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The febuxostat drug labels already carry a warning and precaution about cardiovascular events because the clinical trials conducted before approval showed a higher rate of heart-related problems in patients treated with febuxostat compared to allopurinol. These problems included heart attacks, strokes, and heart-related deaths.
Lesinurad is used in combination with a xanthine oxidase inhibitor, such as allopurinol or febuxostat, for treating hyperuricemia (high levels of uric acid in the blood serum) associated with gout. It is approved only for patients who have not achieved target uric acid levels with a xanthine oxidase inhibitor alone. [2]
Allopurinol is used to reduce urate formation in conditions where urate deposition has already occurred or is predictable. The specific diseases and conditions where it is used include gouty arthritis, skin tophi, kidney stones, idiopathic gout; uric acid lithiasis; acute uric acid nephropathy; neoplastic disease and myeloproliferative disease with high cell turnover rates, in which high urate ...
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Purine analogues include allopurinol, oxypurinol, [2] and tisopurine. Others include febuxostat, [3] topiroxostat, and inositols (phytic acid and myo-inositol [citation needed]). In experiments, numerous natural products have been found to inhibit xanthine oxidase in vitro or in model animals (mice, rats).
Lesinurad/allopurinol (trade name Duzallo) is a fixed-dose combination drug for the treatment of gout. [1] It contains 200 mg of lesinurad and 300 mg of allopurinol.In August 2017, the US Food and Drug Administration approved it for the treatment of hyperuricemia associated with gout in patients for whom target serum uric acid levels have not been achieved with allopurinol alone. [2]
There are concerns about more deaths with febuxostat compared to allopurinol. [72] Febuxostat may also increase the rate of gout flares during early treatment. [73] However, there is tentative evidence that febuxostat may bring down urate levels more than allopurinol. [74] Probenecid appears to be less effective than allopurinol and is a second ...
Drugs with other primary uses, that have known uricosuric properties, include losartan, [1] atorvastatin, and fenofibrate.Although these drugs may have significant uricosuric action, their other significant pharmacological actions in off-label use as a uricosuric requires careful assessment of the patient to achieve the most benefit and least risk.