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Febuxostat (brand name: Adenuric) is a medicine used to treat gout, which is a type of arthritis caused by a build up of uric acid crystals in the joints. Cells produce uric acid normally. In gout the body does not flush it out fast enough. Febuxostat works by reducing the amount of uric acid made by cells.
This helps prevent uric acid crystals building up in the joints and therefore helps prevent joints becoming swollen and painful.
Febuxostat is taken on a long-term basis to prevent attacks of gout. Taking febuxostat regularly each day will also help to prevent permanent damage to the joints and bone. It does not treat the pain or inflammation of an ‘attack’ of gout and it is not normally started during a sudden attack.
Febuxostat does not work straight away. It may take several weeks to reduce the level of uric acid so you may continue to have gout attacks for some time.
Sometimes starting febuxostat or increasing the dose can actually cause an attack of gout. This does not mean the medicine is not working, so keep taking it during such attacks together with any other medicine your doctor may recommend to manage pain.
To reduce the risk of a gout attack, medicines such as colchicine or anti-inflammatory drugs may be recommended before or at the same time febuxostat is started.
Your doctor will advise you about how these medicines should be taken.
Febuxostat is not a pain reliever. You should continue to take febuxostat during an attack, but your doctor will also recommend medicines to treat pain and inflammation. These may include paracetamol, colchicine, anti-inflammatory drugs such as naproxen (Naprosyn), ibuprofen (Brufen/Nurofen), indomethacin (Indocid) or steroids such as prednisolone.
It is a good idea to plan with your doctor what to do if a gout attack occurs and to have symptom controlling medicine ready to use if needed. It is also important that you tell your doctor if your condition persists or worsens.
Febuxostat is taken by mouth as a tablet. It is usually taken once a day. You should take your febuxostat at about the same time each day.
It does not matter if you take febuxostat before or after food. It should be taken with a full glass of water.
For greatest benefit, febuxostat should be taken regularly. If you forget to take a dose, take it as soon as you remember, then go back to taking it as you would normally. There is no need to double the dose at the next scheduled dose time.
Febuxostat tablets are available in one strength of 80mg. Treatment may start with a small dose of 40mg (half a tablet) once a day. Over time your doctor may increase your dose to 80mg (one tablet) daily. Higher doses are used in some cases.
Febuxostat may be taken in combination with other arthritis medicines, including:
There are separate information sheets for the medicines mentioned above.
Treatment with febuxostat may be continued indefinitely as long as it is effective and as long as no serious side effects occur.
If you stop febuxostat treatment suddenly there is a high risk that your gout may worsen. It is very important not to stop your treatment unless advised by your doctor or unless side effects develop.
Most people do not experience side effects from febuxostat. A clinical study published in 2018 compared approximately 3000 people taking febuxostat with the same number of people taking allopurinol to treat gout. All patients had heart disease as well as gout. The risk of dying was about 30% higher in people taking febuxostat. Tell your doctor if you are concerned about any possible side effects.
There are some very rare but potentially serious side effects with febuxostat.
Febuxostat can be taken for long periods to manage gout. Very rarely, febuxostat may alter thyroid function when used long term. Your doctor will monitor for this with blood tests.