Uric Acid Nephropathy Medication

Updated: Sep 10, 2019
  • Author: Mark T Fahlen, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Medication

Medication Summary

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

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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. [15, 30, 31] 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.

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