How is lesinurad (Zurampic) used in the treatment of chronic gout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Lesinurad (Zurampic) is the first selective uric acid reabsorption inhibitor (SURI) approved by the FDA. It acts by inhibiting the urate transporter, URAT1, which is responsible for the majority of the renal reabsorption of uric acid. It also inhibits organic anion transporter 4 (OAT4), a uric acid transporter associated with diuretic-induced hyperuricemia.

Lesinurad must be coadministered with a xanthine oxidase inhibitor and is for hyperuricemia associated with gout in patients who have not achieved target serum uric acid levels with a xanthine oxidase inhibitor alone. Monotherapy or higher than recommended doses are associated with an increased serum creatinine. Renal function should be assessed before initiating therapy and periodically thereafter. More frequent monitoring is required for an estimated CrCl < 60 mL/min. Do not initiate therapy if CrCl is < 45 mL/min and discontinue if CrCl decreases persistently to < 45 mL/min

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