Adenuric (febuxostat) is a xanthine oxidase inhibitor used to help treat hyperuricemia (high levels of uric acid in the blood) in adult patients.

In most cases Adenuric is prescribed to patients already exhibiting symptoms of gout or gouty arthritis. Less commonly it may be prescribed to patients undergoing chemotherapy to help prevent hyperuricemia from developing. Adenuric is not typically prescribed to patients who have hyperuricemia but are not experiencing gouty symptoms.

Dosage & Administration

Adenuric comes in tablets, which can be taken with or without food according to personal preference. Administration is typically once per day regardless of dosage, though there may occasionally be exceptions.

Patients starting treatment with Adenuric---or any gout treatment---often experience an increase in gout flareups for around six months following the start of treatment. This happens because the reduction of uric acid in the bloodstream causes deposits to be mobilized, which causes gout symptoms.

In other words, increased flareups mean the medication is working. Adenuric does little for pain; a doctor can prescribe a more powerful painkiller if over-the-counter varieties are not enough to manage pain and inflammation.

Patients who get through the first six months soon find gout flareups begin to decrease in both frequency and severity, and may be completely eliminated.

To take Adenuric:

• Most patients are started on 40 mg per day, taken once per day.
• Results should be evaluated after two weeks. If needed, dosage may be increased to 80 mg per day, taken once per day.
• Results should again be evaluated after two weeks. At this point, if uric acid levels are still too high, dosage may be increased to 120 mg per day. Alternatively, other medications may be tried instead of Adenuric.
• Treatment typically lasts a minimum of six months and may continue for several years if needed.

Duration of treatment depends to a large extent on lifestyle changes the patient has made; in many cases, lifestyle changes can eliminate, or at least minimize, high uric acid levels. This is not always the case, however, and sometimes lifestyle changes are not quite sufficient on their own even if well-maintained. These patients typically take Adenuric for longer than six months, though dosage may be lowered to some extent after the first six months.

Doctor checkups every six months to one year are strongly recommended for patients taking Adenuric; checkups both help determine the medication is working as intended and can help monitor for developing side effects.

Comparing Adenuric

The active ingredient in Adenuric, febuxostat, is often compared to another popular gout treatment, allopurinol (better known by the brand name Zyloprim). Both of these have been studied independently and in comparison, in both clinical trials and real-world use.

Here is how they compare:

• At standard doses (80 mg or lower), febuxostat has proven more effective than allopurinol.
• At standard doses patients experienced positive results faster with febuxostat than allopurinol.
• At higher doses (greater than 80 mg per day), allopurinol has proven more effective than febuxostat.
• Allopurinol is more versatile than febuxostat; it can be used to manage uric acid levels when gout is not present.
• The medications produce different side effects; individuals who experience a disruptive side effect from one may experience no side effects from the other, and vice versa.
• Febuxostat is better tolerated by patients who have kidney problems.

These two medications are both proven effective and produce similar results, though dosage and administration guidelines vary between the two. Which one is preferred depends on individual patient circumstances and, to some extent, trial and error. Odds are good a doctor will start a patient with lower doses of Adenuric, and if not particularly effective once dosage has risen to 80 mg, the patient may be switched to allopurinol.

Adverse Reactions

Side effects from Adenuric are typically mild and often stop occurring after the first few weeks of treatment. Most common are:

• Nausea
• Mild dizziness
• Mild skin rash
• Diarrhea
• Headache

The above are not cause for concern unless they become severe enough to be disruptive, in which case a doctor should be consulted. Patients experiencing severe side effects from Adenuric may not experience them if switched to allopurinol.

Patients with other medical conditions are at greater risk of experiencing more serious side effects. Discuss risks and warning signs with a doctor before using Adenuric if there is a history of:

• Liver problems
• Heart disease
• Cancer
• Organ transplant

This product should not be used while taking medications containing azathioprine or mercaptopurine.