Febuxostat Versus Allopurinol

Author:

Reinders MK, Jansen TL.

Title:

Management of hyperuricemia in gout: focus on febuxostat.

Published:

Clin Interv Aging. 2010 Feb 2;5:7-18.

Review of febuxostat, with particular emphasis on the comparison with allopurinol as a gout treatment.

Assessing Kidney Function For Allopurinol In Gout

Serum Cystatin C is a Potential Endogenous Marker for the Estimation of Renal Function in Male Gout Patients with Renal Impairment. Jan 2010, Choe JY et al. Shows Cystatin C is a better measure of kidney function than more traditional tests. Important for allopurinol users, and they recommend allopurinol for kidney patients.

Leave Assessing Kidney Function For Allopurinol In Gout to browse the Gout Disease pages

Purine Metabolism

Purine Metabolism And Gout

The purine metabolism review is an in-depth analysis of how uric acid forms as a product of purine metabolism. This is not straightforward, as there are many different types of purines. Many common charts of foods high in uric acid list all purines as a total value. However, prompted by investigations and reviews such as this one, I have narrowed the list down to purine rich foods most likely to affect gout.

Metabolism Of Purines And Diet

The report also explains important nutritional aspects of the metabolism of purines, including results of experiments in the laboratory and in humans.

Purine Metabolism Review File Details

Purine and pyrimidine metabolism. Sep 1985 Zöllner. In-depth analysis of different sources of purines and uric acid, differentiating between endogenous purines, from body tissue, and exogenous purines, from diet. Reveals that allopurinol eliminates half of internally generated uric acid, and almost all dietary uric acid.

Lower Uric Acid Gives Faster Gout Cure

Effect of Urate-Lowering Therapy on the Velocity of Size Reduction of Tophi in Chronic Gout. Aug 2002 Perez-Ruiz et al. This study of 63 gouty patients explodes the myth that a standard 300mg dose of allopurinol is adequate: “There is much more to the therapy of hyperuricemia than simply prescribing 300 mg/day of allopurinol. How much? As much as necessary to obtain low serum urate levels.” It shows that urate deposits will dissolve when uric acid is reduced below 7 mg/dL (0.42 mmol/L), but they dissolve about 4 times faster with urc acid levels below 4 mg/dL (0.24 mmol/L).

If you are taking allopurinol for gout, this shows how important it is to regularly discuss the right dosage with your doctor.

Alopurinol

Alopurinol Patient Information File Details

Patient information on allopurinol from the Australian Rheumatology Association. May 2009 (reviewed annually)

Allopurinol Side Effects Alcohol

Please note that this information contains recommendations about limiting alcohol to 1 to 2 drinks, once or twice a week. There is no background to this information about allopurinol and alcohol, therefore it is difficult to judge how important this is.

Allopurinol During Gout Attack

This allopurinol patient information clarifies the misunderstanding about taking allopurinol during an acute gout attack. Even some doctors are unsure, hence Jenny’s cry for help: Doc says to stop allopurinol due to gout flare?? HELP!

As the patient information makes clear:

You should also continue to take it during an attack of gout.