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Uric Acid Nephropathy Medication

  • Author: Mark T Fahlen, MD; Chief Editor: Vecihi Batuman, MD, FACP, FASN  more...
Updated: Nov 20, 2015

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.


Xanthine oxidase inhibitors

Class Summary

Allopurinol is used for the prevention of acute uric acid nephropathy. By blocking the conversion of hypoxanthine and xanthine to uric acid, it produces a reduction in serum uric acid concentration and in the urinary excretion of urates. Allopurinol is used in the treatment of gouty arthritis.[13, 21, 22] Febuxostat may be considered for patients with allopurinol allergy or for those with renal impairment.

Allopurinol (Zyloprim)


Inhibits xanthine oxidase, the enzyme that synthesizes uric acid from hypoxanthine. Reduces synthesis of uric acid without disrupting biosynthesis of vital purines.

Febuxostat (Uloric)


Xanthine oxidase inhibitor. Prevents uric acid production and lowers elevated serum uric acid levels. May be considered as an alternative to allopurinol. Febuxostat is extensively metabolized in the liver and excreted in the feces and urine, largely as metabolites. No dosage change is necessary unless severe renal or hepatic impairment exists.

Contributor Information and Disclosures

Mark T Fahlen, MD Private Practice, Mark T Fahlen, MD, Inc

Mark T Fahlen, MD is a member of the following medical societies: American College of Physicians, Renal Physicians Association

Disclosure: Nothing to disclose.


Mahendra Agraharkar, MD, MBBS, FACP FASN, Clinical Associate Professor of Medicine, Baylor College of Medicine; President and CEO, Space City Associates of Nephrology

Mahendra Agraharkar, MD, MBBS, FACP is a member of the following medical societies: American College of Physicians, American Society of Nephrology, National Kidney Foundation

Disclosure: Received ownership interest/medical directorship from South Shore DaVita Dialysis Center for other; Received ownership/medical directorship from Space City Dialysis /American Renal Associates for same; Received ownership interest from US Renal Care for other.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Eleanor Lederer, MD, FASN Professor of Medicine, Chief, Nephrology Division, Director, Nephrology Training Program, Director, Metabolic Stone Clinic, Kidney Disease Program, University of Louisville School of Medicine; Consulting Staff, Louisville Veterans Affairs Hospital

Eleanor Lederer, MD, FASN is a member of the following medical societies: American Association for the Advancement of Science, International Society of Nephrology, American Society for Biochemistry and Molecular Biology, American Federation for Medical Research, American Society for Bone and Mineral Research, American Society of Nephrology, American Society of Transplantation, Kentucky Medical Association, National Kidney Foundation, Phi Beta Kappa

Disclosure: Received grant/research funds from Dept of Veterans Affairs for research; Received salary from American Society of Nephrology for asn council position; Received salary from University of Louisville for employment; Received salary from University of Louisville Physicians for employment; Received contract payment from American Physician Institute for Advanced Professional Studies, LLC for independent contractor; Received contract payment from Healthcare Quality Strategies, Inc for independent cont.

Chief Editor

Vecihi Batuman, MD, FACP, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology

Disclosure: Nothing to disclose.

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