What is the role of medications in the treatment for hyperuricemia?

Updated: Nov 03, 2020
  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

Pharmacotherapy for hyperuricemia is based on whether patients are overproducers or undersecretors. Allopurinol continues to be the mainstay for the treatment of patients who are overproducers, but febuxostat has become an established alternative to allopurinol. Febuxostat is a nonpurine selective xanthine oxidase inhibitor that does not require dose reduction in patients with renal impairment.

Rasburicase is another antihyperuricemic medication. It is a recombinant urate oxidase that is indicated for preventing complications of hyperuricemia during the tumor lysis syndrome. Since losartan has been found to have an uricosuric property, it may be worthwhile to use it in hypertensive patients with hyperuricemia that lack any contraindication to angiotensin receptor blockers. Other uricosuric drugs used in underexcretors are mentioned below.


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