decrease serum uric acid in the body. Gout is a common painful and debilitating condition that develops in some people with high uric acid level or hyperuricemia. Not all people with hyperuricemia will develop gout.

The preventative therapy for gout is to reduce uric acid in the body. This can be achieved through medication and dietary changes. Foods to avoid are red meats, seafood, beer and hard alcohol, and foods containing high fructose syrup. There are various medications that can be taken for prevention of hyperuricemia. The medications that can be used are probenecid, losartan, allopurinol or febxostat.

Lowering urate levels is a process that can take many months, and the dosage is usually started out at a low dose and increased over time until urate levels can be lowered. Allopurinol and febxostat work very similarly to decrease urate levels. A percentage of patients do not tolerate doses of allopurinol that are required to achieve the desired level of uric acid. Febxostat is approved for hyperuricemia and may be a good alternative for patients who do not tolerate allopurinol or who have kidney dysfunction. It is a more expensive agent, but it is an alternative for patients who would fail allopurinol therapy or need an equal alternative, especially for patients with kidney dysfunction.

If you are not tolerating allopurinol, not able to decrease your uric acid level, or have kidney dysfunction, febxostat may be a better option. If this is not the case, allopurinol and febxostat would be equivalent for decreasing uric acid as long as it is dosed appropriately. 

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Response by:

Sarah Hudson-DiSalle, PharmD, RPh
Specialty Practice Pharmacist of Outpatient Pharmacy
College of Medicine
The Ohio State University