Febuxostat is a very good drug for gout, developed in 2008 and marketed in our country in 2013. The price of this drug is very expensive, a box is around two to three hundred dollars (because of the patent issue). This drug is very amazing and effective, gout patients will take the drug, uric acid will rub down, loved by doctors and patients. However, there are some precautions when using this medicine, you should pay attention to, the medicine is used properly, twice the result with half the effort.

1. The drug is used in patients with symptomatic gout and is not recommended for patients with asymptomatic hyperuricemia.

Note that there are symptoms, the most common symptom being joint pain. If there are no symptoms, it is not recommended to take this to. I once answered how to quickly reduce uric acid in patients with hyperuricemia, and there is a lot of content that describes how to reduce uric acid through conditioning, so you can take a look at it

2. At the initial stage of using the drug, many people will experience worsening of symptoms, which is normal, and at this time, it is necessary to use the combined use of Sanliquid pain, which can reduce the pain.

3. The safety of this medication in minors under 18 years of age is not known and therefore is not recommended for use in minors

4. The drug can pass into breast milk, so breastfeeding women should be careful in choosing this drug

5. It is forbidden to take febuxostat in patients who are taking the drugs azathioprine, mercaptopurine, and cholestyramine, because toxicity can occur.

6. While taking the drug, you need to drink a lot of water, which can promote the excretion of uric acid!

Welcome to follow me to bring you reliable medical science

Febuxostat is a drug that many people may find unfamiliar, with a rather awkward name, but for gout sufferers, it's all too familiar, and it's currently considered to be the best drug for treating gout. Previously, the price is more expensive, many people go to buy the Indian version of the generic drug, now febuxostat substantial price reduction, the hospital on more than a hundred a box, and in the health insurance reimbursement scope.

We all know that gout and high blood uric acid has a relationship with the body's uric acid metabolism abnormalities, elevated uric acid is the basis of gout and the most direct risk factors, and high uric acid is a substance called purine metabolism disorders in the human body. The mechanism of action of Febuxostat is to selectively act on xanthine oxidase, inhibit the body's generation of xanthine into uric acid, so as to inhibit the generation of uric acid, and achieve the purpose of reducing blood uric acid.

indications

Febuxostat is mainly used for long-term treatment of hyperuricemia with gout symptoms, and is not recommended for patients with simple hyperuricemia without symptoms. The main symptom of gout is swollen and painful joints, commonly red and swollen big toe, ankle, knee and other parts of the body, severe pain, inability to walk, accompanied by fever. After taking febuxostat, due to the rapid lowering of blood uric acid, resulting in the release of urate activity deposited in the joints, acute inflammation, manifested by worsening of the symptoms of gout, and the increased risk of gout in people with simple hyperuricemia, so the use of febuxostat is not recommended if it is simply a laboratory test found to be high in blood uric acid, but has never occurred any symptoms of swollen and painful joints. In addition, it is contraindicated in severe hepatic and renal insufficiency.

The main effect of Febuxostat is to lower uric acid, but some gout patients do not have particularly high uric acid, belong to the poor excretion of uric acid, this type is not suitable for the use of Febuxostat. Therefore, before using Febuxostat, it is best to keep 24 h urine to check urinary uric acid, in order to determine the type of hyperuricemia.

How to Eat

The use of febuxostat varies in therapeutic dosage depending on the population and uric acid levels. For hyperuricemia patients with acute gouty attacks who have normal liver and kidney function, the recommended dose is 40mg or 80mg, and a starting dose of 40mg once daily is generally recommended. Since Febuxostat has a stronger uric acid-lowering effect than allopurinol, blood uric acid can be rechecked after 2 weeks of administration. If the blood uric acid level is still not lower than 360μmol/L after 2 weeks, it is recommended that the dose be increased to 80 mg once daily. If febuxostat does not achieve the therapeutic goal when increased to 80 mg/day, it can be combined with a drug that promotes uric acid excretion. In special populations, such as patients with mild to moderate hepatic or renal impairment, 40 mg once daily is preferred whenever possible. Febuxostat increases the toxicity of azathioprine, mercaptopurine, and theophyllines, so it should not be combined with these drugs.

side effects

Overall, Febuxostat side effects are relatively minor. The majority of people can tolerate them. Rare side effects include 1. allergic reactions Manifested as rash, itching, although compared with allopurinol, febuxostat occurs significantly fewer allergic reactions.2. cardiovascular risk In November 2017, the FDA officially issued a safety alert for febuxostat to increase the risk of cardiovascular events in patients, especially when used in high doses.3. abnormalities of liver function There is a possibility of elevated aminotransferases, loss of appetite, jaundice, Diarrhea, etc. Abnormalities in liver function need to be discontinued promptly.

Gout is a chronic disease, hyperuricemia can cause vascular endothelial damage and chronic kidney damage, which will increase the risk of diabetes, hypertension, coronary heart disease, stroke and other chronic diseases. For patients with gout of the overproduction of uric acid type, it is advisable to take febuxostat to control uric acid and test the uric acid level regularly, and for those who have frequent gout attacks or gout stones, it is advisable to control it below 300μmol/L. If the symptoms are relieved, the condition is stabilized, and the blood uric acid drops below the target, the dosage can be reduced; if the blood uric acid level can also be controlled by diet alone at around 300μmol/L, the drug can also be stopped. However, after stopping the drug, we should pay attention to diet and regular follow-up.

To prevent gouty attacks from worsening while taking febuxostat, it is recommended to take oral NSAIDs or colchicine at the same time.

Febuxostat is a medication for the treatment of hyperuricemia with gout symptoms. High concentrations of uric acid in the blood are caused by two main factors.

1, the body of purine metabolism generation disorders, so that the synthesis of uric acid is abnormal. 2, uric acid excretion in the body of obstacles, can not be through the renal excretory system out of the body.

When the body's uric acid production or excretion problems, resulting in increased concentrations of uric acid in the blood, high concentrations of uric acid will form urate crystals deposited in the joints and other places to produce inflammation and irritation of the tissues occurring gout inflammatory symptoms.

For almost 40 years febuxostat was the first drug approved in the United States for the treatment of gouty interstitials and was introduced in 2009. It is a drug that affects the production of uric acid, mainly through the inhibition of xanthine oxidase. Compared with allopurinol, febuxostat has a highly selective inhibition of xanthine oxidase and the in vivo metabolites of febuxostat also work, and the experimental data show that it has a better clinical effect than allopurinol, which has the same in vivo effect.

Allopurinol is a purine analog that, in inhibiting xanthine oxidase, affects the enzymes involved in the purine and pyrimidine metabolic pathways, and it is more damaging to the kidneys. Whereas febuxostat is an inhibitor of a non-purine structure, which may have less effect on purines, etc., and the damage to the kidneys may not be as great as that of allopurinol.But febuxostat compared to allopurinol, the treatment cost is higher, short-term treatment benefit is better than allopurinol, but long-term treatment benefit allopurinol will be better than febuxostat。

Febuxostat is marketed and produced by three manufacturers in China, namelyHangzhou Zhu Yangxin Pharmaceutical's Fengdingning, Jiangsu Wanbang's Yulitong, Hengrui Pharmaceutical's Ruiyang.. The initial dose of febuxostat administered is 40 mg a day, and febuxostat is not recommended for patients with asymptomatic hyperuricemia.

Currently, Febuxostat has not been used for a very long time in the domestic clinic, and its safety for long-term use cannot be very accurately described, pending the collection of a large amount of clinical data at a later stage. In the existing clinical trials, the main common side effects of Febuxostat were found to be abnormal liver function 3.5%, diarrhea and nausea 2.2%, dizziness and headache 1.8% and skin allergic reaction 1.5%. Studies have also shown an increased risk of cardiovascular disease when taking febuxostat, suggesting a correlation between febuxostat and cardiovascular disease.

Febuxostat is a new therapeutic drug for gout patients with hyperuricemia, marketed in the U.S. in 2009, with good uric acid-lowering effect, it and allopurinol are xanthine oxidase inhibitors, lowering serum uric acid concentration by inhibiting uric acid synthesis. The probability of skin allergic reaction of febuxostat is significantly lower than that of allopurinol. However, the current price is high in China, and the following problems need to be noted in clinical application.

side effects

Febuxostat can cause a variety of adverse reactions and some of these adverse reactions may be more common with Febuxostat than with allopurinol, including cardiovascular abnormalities and hepatic abnormalities.

1 Cardiovascular risk

In clinical trials, the rate of thromboembolic cardiovascular events was higher with febuxostat than in the allopurinol group. The possibility that febuxostat may cause heart failure has been suggested in Europe, Canada, and the World Health Organization (WHO).

On November 15, 2017, the FDA, issued a safety report on the cardiovascular risks of febuxostat.The FDA's report states that based on the results of previous clinical trial studies of febuxostat and allopurinol, it was found that febuxostat was associated with a higher risk of cardiovascular events (heart disease, stroke, and cardiac-related deaths) compared to allopurinol.

Therefore.In patients at higher risk of cardiovascular disease, we prefer the alternative use of febuxostat, such as allopurinol (if tolerated), and coadministration of the uric acid-lowering drug benzbromarone if necessary.

In patients currently being treated with febuxostat who have successfully lowered their uric acid levels and are at mild or low risk of cardiovascular events, we will also advise of available information related to cardiovascular risk, but generally recommend continued application of febuxostat.

2 Abnormal liver function

During clinical trials, the incidence of abnormal liver function, nausea, arthralgia, and rash was higher in the febuxostat group than in the placebo group, but not in the allopurinol group. The manufacturer of febuxostat recommends regular monitoring of liver function, primarily liver aminotransferase levels (liver function should be checked prior to dosing and periodically during dosing).

If symptoms indicative of hepatic injury (including fatigue, anorexia, right upper abdominal discomfort, deepening of urine color, or jaundice) occur during drug administration, liver function should be checked immediately. If the test result is abnormal [ALT more than 3 times the upper limit of normal (ULN)], the drug should be suspended and the cause should be investigated.

If an ALT greater than 3 times the ULN accompanied by a serum total bilirubin greater than 2 times the ULN occurs and no cause other than this drug is identified, there is a risk of drug-induced severe hepatic injury, and this drug should not be reintroduced in such patients.

indications

1 Febuxostat is only used for the treatment of hyperuricemia in patients with gout.

2 Febuxostat does not recommend this drug for hyperuricemia without clinical symptoms.

3 Febuxostat is not recommended for use in patients with substantial elevations of urate (e.g., malignant disease, Lesch-Nyhan syndrome).

Dosage

The uric acid-lowering effect of febuxostat is dose-related. The starting dose of febuxostat tablets is 40 mg once daily without regard to the effect of food. If, after 2 weeks, the blood uric acid level does not fall below 6 mg/dl (approximately 360 µmol/L), it is recommended that the dose be increased to 80 mg once daily.

Prevent gout attacks before taking medication

At the beginning of taking this product, may cause an attack of gout due to changes in blood uric acid levels that result in mobilization of tissue deposits of urates. To prevent gouty attacks during the initiation phase of taking febuxostat, theConcurrent NSAIDs or colchicine are recommended.

No need to stop the medication if you have a gout attack while taking the medication

If you have a gouty attack during febuxostat treatment, you don't need to stop taking the drug.. It should be based on the individual patient'sTreat gout accordingly.

Drug interactions and contraindications

Xanthine oxidase inhibitors decrease the metabolism of azathioprine, mercaptopurine, and theophylline, and the need for continued use of any of these 3 drugs is considered by the manufacturer to be a contraindication to the use of febuxostat.

Precautions for the use of the uric acid-lowering drug febuxostat

Excessive production of uric acid or decreased excretion of uric acid are the two main factors in hyperuricemia. In the past, the latter was thought to be the main cause, but it is now believed that each is responsible for 50% of the cases.

Febuxostat is a new selective xanthine oxidase inhibitor, which achieves uric acid-lowering effect by inhibiting the production of uric acid, and is suitable for most patients with hyperuricemia and gout.

Precautions for the use of febuxostat;

Febuxostat is contraindicated in patients being treated with azathioprine and mercaptopurine.

I. Dosage

The initial dose of febuxostat is 20 to 40 mg/dose once a day. if the blood uric acid does not reach the standard after 2 weeks, the dose can be gradually increased to a maximum dose of 80 mg/day.

II. Effects of febuxostat on liver and kidney

Adverse reactions to febuxostat include liver impairment, nausea, and rash.

1, liver safety: febuxostat is mainly metabolized by the liver, it can be used in patients with mild to moderate liver injury, and is not recommended for patients with severe liver injury.

2、Renal safety: febuxostat is not excreted through the kidneys, and has high safety in renal insufficiency and renal transplant patients. No dosage adjustment is needed in patients with mild to moderate renal insufficiency with glomerular filtration rate of 30 ml/min or more, and it should be used with caution in patients with severe renal insufficiency with glomerular filtration rate of 30 ml/min or less, and the recommended starting dosage is 20 mg once daily.

Third, induced gout attacks

A rapid decrease in blood uric acid concentration can lead to the release of urates deposited in the tissues into the bloodstream and induce gouty attacks. Therefore, an increase in the frequency of gouty attacks is seen during the initial period of febuxostat administration. In this case, there is no need to discontinue febuxostat treatment, and NSAIDs (antipyretic painkillers) or colchicine can be taken at the same time.

IV. Cardiovascular events

One study of more than 6,000 gout patients treated with febuxostat or allopurinol found an increase in heart-related deaths with febuxostat. As a result, the FDA did a communication on the cardiac safety of febuxostat. However, the dosages of febuxostat in this study were all 80mg or more per day, with half of the patients' dosages reaching 120mg or even 240mg or more per day.

In contrast, in a recent study published on October 4, 2017, the incidence of cardiovascular events was not high with febuxostat 40 mg to 80 mg per day. Therefore, the cardiovascular safety of febuxostat may be dose-related.

40mg to 80mg of febuxostat per day is still safe, and cardiovascular risk increases with dosages above 80mg.

Febuxostat essentially belongs to the anti-gout group of drugs. The two main categories of anti-gout drugs are those that promote uric acid excretion and those that inhibit uric acid synthesis. Febuxostat is mainly used for the long-term treatment of gout patients (hyperuricemia). Note that the drug is currently not recommended for patients with hyperuricemia without clinical symptoms.

What should I be aware of while using Febuxostat?

The following precautions need to be taken during the use of Febuxostat:①. For patients with gout, there is a certain chance that the initial use of the drug can lead to an acute attack of gout. Therefore, when initially taking this drug, it is recommended to take it together with colchicine for a period of time to prevent acute attacks of gout; ②. Febuxostat has a certain degree of liver damage, for mild and moderate hepatic insufficiency (generally liver function Child-Pugh A, B) patients generally do not need to adjust the dose of the drug, for poor liver function (generally liver function Child-Pugh C) patients are not recommended to use Febuxostat; In addition, it is recommended to avoid some of the behaviors that damage liver function during the drug, such as drinking alcohol, Staying up late, etc., and review liver function every 1 month if necessary; ③. The use of Febuxostat is prohibited in patients treated with azathioprine or mercaptopurine; (4). Febuxostat should be used with caution in patients with severe renal insufficiency (creatinine clearance < 30 ml/min); ⑤. It is recommended to take the medicine regularly, not to adjust the dose and stop the medicine privately, and to check the uric acid level regularly. Meanwhile, high purine diet should be avoided in daily life. The above are some precautions during the use of Febuxostat, consult the endocrinologist or attending physician for specific use when necessary.

What do I need to know about living with elevated uric acid?

Patients with increased uric acid need to pay attention to the following matters in their lives: ①. Increase the amount of water consumption: to ensure that the amount of urine is more than 2000ml per day, which is also a way to promote uric acid excretion; ②. Avoid high-purine diet (such as not eating seafood, animal offal, thick soup and other high-purine food), which is very important for the prevention of complications; ③. Control your weight and keep it within the normal range.

I hope that my answer will help you! Give me a like if you like it!

(Contributed by: Gao Lili, Clinical Pharmacy Department, Plain Hospital, Qianfoshan Hospital, Shandong Province)

Hyperuricemia (HUA) is a phenomenon in which blood uric acid is elevated due to a disorder of purine metabolism and impaired uric acid metabolism. Gout is a crystal-associated arthropathy caused by monosodium urate (MSU) deposition, which is directly related to hyperuricemia caused by purine metabolism disorder and/or decreased uric acid excretion. At present, the main uric acid lowering drugs are inhibiting uric acid production drugs, promote uric acid excretion drugs, promote uric acid decomposition drugs, alkalinizing urine drugs. So, what do you need to pay attention to during the use of the uric acid-lowering drug Febuxostat?

Febuxostat, also known as febuxostat, belongs to the non-purine class of selective inhibitors of xanthine oxidase, which reduces serum uric acid concentration by inhibiting uric acid synthesis, and does not inhibit other enzymes involved in the synthesis and metabolism of purines and pyrimidines at routine therapeutic concentrations. The plasma protein binding rate of this drug is about 99.2%; long duration of action, l-1.5h after taking the drug can reach the maximum plasma concentration, the elimination half-life of 5-8h, can be given once a day; 49% through the renal excretion, 45% through fecal excretion, is a dual-channel excretion of drugs.

Things to keep in mind while using Febuxostat:

① Pay attention to the indications and dosage range:

Febuxostat is indicated for the long-term treatment of hyperuricemia in patients with gout and is not recommended for hyperuricemia without clinical symptoms. The recommended starting dose is 40 mg once daily; after 2 weeks, the blood uric acid level is still not less than 360 μmol/L, the recommended dose is increased to 80 mg once daily. For patients with CKD stage 4 and above, the recommended starting dose is 20 mg once daily.

② Pay attention to adverse reactions and use in special populations:

Adverse reactions of this drug mainly include liver function abnormalities, diarrhea, headache, nausea, arthralgia, rash, etc. Most of them are transient mild or moderate reactions. The incidence of adverse reactions is lower than that of allopurinol.

The drug is simultaneously excreted in the liver and kidneys; therefore, no dosage adjustment is required for patients with mild to moderate renal insufficiency (Clcr 30-89 ml/min), and no dosage adjustment is required for patients with mild to moderate hepatic insufficiency (Child-Pugh classes A and B). In addition, febuxostat belongs to FDA pregnancy class C and should be used with caution in lactating women.

③Note contraindications and interactions：

This drug is contraindicated in patients being treated with azathioprine and mercaptopurine. Also, the effects of food and antacids need not be considered when taking this drug.

④Other:

In the initial period of taking febuxostat, the frequency of gouty attacks increases, due to the lowering of blood uric acid concentration, resulting in the mobilization of urate deposited in the tissues, and it is recommended that non-steroidal anti-inflammatory drugs or colchicine be taken at the same time.

There is no need to discontinue febuxostat treatment in the event of a gout attack during febuxostat therapy.

A causal relationship between this drug and cardiovascular thrombotic events has not been established so far, but more cardiovascular events have been found with 80 mg of this drug, so care should be taken with higher doses.

References:

1 Multidisciplinary expert consensus on the diagnosis and treatment of hyperuricemia-related diseases in China[J]. Chinese Journal of Internal Medicine, 2017,56(3):235-242

2 Expert consensus on the diagnosis and treatment of combined hyperuricemia in Chinese patients with chronic kidney disease[J]. Chinese Journal of Nephrology,2017,33(6):465

3 Practice guidelines for the diagnosis and management of hyperuricemia in renal diseases in China (2017 edition)[J]. Chinese Medical Journal,2017,97(25):1927-1934

4 Chinese expert consensus on the treatment of hyperuricemia and gout[J]. Chinese Journal of Endocrinology and Metabolism,2013,29(11):913-918

5 Guidelines for the diagnosis and treatment of primary gout[J]. Chinese Journal of Rheumatology,2011,15(6):410-413

6 Zhu Xiaoyu et al. Clinical application and progress of febuxostat, a drug for the treatment of gout[J]. Drug Evaluation,2014,11(20):22-27

7 Mou Yi-Ming et al. Clinical pharmacotherapy-endocrine metabolic diseases [M]. Beijing:People's Health Press,2016:115,119

Febuxostat is a drug used to treat hyperuricemia in gout patients, which was launched in the United States in 2009 and marketed in China in 2013. The drug works primarily by inhibiting xanthine oxidase, thereby inhibiting uric acid synthesis and lowering serum uric acid concentrations. Febuxostat does not inhibit other enzymes involved in purine and pyrimidine synthesis and metabolism at routine therapeutic concentrations. Compared with allopurinol, febuxostat has a highly selective inhibition of xanthine oxidase, and the drug's in vivo metabolites can also play a role in its clinical efficacy is also better than allopurinol. The following points should be noted during the use of this drug:

1, Indications: Febuxostat is indicated for the long-term treatment of hyperuricemia in patients with gout. It is not recommended for hyperuricemia without clinical symptoms. That is, if there are no symptoms, this drug is not recommended.

Dosage: The recommended starting dose is 40 mg once daily. If after 2 weeks of use, the blood uric acid level is still not less than 6 mg/dl, it is recommended that the dose be increased to 80 mg once daily. The effects of food and antacids need not be considered when administering the drug.

During the initial phase of taking the drug, it may cause gouty attacks due to the mobilization of tissue deposits of urate as a result of changes in blood uric acid levels. To prevent gouty attacks during the initial phase of taking febuxostat, it is recommended to take NSAIDs or colchicine at the same time. The benefit of prophylactic treatment can last up to 6 months. There is no need to discontinue the medication if a gout attack occurs during febuxostat treatment. Gout should be treated accordingly to the individual patient.

3. Adverse reactions:

(1) Compared with allopurinol, the febuxostat-treated group had a higher incidence of cardiovascular risk events, but a causal relationship with febuxostat has not been established. Signs and symptoms of myocardial infarction and stroke should be monitored while taking the drug. Therefore, for patients with a higher risk of cardiovascular disease, it is recommended to prioritize the use of alternatives to febuxostat, such as allopurinol, and the uric acid-lowering agent phenylbromarone in combination if necessary.

② In addition, after taking febuxostat need to pay attention to the abnormalities of liver function, during the drug, especially in the early stage of taking the drug, should pay attention to regular checks of liver function, if there is a transaminase elevation exceeding the normal value of more than three times, the drug should be stopped immediately. In addition, febuxostat may also trigger rash, nausea, diarrhea and other adverse effects effects, in addition, febuxostat may also trigger acute hemoglobin reduction, angioneurotic edema, acute renal failure and other adverse effects, but these are relatively rare.

4, Contraindications: febuxostat is contraindicated in patients undergoing treatment with azathioprine and mercaptopurine.

5. Special populations:

(1) No dose adjustment is required for patients with mild to moderate hepatic or renal insufficiency, while caution is needed for those with severe hepatic or renal insufficiency.

For pregnant women: FDA pregnancy safety classification is Category C, meaning that no harm can be excluded. In addition, this drug should be used with caution in nursing mothers. ③ For children: The safety and efficacy of this product in the treatment of patients under 18 years of age have not been established; therefore, it is not recommended for use in the underage. ④ Geriatric Use: No dosage adjustment is required for elderly patients.

6, drug interactions: patients who are taking azathioprine, mercaptopurine, theophylline these three drugs are prohibited to take febuxostat, because poisoning may occur.

Finally, it is emphasized that it is important to drink plenty of water while taking febuxostat, which can increase the excretion of uric acid and at the same time reduce the chances of urate-active gout. In addition, it is also important to pay attention to lifestyle adjustments, such as a low purine diet, quit smoking and drinking, weight control, and appropriate exercise, all of which can help to control the production of uric acid.

The authoritative interpretation of Pharmaceutical Affairs, unauthorized reproduction, plagiarism will be punished.

Febuxostat, is the phonetic name, sometimes translated as febuxotan, in fact, are a drug, is a new drug to lower uric acid, its mechanism of action and allopurinol is similar, are through the inhibition of purine metabolism in the enzyme xanthine oxidase (XO), so as to achieve inhibition of uric acid production of pharmacological effects, this drug is newer, compared to allopurinol, the effect of lowering uric acid is also more powerful, but for this new type of drug, the use of drugs during the period of time there are also The new drug has a lot of precautions, and today we'll give you a brief introduction.

Febuxostat should be applied with the following precautions -

1. Note the indications for febuxostat

The main function of Febuxostat is to lower uric acid, for patients with gout and high uric acid, it is a good choice to take Febuxostat to control uric acid in the period between gout. Usually for gout patients, taking febuxostat, the target value of lowering uric acid is best below 360μmol/L. Therefore, during the period of taking febuxostat, it is important to monitor the uric acid value on a regular basis to ensure that the uric acid value is up to the standard, which is also conducive to the selection of the dosage of the drug. However, one point to note is that for secondary hyperuricemia, such as organ transplantation-induced elevation of uric acid, some malignant diseases triggered by a large accumulation of urates, should not use Febuxostat to lower uric acid.

2. Attention to side effects of medication

The most noteworthy side effect of Febuxostat is the abnormality of liver function, therefore, during the period of taking the drug, especially in the initial period of taking the drug, liver function should be checked regularly, and the drug should be discontinued if there is an elevation of aminotransferases that exceeds the normal value by more than three times. In addition to possible hepatic side effects, Febuxostat may also trigger side effects such as nausea, diarrhea, rash, etc. In addition to this, Febuxostat may also trigger angioneurotic edema, acute renal failure, acute hemoglobin reduction and other adverse reactions, but they are relatively rare.

3. Attention to cardiovascular disease risk

Febuxostat does not cause cardiovascular disease, but in patients with cardiovascular disease or risk of cardiovascular disease, taking Febuxostat, can lead to an increased risk of the incidence of thrombotic cardiovascular disease, of course, the treatment of the disease is a trade-off between the risks and benefits, and it is not for this reason that patients with cardiovascular disease should not be able to take Febuxostat, but it is necessary to note that during the administration of Febuxostat, be more attentive to the cardiovascular disease-related Risks.

4. Attention to dose selection

It is usually recommended to take febuxostat once a day, each time to take 40mg or 80mg dose, with the increase in the dose of the drug, febuxostat uric acid lowering intensity will also increase, but it should be noted that the lower uric acid is not the greater the better, the general starting to take the drug, the recommended choice of 40mg daily dose, if the drug through the 2~4 weeks, the decline in uric acid did not reach the target value, you can consider increasing the daily dose to 80mg. You can consider increasing the daily dose to 80mg. febuxostat taking time is not affected by diet, choose a fixed time to take it every day.

5. Attention to gout during medication

Generally, during the acute attack of gout, anti-inflammatory and analgesic treatment is mainly carried out to relieve pain treatment, and in the interval of gout attack, uric acid-lowering drugs can be taken to control the uric acid value and prevent the reoccurrence of acute gout. During the period of taking such drugs as febuxostat, due to the decrease in the concentration of uric acid, it may cause the activity of urate deposited in the joints, which may cause pain. In this case, there is no need to stop taking febuxostat, and you can add non-steroidal anti-inflammatory drugs or low-dose colchicine, etc, to relieve the symptoms of pain and reduce the inflammatory response.

6. The same attention should be paid to the management of life while taking medication.

First of all, a key thing - drink more water! Generally we say, for the promotion of uric acid excretion of the drug benzbromarone during the drug to drink more water, to prevent the accumulation of a large number of uric acid and thus affect the health of the kidneys, in fact, for the purine inhibitor febuxostat, the drug should also pay attention to drink more water during the period of time, drink more water on the one hand can increase the excretion of uric acid, auxiliary lowering of uric acid, and at the same time also be able to reduce the incidence of urate-activated gout chances.

In addition, during the medication to lower uric acid, the same should also pay attention to life regulation, low purine diet, quit smoking and alcohol, weight control, moderate exercise, these are good habits to help control uric acid, should be adhered to.

　　Febuxostat Tablet is a new prescription drug for the long-term treatment of hyperuricemia with gout symptoms with good efficacy. However, it has many contraindications in addition to adverse reactions and side effects. Therefore, the precautions of using Febuxostat tablets should not be ignored. So, what do you need to pay attention to during the use of Febuxostat?

　　Precautions during the use of febuxostat tablets:

　　1, pay attention to the indications and dose range:

　　Febuxostat is indicated for the long-term treatment of hyperuricemia in patients with gout and is not recommended for hyperuricemia without clinical symptoms. The recommended starting dose is 40 mg once daily; after 2 weeks, the blood uric acid level is still not less than 360 μmol/L, the recommended dose is increased to 80 mg once daily. For patients with CKD stage 4 and above, the recommended starting dose is 20 mg once daily.

　　During the initial period of taking febuxostat, an increase in the frequency of gout attacks may often occur. This is due to a decrease in blood uric acid concentration, which leads to the mobilization of urates deposited in the tissues. To prevent gouty attacks in the early stages of treatment, it is recommended to take NSAIDs or colchicine at the same time. There is no need to discontinue febuxostat therapy in the event of a gout attack during febuxostat treatment. Gout should be treated accordingly to the patient's specific condition.

　　2, pay attention to adverse reactions and special populations use:

　　Adverse reactions of this drug mainly include liver function abnormalities, diarrhea, headache, nausea, arthralgia, rash, etc. Most of them are transient mild or moderate reactions. The incidence of adverse reactions is lower than that of allopurinol.

　　The drug is simultaneously excreted in the liver and kidneys; therefore, no dosage adjustment is necessary in patients with mild to moderate renal or nephrogenic insufficiency. In addition, febuxostat belongs to the FDA pregnancy class C and should be used with caution in nursing mothers; there are no sufficiently adequate controlled studies in pregnant women, and this product should be taken by pregnant women only if the potential benefits to the infant are comparable to the risks; the safety of using this drug in minors under the age of 18 years is unclear and is not recommended for use in minors; and no dosage adjustments are required for use of this product in geriatric patients. There were no clinically significant differences in safety and efficacy compared to other age groups, but it cannot be ruled out that some elderly patients are more sensitive to this product. Cmax and AUC24 after multiple oral doses of febuxostat in elderly patients (≥65 years of age) were similar to those in younger patients (18-40 years of age).

　　3. Pay attention to contraindications and interactions:

　　It is forbidden to take Febuxostat in patients who are taking three medications: azathioprine, mercaptopurine, and cholestyramine. Also, the effects of food and antacids need not be considered when taking this drug.

　　4, Storage Editor: Shade sealed, room temperature 15 ~ 30 ℃ storage.

Click on the bottom of the page [Learn More] to see more answers or ask the doctor a question for free!

Follow "Family Doctor Online" headline, more health Q&A easy to see~~~~