This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. Febuxostat is a commonly used urate-lowering drug in clinical practice, mainly by antagonizing xanthine oxidase, thereby inhibiting the biosynthesis of uric acid and reducing blood uric acid concentration, which is mainly used in the long-term treatment of hyperuricemia in gout patients, especially for hyperuricemia of hyperuricemia with excessive uric acid production, before medication, patients should test the 24-hour uric acid quantification to determine the type of hyperuricemia, if the 24-hour urinary uric acid excretion exceeds 800mg (48mmol), which belongs to hyperuricemia with hyperuricemia of uric acid production, and febuxostat is the most appropriate. Febuxostat has a good safety profile, after being metabolized by the liver in the body, it can be excreted through the dual channels of kidney and bile, and can be used in patients with liver and kidney insufficiency, and is the first choice of uric acid-lowering drugs for patients with renal insufficiency, but it is not recommended for asymptomatic patients with hyperuricemia.
Gout is a chronic metabolic disease, uric acid control is not up to standard or fluctuates greatly can lead to frequent attacks of gout, in the long run, the formation of tophi, resulting in kidney damage, hypertension, diabetes, hyperlipidemia and other complications, by reducing blood uric acid, so that uric acid can be smoothly controlled, so as to prevent gout attacks and tophi formation, help tophi dissolve, in order to effectively curb gout to the joints, kidneys and cardiovascular damage brought by various chronic damage, therefore, it is recommended that all gout patients should control blood uric acid at 360 If lifestyle changes cannot make the blood uric acid reach the standard, it is necessary to take febuxostat and other uric acid-lowering drugs for a long time under the guidance of a doctor**, uric acid-lowering drugs ** is a protracted battle, patients should insist on taking the drug, and it is not advisable to stop the drug without authorization, so as to avoid rapid uric acid**.
Febuxostat has a strong urate-lowering effect, few adverse reactions, and good safety, and is the first-line preferred urate-lowering drug, which needs to be taken for a long time, and needs to be noted
1.Lifestyle interventions are essential for gout prevention and treatment, even in the case of long-term medication: emphasize a balanced diet, control the intake of high-purine foods, and avoid large amounts of high-purine foods such as animal offal, meat, and seafood (such as shellfish);Eat more fresh vegetables, drink more water (more than 2000ml per day), and avoid sugary drinks and alcoholic beveragesQuit smoking and limit alcohol, exercise regularly, control weight, 5-7 days a week, 30 minutes of moderate-intensity aerobic exercise each time, such as brisk walking, tai chi, cycling, table tennis, badminton, golf, etc., to avoid strenuous exercise or sudden cold.
2.During febuxostat**, if there is an acute attack of gout, there is no need to interrupt** to avoid causing fluctuations in serum uric acid and worsening gout, and a small dose of colchicine or a nonsteroidal anti-inflammatory drug can be added to relieve pain.
3.A large amount of urate is deposited in the muscles, bones and joints and other tissues of gout patients, and in the early stage of febuxostat, the blood uric acid decreases sharply, and the urate in the tissues dissolves rapidly, which increases the frequency of gout attacks.
4.Febuxostat is common for abnormal liver function, during long-term medication, if there are symptoms and signs of liver damage such as loss of appetite, jaundice, itching, right upper quadrant discomfort, soy sauce colored urine, etc., liver function should be tested in time, and if the aminotransferase exceeds the upper limit of the reference range by 3 times, it should be interrupted** to investigate the possible cause.
5.Long-term use of febuxostat can increase the risk of cardiovascular death, and patients with a history of ischemic heart disease, heart failure, and stroke are advised to use febuxostat with caution, and monitor the signs and symptoms of myocardial infarction and stroke during treatment.