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Febuxostat 

Febuxostat

Febuxostat is an FDA-approved prescription medicine that belongs to the class xanthine oxidase inhibitor that is indicated for use in adults to lower blood uric acid levels with gout when allopurinol has not worked well enough or when allopurinol is not correct. It contains Febuxostat as its active ingredient. Febuxostat is available in tablet form with strengths of 40 and 80 mg, taken once daily with or without meal. For safe and efficient medication use, consult a licensed healthcare professional and ask them if you have any queries or concerns regarding medication use. To ensure your medication is authentic and safe, you should buy Febuxostat (Febuxostat) online from reliable and trustworthy sources. 

Product Overview

Febuxostat tablets are a prescription medication containing the active ingredient Febuxostat, a xanthine oxidase inhibitor. When allopurinol has not worked well for adult gout patients or the patient is unable to take it, this medication is used to lower the blood uric acid levels. Febuxostat works by inhibiting xanthine oxidase, an enzyme responsible for uric acid synthesis, thereby reducing serum uric acid levels. Febuxostat is available in tablet form with strengths of 40 and 80 mg. The initial dosage for adults is 40 mg or 80 mg once daily, and the maximum dosage should not exceed 80 mg once daily. 

It is typically taken once daily with or without food. This medication is not recommended for children due to insufficient data on safety and efficacy. Febuxostat helps manage chronic hyperuricemia in gout patients by lowering uric acid levels in the blood. Common side effects of Febuxostat include abnormal liver test results, diarrhea, gout flare-ups, headache, joint pain, nausea, and rash. Serious side effects may include heart problems, liver issues, and severe skin reactions. Patients should avoid drinking alcohol and ensure they stay well-hydrated. 

Febuxostat increases the risk of cardiovascular death in patients with known heart disease and should be used with caution. If a dose is missed, take it as soon as remembered, but skip it if it is almost time for the next dose. Do not double up doses. In case of overdose, seek immediate medical attention. Store Febuxostat in its original container, away from light, moisture, and heat, and keep it out of reach of children. Unused medication should be disposed of properly through a medicine take-back program. Consult a healthcare provider for any questions or concerns regarding Febuxostat use.

Uses of Febuxostat 

It is indicated for use in:

  • Chronic management of hyperuricemia in adult patients with gout who have an inadequate response to allopurinol, are intolerant to it, or for whom treatment with allopurinol is not advisable.

How to Use Febuxostat?

Dosage

Febuxostat is available in the form of a tablet that comes in the following strengths:

  • 40 g 
  • 80 mg 

Recommended Dosage for Febuxostat

For Treatment of Hyperuricemia:

  • Adults- The initial dosage for Febuxotat is 40 mg or 80 mg once daily. Your doctor may increase your dose as required, but the maximum dosage should not exceed 80 mg once daily. 
  • Children- There is not enough data to support the medication’s safety and efficacy. Hence, a licensed healthcare professional will determine the medication’s usage and dosage.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

  • Before taking this medication, carefully read and follow the instructions for use given on the patient information leaflet. 
  • You should take the medication as directed by your doctor or healthcare provider to ensure its safe and efficient use. Do not take it in greater quantities, more frequently, or for longer than prescribed. 
  • Ask your doctor, pharmacist, or healthcare provider if you have any questions or concerns about the medication’s use. 
  • Febuxostat is typically required to be taken once daily, with or without a meal. It can also be taken with an antacid. 
  • Drink two to three liters of fluids every day while using Febuxostat.
  • Your gout may get worse when you start taking this medication. Continue using it even if this happens. Your doctor may give you other medicines to help avoid gout attacks. 
  • If a laboratory test shows that you still have too much uric acid in your bloodstream after 14 days, your doctor may increase your dosage. 
  • It may take a couple of months before the medication begins to prevent gout attacks. 
  • The medication can control gout but does not cure it. You should keep taking this medication even if you feel well. You should not stop taking this medication without consulting your doctor. 
  • You should not start taking this medication until an attack of gout has completely settled. If this is not possible, your doctor may advise you to take it while the gout is in the mild phase. 
  • Gout attacks usually stop within a year once your urate levels have stabilized significantly. 
  • Once your urate level has lowered significantly and is in a stable range, you’ll require yearly blood tests to ensure that it remains the same.
  • Once you start using Febuxostat, you may be required to take the medication for the long term. It’s crucial to continue taking the drug, even if:
  • It doesn’t seem to work initially. 
  • If you have more gout attacks during the initial treatment. 
  • When you no longer have gout attacks
  • Avoid drinking alcohol while taking this medication, as it may trigger a flare-up of your gout.
  • If you experience any of the following symptoms: fever, rash, itching, difficulty breathing, or swelling in your face or limbs, or difficulty breathing, stop taking this medication immediately and call your doctor.
  • Let your doctor know if your condition does not improve or worsen. 

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Febuxostat Work?

Febuxostat is a non-purine xanthine oxidase inhibitor used to manage chronic hyperuricemia in adults with gout who have an inadequate response or intolerance to allopurinol. It is an enzyme responsible for uric acid synthesis in the body. By inhibiting xanthine oxidase, Febuxostat reduces the production of uric acid, leading to decreased serum uric acid levels. It functions by non-competitively obstructing xanthine oxidase’s active site, the molybdenum pterin center. Febuxostat lowers the mean concentrations of uric acid and xanthine in the serum as well as the total amount of uric acid excreted in the urine in healthy individuals. Overall, Febuxostat helps manage hyperuricemia associated with gout by lowering uric acid levels in the blood.

Important Safety Information

Side Effects

Common side effects of Febuxostat may include:

  • Abnormal liver test results
  • Diarrhea
  • Gout flare-ups
  • Headache
  • Inaccurate liver function test results
  • Joint pain
  • Nausea 
  • Rash 

Adverse side effects of Febuxostat may include:

  • Gout flares
  • Heart problems
  • Liver problems
  • Severe skin and allergic reactions

[Note: This list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

  • Febuxostat increases the risk of cardiovascular death in patients with known heart disease, so it should only be used with caution in such patients. Before starting to take the medication, you should consider the potential risks and benefits. If you notice any bothersome signs or symptoms, contact your doctor immediately. 
  • After you begin to take the medication, you may notice an increase in gout flares, which is due to a decrease in serum uric acid levels. To prevent gout flares while receiving treatment with the medication, it is advised to receive colchicine or an NSAID as concurrent prophylactic treatment.
  • There have been documented cases of both fatal and nonfatal hepatic failure in patients taking Febuxostat. 
  • Before starting Febuxostat, get a baseline liver test panel and frequently visit your doctor to ensure the medication works properly. Measure liver tests periodically to report signs and symptoms that may indicate a liver injury. 
  • You should discontinue taking the medication if you have serum ALT or AST levels more than three times the reference range and serum total bilirubin level is more than two times the reference range without any other etiologies as you may be at risk for severe drug-induced liver injury.
  • Cases of severe skin and hypersensitivity reactions, including DRESS, toxic epidermal necrolysis, and Stevens-Johnson syndrome, have been reported in some patients taking Febuxostat. 

Boxed Warning

Febuxostat has a boxed warning to alert doctors and patients to the increased risk of cardiovascular disease with the medication. The warning further states that only patients who are intolerant of or do not respond to allopurinol should be prescribed Febuxostat. Healthcare professionals should educate patients about the CV risk associated with Febuxostat use. Patients should seek immediate medical attention if they experience symptoms such as shortness of breath, irregular heartbeat, and chest pain while receiving treatment with this medication. 

Precautions

  • Before taking this medication, share your complete medical history with your doctor, especially if you have or had any of the following conditions:
    • Brain or blood vessel disease
    • Cardiovascular disease
    • Cancer
    • Diabetes 
    • Heart attack 
    • Lesch-Nyhan syndrome 
    • Organ transplant
    • Severe kidney disease
    • Severe liver disease
    • Stroke
  • While determining if this medicine works best for you, weigh the risks and benefits and only use it when the benefits outweigh the potential risks associated with this medicine. 
  • Before taking this medicine, let your doctor know if you have or ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare provider or physician know if you have certain types of allergies, especially to foods, preservatives, dyes, or animals. 
  • There is not enough data to support the medication’s safety and efficacy in pediatric patients, so you should consult a licensed healthcare professional while receiving treatment with Febuxostat.
  • Geriatric patients are more sensitive to the side effects of this medication as compared to the younger generation.
  • It is not known if this medication will cause harm to the fetus. At the same time, it is taken during pregnancy, so you are advised to consult your doctor or healthcare provider if you are pregnant, suspect a pregnancy, or if you are planning to become pregnant while receiving treatment with this medication. 
  • It is unknown if Febuxostat passes into the breastmilk and causes harm to the infant, so you should consult your doctor before nursing an infant while taking this medication. 
  • Make regular visits to your doctor to check your progress and ensure this medication works properly. Your doctor may suggest that you undergo certain blood and urine tests to check for unwanted side effects. 
  • You should not take azathioprine or mercaptopurine while you are using this medication. Using this medication with the mentioned drugs may cause serious, life-threatening medical problems. 
  • Febuxostat may increase your risk of having severe heart and blood vessel issues like angina, heart failure, stroke, or death. Call your doctor immediately if you have unstable chest pain, difficulty breathing, vision problems, sudden or severe headaches, and problems with walking or vision. 
  • Call your doctor immediately if you have tenderness or pain in the upper abdomen, light-colored stool, reduced appetite, vomiting/nausea, yellow skin, or eyes. These may be symptoms of a severe liver problem. 
  • While taking this medication, severe skin reactions may occur. Consult with your doctor immediately if you experience peeling, blistering, red skin lesions, loosening skin, sores or ulcers on the skin, severe acne, skin rash or fever, and chills while taking Febuxostat. 
  • Do not share your medication with others, even if they have the same symptoms as you. 
  • You should not take other medicines alongside Febuxostat unless you have discussed this with your doctor. This includes prescription medication, over-the-counter drugs, and herbal supplements you are planning to take. 

Contraindications

Febuxostat is contraindicated for use in patients who have:

  • Abnormal liver function tests 
  • Cerebrovascular disorders 
  • Chronic heart failure 
  • Hardening of arteries due to plaque buildup 
  • Increased risk of cardiovascular events 
  • Stage 4 chronic kidney disease

Missed Dose

  • To get the best results from the medication, you should maintain consistency in dosage and take it at the same time every day. 
  • If you have missed a dose of Febuxostat, you should take it as soon as you remember. 
  • However, if it is almost time to take the next dose of Febuxostat, you should omit the missed dose and continue as per your regular dosing schedule. 
  • Do not take double or extra doses to compensate for the missed dose. 
  • Do not take two doses of the same medication simultaneously, as it can cause unwanted side effects.
  • To further prevent missing doses in the future, you should set a reminder on your phone.

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

You should not take Febuxostat more than recommended, in large quantities, or more frequently. Taking the medication more than recommended can cause unwanted side effects. If someone has overdosed on the drug and is having severe symptoms such as difficulty breathing, seizures, and loss of consciousness, immediate medical attention should be taken. You can call 911 or head to the nearest emergency room. 

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

Storage

  • Keep this medication in its original container tightly closed, away from direct sunlight, moisture, and excess heat. 
  • Do not allow this medication to be exposed to extreme temperatures such as open flame and when kept inside the car’s cabinet. 
  • Do not store the medication in the bathroom. 
  • Keep all medications, including Febuxostat, away from the sight and reach of children. 
  • Do not keep medicines that are outdated or no longer needed. 
  • Discard medications that are no longer needed in such a way that children, animals, and others cannot consume them. 
  • With that said, do not throw unwanted medications into the drain or your household garbage bin. 
  • You should not pour Febuxostat into wastewater or flush it down the toilet. 
  • The best way to eliminate unwanted medication is to give it away in the medicine take-back program.
  • To learn more about properly disposing of unwanted medications, consult your healthcare provider, pharmacist, and local waste disposal company. 

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

Febuxostat Interactions

The following drugs may interact with Febuxostat and affect how it may work. 

  • Alpelisib
  • Azathioprine
  • Levoketoconazole
  • Mercaptopurine
  • Methotrexate
  • Ozanimod
  • Rosuvastatin
  • Talazoparib
  • Theophylline
  • Topotecan
  • Ubrogepant

[Note: This isn’t a complete list, and there could be other drugs that interact with Febuxostat. Tell your doctor about prescription, over-the-counter medicines, and herbal products.]

Febuxostat Alternatives

  • Aloprim (allopurinol)
  • Ebuxo (Febuxostat)
  • Fabulas (Febuxostat)
  • Febuday (Febuxostat)
  • Febumac (Febuxostat)
  • Febucip (Febuxostat)
  • Foxstat (Febuxostat)
  • Febuxor (Febuxostat)
  • Krystexxa (pegloticase)
  • Pegloticase  (pegloticase)
  • Probenecid (probenecid)
  • Rilonacept (rilonacept)
  • Zyloprim (allopurinol)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

What are the potential cardiovascular risks associated with Febuxostat?

Febuxostat carries a boxed warning about an increased risk of cardiovascular death. Patients with known heart disease should use this medication with caution, and healthcare professionals must weigh the benefits and potential risks before prescribing it. Symptoms such as shortness of breath, irregular heartbeat, and chest pain should be reported immediately to a doctor.

Can Febuxostat cause liver problems?

Yes, there have been cases of both fatal and nonfatal hepatic failure in patients taking Febuxostat. Before starting treatment, a baseline liver test panel is recommended, followed by periodic liver tests to monitor for signs of liver injury. The medication should be discontinued if serum ALT or AST levels exceed three times the reference range or serum total bilirubin exceeds two times the reference range without other causes.

Is Febuxostat safe for use in pregnant or breastfeeding women?

The safety of Febuxostat during pregnancy and breastfeeding has not been established. It is unknown if the medication can harm the fetus or if it passes into breast milk. Pregnant or breastfeeding women should consult their healthcare provider before starting Febuxostat to discuss potential risks and benefits.

What should I do if I experience a severe skin reaction while taking Febuxostat?

Severe skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported with Febuxostat. If you experience symptoms such as peeling, blistering, red skin lesions, or severe rash, you should stop taking the medication immediately and seek urgent medical attention.

Can Febuxostat be taken alongside other medications for gout management?

No, it should not be taken with certain medications, such as azathioprine or mercaptopurine, due to the risk of serious, life-threatening interactions. Patients should inform their healthcare provider about all prescription medications, over-the-counter drugs, and herbal products they are taking to avoid harmful interactions.

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