Names and pronunciation
(feb-ux′oh-stat) Uloric
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Individual generic drug information
Extracted information for febuxostat only.
(feb-ux′oh-stat) Uloric
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Func. class.: Antigout drug, antihy- peruricemic
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Chem. class.: Xanthene oxidase inhibitor
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ACTION: Inhibits the enzyme xan- thine oxidase, thereby reducing uric acid synthesis; more selective for xanthine oxidase than allopurinol
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USES: Chronic gout, hyperuricemia
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Extracted information for febuxostat only.
CONTRAINDICATIONS: Hyper sensitivity Precautions: Pregnancy, breastfeeding, children, renal/hepatic/cardiac/neoplas- tic disease, stroke, MI, organ transplant, F Lesch-Nyhan syndrome
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SIDE EFFECTS CNS: Dizziness, weakness, flushing GI: Nausea, vomiting, diarrhea, constipa- tion, hepatitis EENT: Cataracts, retinopathy, epistaxis HEMA: Thrombocytopenia, anemia, leu- kopenia, bone marrow suppression INTEG: Rash, DRESS, SJS, TEN MISC: Arthralgia, gout flare
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INTERACTIONS Increase: toxicity—azaTHIOprine, didan osine, mercaptopurine; do not use together Increase: xanthine nephropathy, cal- culi—rasburicase, antineoplastics Drug/Lab Increase: LFTs, alkaline phosphatase, serum cholesterol, triglycerides, amylase, BUN, creatinine, aPTT, PT, CPK, creatine Decrease: Hct/HB, RBC, platelets, lym- phocytes, neutrophils, TSH, blood glucose
Source pages 547, 548
Extracted information for febuxostat only.
DOSAGE AND ROUTES • Adult: PO 40 mg daily, may increase to 80 mg daily if uric acid levels are >6 mg/ dL after 2 wk of therapy Renal dose • Adult: PO CCr <30 mL/min 40 mg/day
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Available forms: Tabs 40, 80 mg
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Administer: PO route • Without regard to meals or antacids; may crush and add to foods or fluids • Only use in patients unable to take allopurinol or if allopurinol is ineffective
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Extracted information for febuxostat only.
Assess: • Hyperuricemia: uric acid levels q2wk; uric acid levels should be ≤6 mg/dL, flares may occur during first 6 wk of treatment • Hepatic studies before use, then 2, 4 mo and then periodically; assess for fa- tigue, anorexia, right upper abdominal discomfort, dark urine, jaundice • CV disease: Avoid use in those with CV disease, deaths have occurred, monitor for MI, stroke • Renal disease: I&O ratio; increase flu- ids to 2 L/day to prevent stone formation and toxicity • For rash, hypersensitivity reactions; dis- continue • Gout: joint pain/swelling, may be re- lieved with NSAIDs for acute gouty at- tacks and gout flare (first 6 wk)
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Evaluate: • Therapeutic response: decreased pain in joints, decreased stone formation in kidneys, decreased uric acid levels
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • That tabs may be crushed • To take as prescribed; if dose is missed, to take as soon as remembered; not to double dose • To increase fluid intake to 2 L/day un- less contraindicated • To avoid alcohol, caffeine because they will increase uric acid levels • To report cardiovascular events to pre- scriber immediately (chest pain, dyspnea, slurred speech, weakness) • Gout: that flares may occur during first 6 wk of treatment; continue and notify prescriber; NSAIDs or colchicine may be added to reduce the risk of flares See Appendix B
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Extracted information for febuxostat only.
PHARMACOKINETICS Peak 1-1.5 hr, duration up to 24 hr; metab- olized extensively in the liver, excreted in feces, urine; half-life 5-8 hr; protein bind- ing 99.2%; max lowering of uric acid 2 wk
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Filter the extracted dose blocks for this individual drug.
• Adult: PO 40 mg daily, may increase to 80 mg daily if uric acid levels are >6 mg/ dL after 2 wk of therapy Renal dose
Candidate age grouping · source page 547
• Adult: PO CCr <30 mL/min 40 mg/day
Candidate age grouping · source page 547