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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 ...
Not everyone with risk factors for gout will develop it, but those with risk factors are more likely to have gout than people without them. ... allopurinol is the first-line medication for ...
Levels that cannot be brought below 6.0 mg/dL while attacks continue indicates refractory gout. [68] While historically it is not recommended to start allopurinol during an acute attack of gout, this practice appears acceptable. [69] Allopurinol blocks uric acid production, and is the most commonly used agent. [20]
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]
Febuxostat is used to treat chronic gout and hyperuricemia. [12] Febuxostat is typically recommended only for people who cannot tolerate allopurinol. [13] National Institute for Health and Clinical Excellence concluded that febuxostat is more effective than standard doses of allopurinol, but not more effective than higher doses of allopurinol.
A xanthine oxidase inhibitor is any substance that inhibits the activity of xanthine oxidase, an enzyme involved in purine metabolism.In humans, inhibition of xanthine oxidase reduces the production of uric acid, and several medications that inhibit xanthine oxidase are indicated for treatment of hyperuricemia and related medical conditions including gout. [1]
Lesinurad (brand name Zurampic) is a urate transporter inhibitor for treating high blood uric acid levels associated with gout. [2] It is recommended only as an adjuvant with either allopurinol or febuxostat when these medications are not sufficient. [3] It received FDA approval on 22 December 2015. [3]
When uric acid levels and gout symptoms cannot be controlled with standard gout medicines that decrease the production of uric acid (e.g., allopurinol, febuxostat) or increase uric acid elimination from the body through the kidneys (e.g., probenecid), this can be referred to as refractory chronic gout (RCG). [3]