Febuxostat belongs to a class of medicines called xanthine oxidase inhibitor which lower uric acid (also called urate) levels in the blood. The other xanthine oxidase inhibitor is allopurinol. Usually you are prescribed Febuxostat if allopurinol is unsuitable for you.
When the uric acid builds up in the blood and becomes too high, urate crystals may form in and around the joints (such as big toe joints, ankles, elbows). These crystals irritate the tissues and cause sudden, severe pain, redness, warmth and swelling in a joint, commonly known as a gout flare or attack. Left untreated, larger deposits called tophi may form in and around joints. These tophi may cause joint and bone damage.
Febuxostat is used for reducing uric acid levels, stopping crystal formation and dissolving crystal for excretion. Over time, it reduces gout flare and associated symptoms. Keeping uric acid levels sufficiently low for a long enough period can also shrink tophi.
Side effects may occur when taking Febuxostat, but the majority of these effects tend to resolve spontaneously. Common side effects include:
Consult your doctor, specialty nurse or pharmacist about any symptoms that becomes bothersome.
You may experience gout flare when you first start taking Febuxostat, as the urate crystals start to dissolve and are “shed” into the blood stream again as uric acid. This shows that the drug is working, and these will soon become less frequent over time with regular use of Febuxostat. To prevent this, your doctor may prescribe other medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs) or colchicine with Febuxostat for the first 6 months.
STOP taking Febuxostat and let your doctor know if you develop an allergic reaction. Rash due to allergic reaction to Febuxostat is rare. Possible symptoms of allergic reaction are:
rash, hives, or itching
red, swollen, blistered or peeling skin with or without fever
wheezing or tightness in the chest or throat
trouble breathing or talking
unusual hoarseness
swelling of the mouth, face, lips, tongue or throat
STOP taking Febuxostat and seek medical attention immediately if you experience any of the rare but severe side effects
liver problems - possible symptoms are dark urine, feeling tired, lack of appetite, nausea, abdominal pain, light-coloured stools, vomiting, or yellow skin or eyes
blood clot in the vessels - possible symptoms are severe chest pain with extreme sweating, severe headache, severe giddiness, passing out, change in strength on one side is greater than the other, difficulty speaking or thinking, suggesting heart attack and stroke
Inform the doctor, specialty nurse or pharmacist if you have heart failure or heart problems, kidney, liver and thyroid problems. Your doctor may consider changing the medicine or dosage depending on your condition.
Febuxostat may interact with other medicine or supplement that you are taking. Inform the doctor, pharmacist or specialty nurse (such as dermatology, gastroenterology or rheumatology) before starting any medicines and supplements. Medicines such as Azathioprine, Mercaptopurine and Theophylline should not be taken together with Febuxostat as they might increase the chance of you experiencing severe side effects.
It is not known if Febuxostat harm an unborn child and if Febuxostat pass into human breast milk. You should not use Febuxostat if you are pregnant or breastfeeding. If you think you may be pregnant or are planning to have a baby or breastfeeding, ask your doctor, specialty nurse, or pharmacist for advice before taking this medicine. The doctor may prescribe another medicine that is safer for your baby.
Your doctor will perform blood tests before and after you start taking Febuxostat to monitor uric acid levels and side effects. Do come back to the hospital for regular follow-ups and blood tests as instructed by your doctor.
There are a number of lifestyle changes that help to reduce the risk of having a gout attack. These include losing weight (if you are overweight), drinking adequate water, and stopping purine-rich diet such as organ meat, meat extracts, gravies, and beer. Your doctor, specialty nurse, or pharmacist will advise you about the changes which could benefit you.
Febuxostat should be taken as prescribed by the doctor. The usual dose is one tablet daily, taken at the same time of each day. The tablets can be taken with or without food. Continue to take Febuxostat as prescribed even when you are not experiencing gout flare or attack.
If you forget to take the tablet, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose. Resume the next dose at the regular timing. Do not take a double dose to make up for a forgotten tablet.
If you have further questions about Febuxostat, do contact your doctor, specialty nurse or pharmacist.
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