Febuxostat to prevent gout attacks

About febuxostat

Gout causes attacks of painful inflammation in one or more of your joints. It is caused by a build-up of a naturally occurring chemical in your blood, called uric acid (urate). From time to time, the level of uric acid in your blood may become too high and tiny grit-like crystals may form, which typically collect in your joints and tendons. The crystals irritate the tissues of the joint to cause inflammation, swelling and pain.

If you have had a number of gout attacks, your doctor may advise that you take a medicine known as a xanthine-oxidase inhibitor to help prevent more attacks from occurring. There are two of these types of medicines currently available - allopurinol and febuxostat. You will have been prescribed febuxostat if allopurinol is unsuitable for you. Febuxostat helps to prevent gout attacks by reducing the levels of uric acid in your blood. However, it does not have any painkilling effect during a gout attack, so you will still need to take pain relief should you have any further attacks. In this case, your doctor will prescribe either an anti-inflammatory painkiller or colchicine for you to take alongside febuxostat.

Before taking febuxostat

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking febuxostat it is important that your doctor knows:

• If you are pregnant or breastfeeding.

• If you have a heart condition, such as heart disease or heart failure.

• If you have ever had a heart attack (MI) or a stroke.

• If you have any problems with your thyroid gland, liver or kidneys.

• If you have had an organ transplant. (This is because no studies have been done with this group of people.)

• If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine.

How to take febuxostat

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about febuxostat and will provide you with a full list of the side-effects which you may experience from taking it.

• If you have recently had a gout attack, make sure your symptoms have completely gone before you start taking febuxostat tablets.

• Take febuxostat exactly as your doctor tells you to. Take one tablet each day.

• There are two strengths of tablet - 80 mg and 120 mg. When starting the treatment, your doctor will give you 80 mg strength tablets. The strength of the tablet may be increased after 2-4 weeks to 120 mg, if this is necessary. Your dose will be adjusted in line with how much uric acid is in your blood.

• You can take febuxostat at whatever time of day you find easiest to remember, although most people choose to take it in a morning. Try to take your doses at the same time of day each day, as this will help you to take it regularly. You can take the tablet either before or after meals.

• If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the forgotten dose. Do not take two doses at the same time to make up for a missed dose.

Getting the most from your treatment

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor will want you to have a blood test to check that the level of uric acid has come down. This is often done two weeks or so after starting febuxostat. You will also need to have blood tests from time to time to check that your liver stays healthy.

• Remember, febuxostat should be taken every day to prevent a gout attack. It can take six months to become fully effective. It does not have any effect during a gout attack, although you should continue to take it regularly every day even if this happens.

• During the first few months of taking febuxostat, your blood levels of uric acid may rise for a short while before they fall. This can cause a gout attack. Your doctor will prescribe an anti-inflammatory treatment or colchicine tablets for you to take alongside febuxostat during this time.

• Treatment with febuxostat is usually long-term unless you experience an adverse effect. Continue to take the tablets unless you are advised otherwise by a doctor.

• There are a number of lifestyle changes that you can make to help reduce the risk of having a gout attack. These include losing weight (if you are overweight), eating a healthy diet and not drinking much alcohol or sugar-sweetened soft drinks. Your doctor will advise you about the changes which could benefit you.

Can febuxostat cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with febuxostat. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Important: there have been a few reports of febuxostat causing a serious allergic reaction (such as swelling around the face, difficulties breathing, swollen glands and skin rash). Although this is rare, if you experience any of these symptoms, you should stop taking febuxostat and contact your doctor straightaway.

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

How to store febuxostat

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.
  

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