Allopurinol and febuxostat lower the amount of uric acid the body makes. When the blood level stays below about 6 mg/dL, the crystals already in the joints slowly dissolve and attacks stop. This is why gout is the most curable form of arthritis, and why painkillers alone, which only treat each attack, are not enough.
How long it takes
Uric acid falls within weeks, but attacks may become more frequent for the first few months while crystals dissolve. That is expected, and is not a sign the drug has failed.
Used for
How to take it
- Every day, usually for life. Gout returns if it is stopped.
- The dose starts low and is increased every few weeks until your uric acid reaches the target.
- Do not stop it during an attack. Treat the attack separately, as advised.
- A low-dose preventive medicine (often colchicine) is usually given for the first three to six months.
Common side effects
Most are mild and many settle. Mention them at your next visit; there is often a simple fix.
- More gout attacks in the first months, which is why preventive cover is given
- Mild stomach upset
- Skin rash, mainly with allopurinol
Call the clinic the same day if you have
- Any rash, especially with fever, mouth ulcers or peeling skin. Stop the tablet and call the clinic the same day; this can be the start of a serious allergic reaction.
- Chest pain or breathlessness while on febuxostat
- Yellowing of the eyes or skin
Clinic: +91 70571 19999. If you are very unwell, go to the nearest emergency department and take your medicine strip with you.
Blood tests & checks
- Uric acid every two to five weeks while the dose is being adjusted
- Then every six to twelve months once at target
- Kidney and liver tests
Pregnancy & family planning
- These drugs are generally not used in pregnancy. Gout in women of child-bearing age is uncommon and is discussed individually.
Alcohol, infections, vaccines & other medicines
Medicine interactions
Azathioprine and mercaptopurine interact dangerously with both allopurinol and febuxostat. Make sure every prescriber knows you take them.
Heart disease
Febuxostat is used with caution in people with established heart disease. Allopurinol is usually preferred first.
Diet
Beer, spirits, sugary drinks, organ meat and red meat raise uric acid. Dal, tomatoes and spinach have little effect, despite common advice.