Febuxostat

Rheumatology

Rheumatology · Non-purine xanthine oxidase inhibitor

Febuxostat

Dose

80 mg PO OD; increase to 120 mg if urate >360 µmol/L after 4 weeks.

Contraindications

  • Ischaemic heart disease or heart failure — increased cardiovascular mortality signal

Use

Urate-lowering when allopurinol is not tolerated or ineffective.

Monitoring

Serum urate to target <360 µmol/L (<300 with tophi), LFTs.

Side effects

  • Gout flare on initiation (co-prescribe prophylaxis)
  • Transaminitis
  • Rash

Always confirm dose against your local formulary / BNF before prescribing.

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