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Febuxostat is a selective, non-purine xanthine oxidase (XO) inhibitor. Inhibiting XO blocks the conversion of hypoxanthine to xanthine and subsequently to uric acid, thereby lowering serum uric acid levels. At therapeutic doses, febuxostat does not affect other enzymes involved in purine or pyrimidine metabolism.
Common: Gout flares, diarrhea, nausea, headache, liver enzyme abnormalities, rash, edema.
Rare but serious: Severe hypersensitivity reactions, cardiovascular thromboembolic events.
Gout (chronic management):
Tumor Lysis Syndrome (TLS):
Contraindicated: Azathioprine, mercaptopurine, theophylline (risk of toxicity).
Caution with:
Safe co-administration: Colchicine, indomethacin, hydrochlorothiazide, warfarin, rosiglitazone.
Concomitant use with azathioprine, mercaptopurine, or theophylline.
Known hypersensitivity to febuxostat.
Pregnancy: Category C – Use only if benefits outweigh potential risks.
Lactation: Unknown if excreted in breast milk; use caution in nursing mothers.
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