Febuxostat

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Aug 22, 2024

Warnings

Febuxostat (Uloric) Risks, Warnings, and Complications

Febuxostat can cause or worsen health problems in certain people. Talk to your doctor or pharmacist about other treatment options for gout if you are at a high risk of complications from this medication.

GOUT FLARES: An increase in gout flares is common after starting febuxostat. This happens because the reduction in plasma concentrations of uric acid causes movement of urate out of tissue deposits. During this time, your doctor will prescribe other medications to prevent gout attacks, such as colchicine or NSAIDs.
SERIOUS SKIN REACTIONS: Rarely, taking febuxostat can cause severe allergic reactions. Call your doctor immediately or seek emergency medical attention if you develop signs and symptoms of a serious drug reaction such as a skin rash, hives, itching, peeling, blistering, swelling, or difficulty breathing.
CARDIOVASCULAR EVENTS: Randomized controlled studies have shown that patients treated with febuxostat experience a higher rate of cardiovascular thromboembolic events (non-fatal heart attack, non-fatal stroke, and cardiovascular death). It is unclear if there is a direct causal relationship between these events and febuxostat. Tell your doctor without delay or seek immediate medical care if you develop chest pain, difficulty breathing, numbness or weakness on one side of the body, speech difficulties, or a sudden severe headache.
ABNORMAL LIVER TESTS: Randomized controlled studies have shown that serum transaminase levels (liver enzymes) can increase by up to 3 times the normal levels in people treated with febuxostat and allopurinol. Your healthcare provider will order laboratory testing every 2-4 months to keep an eye on liver function. Keep all your medical and lab appointments while on this drug.

Precautions Before Starting Febuxostat (Uloric)

Tell your doctor if you are allergic to febuxostat, allopurinol, any of the active or inactive ingredients in febuxostat tablets, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor a complete list of your prescribed medicines, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid possible drug interactions.

Give your healthcare provider a complete medical history. Febuxostat may not be safe for people with certain medical conditions, such as cancer, organ transplant, Lesch-Nyhan syndrome, renal impairment (kidney disease), or liver disease.

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy soon, or are breastfeeding.

Precautions During Use of Febuxostat (Uloric)

Keep all your medical and laboratory appointments while taking febuxostat. Your healthcare professional may order certain blood tests to check liver function and monitor your response to febuxostat.

Tell your doctor without delay if you develop symptoms of liver damage (stomach pain, yellowing of the skin or eyes, dark urine).

Tell your doctor if you become pregnant while on febuxostat.

Tell all your healthcare providers you are on febuxostat, including before any surgery or dental procedures.

Febuxostat (Uloric) Drug Interactions

Concomitant use of febuxostat with certain other drugs can affect how the medications work. Possible interactions between febuxostat and other medicines can increase the risk of severe adverse effects. The following medications can interact with febuxostat:

Mercaptopurine (Purinethol, Purixan)
Azathioprine (Azasan, Imuran)
Cancer chemotherapy medications
Theophylline (Elixophyllin, Theo-24, others)

The above list may not describe all possible interactions of febuxostat. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies. Also, tell your health care professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medicines.

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