febuxostat at a glance
Medicine class
Selective xanthine oxidase inhibitor
Licensed role
Long-term urate lowering after urate deposition has occurred
Who it is for
Adults
Food
May be taken with or without food
Gout flares
Flares can increase when treatment begins; treatment is usually continued during a flare
What is febuxostat used for?
It is licensed for adults with chronic hyperuricaemia where urate deposition has already occurred.
Gouty arthritis, including a history of the condition
Tophi caused by deposited urate crystals
How does febuxostat work?
Xanthine oxidase converts purine breakdown products into uric acid. Febuxostat selectively blocks this enzyme, lowering blood urate so that fewer new crystals form and existing deposits can gradually reduce.
febuxostat preparations and strengths
Tablet
Route: Oral
Strengths: 80 mg, 120 mg
How to take febuxostat
Take febuxostat by mouth exactly as prescribed. It can be taken with or without food. The tablet score line is intended to make swallowing easier, not to produce equal portions. Do not stop it solely because a gout flare occurs; ask a clinician how to manage the flare.
Tell the prescriber if you have heart, kidney, liver or thyroid problems.
Do not stop treatment without discussing it with the prescriber.
febuxostat side effects
Common or expected effects
- Gout flares
- Abnormal liver blood-test results
- Diarrhoea or nausea
- Headache or dizziness
- Rash or itching
- Joint, muscle or limb pain
- Swelling caused by fluid retention
- Tiredness
Get urgent medical advice
- Severe allergic reaction or swelling affecting breathing
- Blistering, peeling or widespread rash, or sores affecting mucous membranes
- Fever, rash, swollen glands or signs of liver or kidney involvement
- Marked muscle pain, tenderness or weakness, especially with fever or feeling unwell
- Yellow skin or eyes or other signs of significant liver injury
febuxostat in pregnancy
Febuxostat should not be used during pregnancy because human experience is very limited and the potential risk is unknown. Anyone who is pregnant, planning pregnancy or becomes pregnant while taking it should contact their prescriber.
febuxostat while breastfeeding
Febuxostat should not be used while breastfeeding. It is unknown whether it enters human milk, and a risk to the infant cannot be excluded.
febuxostat interactions
The prescriber and pharmacist should check all medicines before febuxostat is started or stopped.
Azathioprine or mercaptopurine
Concomitant use is generally not recommended because febuxostat can greatly increase exposure and cause severe bone-marrow toxicity.
Potent inducers of glucuronidation
These may increase febuxostat metabolism and reduce its urate-lowering effect; serum urate may need reassessment when such medicines are started or stopped.
Common questions about febuxostat
Answers are fully visible for fast scanning and source review.
Does febuxostat relieve the pain of an acute gout attack?
No. It lowers urate for longer-term control rather than acting as a painkiller or immediate treatment for inflammation.
Can febuxostat cause more gout flares when treatment begins?
Yes. Changing urate levels can mobilise existing crystal deposits and temporarily trigger flares.
Should febuxostat be stopped during a gout flare?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.