Febuxostat

Sounds like 'feb-ux-oh-stat'

Key points about febuxostat

  • Febuxostat is a long-term treatment to prevent gout attacks.
  • When taken every day, febuxostat stops gout attacks and prevents long-term damage to your joints.
  • Find out how to take it safely and possible side effects.
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Febuxostat is used to prevent gout attacks or flares. It helps to prevent permanent damage to your joints. Febuxostat is used when other medicines (eg, allopurinol) can't be taken or haven’t worked well. Febuxostat may be used in people receiving cancer chemotherapy(external link), to prevent high levels of uric acid that can occur with some types of cancer treatment.

  • Febuxostat reduces the amount of uric acid your body makes. Uric acid is produced in your body when you metabolise some types of food and drinks.
  • Usually excess uric acid is passed out in your urine, but when uric acid levels are too high, the extra uric acid can turn into crystals in your joints, causing pain and swelling. This is known as gout.
  • With each new attack, the size and number of crystals grow and can sometimes be seen as lumps under the skin (tophi). Over time this can damage your joints, bones and kidneys.


To reduce gout attacks, it's important to keep your uric acid level below 0.36 mmol/L

  • When your uric acid is below 0.36 mmol/L, no new crystals can form and crystals that are already in your joints can start to dissolve.
  • The risk of gout attacks and joint damage is reduced.
  • If you already have tophi, the goal is to get to a uric acid level below 0.3 mmol/L.
  • Uric acid levels can be checked with a blood test, which can be done at a blood lab, at your doctor's clinic or at some pharmacies.

In Aotearoa New Zealand febuxostat is available as 80 mg and 120 mg tablets.

  • To prevent gout attacks, the usual starting dose of febuxostat is 80 mg once daily.
  • After 2 to 4 weeks of treatment, your doctor will test your uric acid level with a blood test. If it's still above 0.36 mmol/L, your dose may increase to 120 mg once daily.
  • Always take your febuxostat exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much febuxostat to take, how often to take it and any special instructions.

  • Timing: Take febuxostat, once a day, at about the same time each day. It's best taken in the morning. You can take febuxostat with or without food. Take your dose with a full glass of water.
  • Missed dose: If you forget to take your tablet, take it as soon as you remember. But if it's nearly time for your next tablet, just take the next tablet at the right time. Don't take double the dose.
  • Keep taking febuxostat every day, even during a gout attack: If you stop taking it, even for a few days, your uric acid levels will rise and crystals will start to form. This can cause a gout attack and joint damage. Febuxostat is a long-term medicine – you'll probably need to take it for the rest of your life.

You may have gout attacks when starting febuxostat

You may have gout attacks in the first few months when you start taking febuxostat. If you have an attack at this time, it may feel like your gout is getting worse, but it’s not. Febuxostat reduces the amount of uric acid your body makes, and also helps some of the crystals in your joints dissolve. As the crystals dissolve, they can cause a gout attack.

  • To manage this, when you start febuxostat, your doctor will prescribe another medicine, eg,  colchicine, non-steroidal anti-inflammatory drugs (NSAIDs) or prednisone. These will help you manage the pain of a gout attack. It's important to take this regularly, for up to 6 months, while you are starting febuxostat.
  • Keep taking febuxostat every day, even during a gout attack.
  • As your uric acid level decreases over time you're less likely to get gout flares.
  • Keeping your uric acid level below 0.36 mmol/L, will help stop your gout attacks. It may take a few months of taking febuxostat every day to get your level below 0.36 mmol/L.

Video: Febuxostat (Uloric)


(RheumInfo, Canada, 2019)


Note: this video is from Canada so may have information that differs from New Zealand recommendations. In New Zealand febuxostat is also called  Adenuric. Read more about febuxostat.

Here are some things to know when you're taking febuxostat. Other things may be important as well, so ask your healthcare provider what you should know about.

  • Other medicines: Febuxostat may interact with other some other medicines, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting febuxostat and before starting any new products.
  • If I'm having a gout attack, will an extra dose of febuxostat help? No, because febuxostat isn't a pain relief medicine. If you have an attack of gout while taking febuxostat, keep taking it at the same dose. Don't stop taking it. Your doctor will advise you to take a pain relief medicine, eg, NSAIDs (ibuprofen, diclofenac, naproxen), or prednisone or colchicine. You can also apply ice-packs and rest the painful joint to reduce pain. See your healthcare provider if the pain and inflammation doesn't get better in 24 hours.

Like all medicines, febuxostat can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Headache
  • Feeling sick or vomiting
  • Diarrhoea (runny poo)
  • These are quite common when you first start taking febuxostat and usually go away with time.
  • Tell your doctor if these side effects cause you problems or don’t go away.
  • Dizziness
  • Sleepiness
  • Blurred vision
  • Be careful when driving or using tools until you know how this medicine affects you.
  • Don't drink alcohol.
  • Signs of an allergic reaction, such as sudden redness of your skin, skin rashes, itching, swelling of your face, lips or mouth, and problems breathing, such as shortness of breath or wheezing
  • Stop taking febuxostat.
  • Tell your doctor immediately or phone Healthline on 0800 611 116.
  • Signs of problems with your liver such as yellowing of your skin or eyes, dark pee or pain in your abdomen (tummy)
  • Tell your doctor immediately or phone Healthline on 0800 611 116.

Read more about medicines and side effects and reporting a reaction you think might be a side effect.

Gout | Mate waikawa kai kōiwi
Medicines to treat and prevent gout

Gout Guide(external link) Tools and resources to improve gout outcomes Healthify He Puna Waiora, NZ, 2024
Febuxostat(external link) RheumInfo
Adenuric(external link) Medsafe Consumer Information Sheet, NZ
Medicines for gout(external link) Medsafe and Ministry of Health, NZ, 2021 English(external link), te reo Māori(external link), Samoan(external link)

References

  1. Managing gout in primary care(external link) BPAC, NZ, 2018
  2. Febuxostat(external link) NZ Formulary

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Medicines and side effects
Healthify He Puna Waiora, NZ, 2024

5 questions to ask about your medications

5 questions to ask about your medications

Health Quality and Safety Commission, NZ, 2019 English, te reo Māori

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

Last reviewed:

Read more at: https://healthify.nz/medicines-a-z/f/febuxostat/
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