Febuxostat, sold under the brand names Uloric among others, is a medication used long-term to treat gout due to high uric acid levels. It is generally only recommended in those who cannot take allopurinol. When initially started, medications such as NSAIDs are often recommended to prevent gout flares. It is taken by mouth. Common side effects include liver problems, nausea, joint pain, and a rash. Serious side effects include an increased risk of death as compared with allopurinol, Stevens-Johnson syndrome and anaphylaxis. Use is not recommended during pregnancy or breastfeeding It inhibits xanthine oxidase thus reducing production of uric acid in the body. Febuxostat was approved for medical use in the European Union in 2008 and in the United States in 2009. No generic version is avaliable as of 2019. In the United Kingdom a month of treatment costs the NHS about 24 pounds. In the United States the wholesale cost of a month's worth of medication is about 320 USD.
Febuxostat is used to treat chronic gout and hyperuricemia. Febuxostat is typically only recommended in those who cannot tolerate allopurinol. National Institute for Health and Clinical Excellence Dainipon Sumitomo concluded that febuxostat is more effective than standard doses of allopurinol, but not more effective than higher doses of allopurinol. It is a non-purine-selective inhibitor of xanthine oxidase. It works by non-competitively blocking the molybdenum pterin center which is the active site on xanthine oxidase. Xanthine oxidase is needed to successively oxidize both hypoxanthine and xanthine to uric acid. Hence, febuxostat inhibits xanthine oxidase, therefore reducing production of uric acid. Febuxostat inhibits both oxidized as well as reduced form of xanthine oxidase because of which febuxostat cannot be easily displaced from the molybdenum pterin site.
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