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Uric acid levels can be increased by some medicines

Medicine-induced hyperuricaemia

Key points about uric acid increasing medicines

Some medicines can increase uric acid levels.
Your body generally gets rid of extra uric acid and this brings your levels back to a normal range. However, with some people the extra uric acid cannot be cleared and causes high uric acid levels (hyperuricaemia).
The extra uric acid can build up in areas such as joints, causing pain and swelling. This is a condition called gout. Read more about gout.
Note that these medicines don't create a problem for everyone but talk to your healthcare provider or pharmacist if you're concerned.

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Medicines that increase uric acid levels can do so by:

causing your body to make too much uric acid
preventing your body from getting rid of extra uric acid in your urine when you pee (mimi).

The following is a list of medicines that are known to increase uric acid levels, but note that they are not a problem for everybody. Only some people will get gout or kidney stones. If you have concerns, talk to your healthcare provider or pharmacist. They will work out whether you continue the medicine and manage the high levels of uric acid, or if there is an alternative medicine you can try.

It's important that you don't stop taking your medicine suddenly.

Examples of medicines that can increase uric acid levels
Diuretics (see below) Aspirin low dose (less than 300 mg daily) Nicotinic acid Levodopa Ciclosporin Tacrolimus	Cytotoxic chemotherapy Fructose Testosterone Pyrazinamide Ethambutol

Diuretics

Diuretics are also called water pills or water tablets. Diuretics are commonly used to treat high blood pressure and heart failure. They work by helping your body get rid of extra salt (sodium) and water. Read more about diuretics.

The following diuretics are known to increase uric acid levels by preventing your kidneys from getting rid of the extra uric acid in your urine.

Diuretics that can cause an increase in uric acid
Thiazide diuretics Bendroflumethiazide Chlortalidone Indapamide Metolazone Hydrochlorothiazide, which is available only in combination with other medicines: hydrochlorothiazide plus quinapril, is called Accuretic hydrochlorothiazide plus losartan, is called Arrow-Losartan & Hydrochlorothiazide hydrochlorothiazide plus amiloride, is called Moduretic Loop diuretics Furosemide Bumetanide

Diuretics that can cause an increase in uric acid

Thiazide diuretics

Bendroflumethiazide
Chlortalidone
Indapamide
Metolazone
Hydrochlorothiazide, which is available only in combination with other medicines:
- hydrochlorothiazide plus quinapril, is called Accuretic
- hydrochlorothiazide plus losartan, is called Arrow-Losartan & Hydrochlorothiazide
- hydrochlorothiazide plus amiloride, is called Moduretic

Loop diuretics

Furosemide
Bumetanide

You may have symptoms of high uric acid such as gout or kidney problems, or you may have no symptoms. Medicine-related hyperuricaemia is diagnosed by a blood test; an increase in serum uric acid can be seen a few days or weeks after starting the medicine. Your doctor will work out whether to continue the medicine and manage the high uric acid, or if there is an alternative medicine you can try.

Don't stop taking your medicine suddenly. Instead talk to your doctor or pharmacist if you have concerns. Some medicines need to be stopped gradually, as sudden withdrawal can make the effects worse.

✔ Make sure you tell your doctor, and other healthcare providers, about all of the medicines you are taking (including over-the-counter medicines, vitamins or herbal remedies).

✔ Remind your healthcare provider if you have a history of diabetes, liver, kidney or heart disease or if you're receiving cytotoxic medicines for cancer.

✔ If you have high uric acid, follow your healthcare provider's advice on how to lower your blood uric acid level. If your blood levels are very high, they may prescribe medicines to lower the uric acid levels to a safe range. Read more about medicines for gout. If you're receiving some types of cytotoxic medicines for cancer therapy, your doctor may prescribe uric acid lowering medicines at the same time.

✔ Keep hydrated and drink plenty of water (at least 8 glasses per day) unless there is a medical reason not to do so.

✔ Keep active by exercising.

✔ Lose weight if you need to.

See the section on living well with gout on our gout page.

Gout topics | Mate waikawa kai kōiwi
Medicines and side effects

Medicines for gout(external link)Medsafe and Ministry of Health, NZ, 2021 English(external link), te reo Māori(external link), Samoan(external link)
5 questions to ask about your medications(external link) Health Quality and Safety Commission, NZ, 2019 English(external link), te reo Māori(external link)