Febus

Indications

Febuxostat lowers uric acid in the blood. It is used for long-term treatment of gout in adults who have repeated gout attacks or tophi (lumps of uric acid crystals under the skin or in joints). At a higher dose, under specialist care, it is also used to prevent high uric acid during chemotherapy for some blood cancers.

How It Works

Febuxostat blocks xanthine oxidase, the enzyme that makes uric acid in the body. Lower uric acid means fewer crystals form in the joints, so gout attacks become less frequent and tophi slowly shrink.

Dosage and Administration

Gout, adults: usually started at 40 mg or 80 mg once a day. If uric acid is still high after 2 to 4 weeks, the doctor may increase the dose to 80 mg, or in some cases 120 mg, once a day. Take with or without food. During the first months, gout attacks can flare up as uric acid falls; the doctor often prescribes Colchicine or an NSAID to prevent this. Keep taking febuxostat even during a flare. Chemotherapy use: as prescribed. Not for children.

Interactions

Febuxostat must not be taken with Azathioprine or Mercaptopurine, as their levels can rise to dangerous amounts. Use with care with Theophylline. Tell your doctor about all medicines you take.

Contraindications

• Allergy to febuxostat or any ingredient of the product.
• Use of Azathioprine or Mercaptopurine.

Side Effects

Gout flares in the early months, diarrhoea, nausea, headache, rash, swelling and raised liver test results.

Get urgent medical help if you have:

• Chest pain, shortness of breath, sudden weakness on one side of the body, or slurred speech (possible heart attack or stroke).
• A severe rash with blisters, peeling skin, fever or swollen glands.
• Swelling of the face, lips or throat, or difficulty breathing.
• Yellow skin or eyes, dark urine or pain in the upper right belly.

Pregnancy and Lactation

Not recommended during pregnancy or breastfeeding, as safety has not been established.

Precautions and Warnings

Tell your doctor if you have heart disease, heart failure or a past stroke, as a large study found a higher risk of death from heart causes than with Allopurinol in such patients. Your doctor may check liver tests and, sometimes, thyroid tests. Do not start it during an acute gout attack unless the doctor advises. Drink plenty of water, and do not stop taking it without medical advice.

Overdose

No specific effects are well known. Seek medical advice if a large amount has been taken.

Therapeutic Class

Anti-gout medicine (xanthine oxidase inhibitor).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.