Febuxostat (Uloric)


Febuxostat (Uloric) is a medication that lowers the levels of uric acid in the body. It is used for the chronic management of gout if you have had an inadequate response to maximum doses of allopurinol, or are intolerant or cannot take allopurinol. Febuxostat works by blocking an enzyme that converts purines found in certain foods to uric acid. This, in turn, decreases levels of uric acid in the blood and thus helps to prevent gout flares.

How to Take It

Febuxostat comes in pill form. It is recommended to start febuxostat at 40 mg daily. The dose may be increased to 80 mg daily after two weeks if your blood uric acid is greater than 6 mg/dL. Febuxostat should be started in conjunction with a medication to prevent gout flares, such as colchicine or NSAIDs.

Side Effects

This medication should not be used if you are taking azathioprine or mercaptopurine as these medications can increase the blood levels of febuxostat, leading to toxic side effects. Along with elevated liver enzymes, headache, joint pain, and rash can be side effects of this medication. In gout patients with heart disease treated with febuxostat, higher rates of cardiovascular (CV) death occurred compared to those treated with allopurinol in a CV outcome study; hence, febuxostat is used in patients who do not respond, are intolerant, or cannot take allopurinol.

More frequent gout attacks have also been noted in patients when starting febuxostat. If gout attacks occur while on febuxostat, these can be treated with NSAIDs or glucocorticoids (also known as steroids) but febuxostat should not be stopped.

Tell Your Rheumatology Provider

If you notice chest pain, chest pressure, shortness of breath, weakness, or neurological deficits, tell your rheumatology provider immediately. Also inform them if you are taking any other medications which may interact with this drug. If you experience joint pain or rashes while on this medication, tell your rheumatology provider, as the medication dose may need to be adjusted.

Updated March 2023 by Kristen Lee, MD, and reviewed by the American College of Rheumatology Communications and Marketing Committee.

This information provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

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