Febuxostat (Uloric)
Febuxostat (Uloric) is a medication used to treat gout by lowering uric acid levels. When uric acid levels are too high in the body, it can build up leading to small crystal deposits in the joints. This can cause sudden and severe joint pain and swelling, known as gout attacks or flares. An enzyme called xanthine oxidase breaks down certain proteins (purines) in the body into uric acid and febuxostat works by blocking this xanthine oxidase to lower uric acid.
How To Take It
Febuxostat comes in 40 mg or 80 mg tablets. The recommended starting dose for most people is 40 mg daily up to maximum of 120 mg daily. The dose may be increased after a few weeks if your blood uric acid level is higher than 6 mg/dL.
A gout attack can occur when starting febuxostat and can be prevented by taking a second medication (like colchicine or low dose prednisone) when febuxostat is started or when the dose is changed and so people who are starting gout treatment with febuxostat should also be prescribed a second medication to prevent gout attacks. Febuxostat should be taken every day or as prescribed, skipping doses or stopping this medication may increase the risk of having more gout attacks.
Side Effects
People who take febuxostat may experience diarrhea or nausea, rashes, allergic reactions, and abnormal liver tests. Febuxostat contains lactose and gastrointestinal side effects may be more common in people who are lactose intolerant. If gout attacks occur while on febuxostat, these symptoms can be treated with colchicine or NSAIDS or steroids but febuxostat should not be stopped. Regular lab monitoring is recommended during treatment with febuxostat.
This medication should not be used if you are taking azathioprine or mercaptopurine as febuxostat can increase the blood levels of these medicines which may lead to toxic side effects. Additionally, in one clinical trial, more deaths from heart related causes, including heart attacks and strokes, were seen in people with gout and heart disease who took febuxostat compared to a similar group who took allopurinol. However, other clinical trials designed to look for heart complications and deaths from heart disease have not shown similar findings.
Tell Your Rheumatology Provider
Before starting this medication: Let your provider know if you have a history of heart disease or strokes. Let your provider also know if you are pregnant, considering pregnancy or breastfeeding because febuxostat has not been studied in people who are pregnant or breastfeeding; it is not recommended for use in these groups. You should also make sure to review all your medications and any supplements with your rheumatology provider.
If you are taking febuxostat and develop chest pain, chest pressure, shortness of breath, weakness or numbness in an arm, leg, or one side of your face, or symptoms of an allergic reaction, tell your rheumatology provider immediately or seek emergency medical care.
Updated September 2025 by Pankti Reid, MD, MPH, 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.