Long term control of gout
Please see Febuxostat: updated advice for the treatment of patients with a history of major cardiovascular disease - GOV.UK and Recommendations | Gout: diagnosis and management | Guidance | NICE. NG 219 suggests for the long-term management of gout : Offer allopurinol as first-line treatment to people with gout who have major cardiovascular disease (for example, previous myocardial infarction or stroke, or unstable angina).”
Drug Safety Update
May 2023: Febuxostat: updated advice for the treatment of patients with a history of major cardiovascular disease
December 2014: Febuxostat (Adenuric▼): stop treatment if signs or symptoms of serious hypersensitivity.
NICE guidance (see also drug specific guidance below)
NG219:Gout: diagnosis and management, published June 2022.
Allopurinol
This is the drug of choice for prophylaxis. It should not be started during an acute attack but 1-2 weeks after the attack has settled. The initiation of allopurinol may precipitate an acute attack, so an NSAID or low dose colchicine (500mcg 1 - 2 times daily) should be used as a prophylactic and continued for at least 1 month after the hyperuricaemia has been corrected.
Crystallisation of urate in the urine can occur with uricosuric drugs below, therefore it is important to ensure adequate urine output in the first few weeks of treatment.
Aspirin and other salicylates antagonise uricosuric drugs, and so are not indicated in gout.
Used in the treatment of gout and also co-prescribed with cidofovir for CMV retinitis
| Pack |
|---|
| 60 tablet |
| 100 tablet |
| 500 tablet |
| 1 tablet |
| 30 tablet |
| 50 tablet |
- On Formulary Preferred
- On Formulary Second Line
- On Formulary Third Line
- Specialist Initiation
- Secondary Care Only
- Not Approved for Formulary