Febuxostat
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What is febuxostat?
Febuxostat (brand name: Adenuric) is a medicine used to treat gout, which is a type of arthritis caused by a build-up of urate crystals in the joints. Although urate is a normal substance in the blood, if the level rises too high, urate crystals can form which lead to the symptoms of gout. These symptoms include painful gout flares and lumps under the skin called tophi. This can lead to joint damage and deformities.
Febuxostat works by lowering the urate in the blood. This eventually leads to the accumulated crystals dissolving.
What benefit can you expect from your treatment?
Febuxostat is taken on a long-term basis to prevent gout flares and tophi. Taking febuxostat regularly each day will also help to prevent permanent damage to the joints. It does not treat the pain or inflammation of a gout flare. Febuxostat does not work straight away; it may take weeks to months to reduce the level of uratein your blood to the target concentration, so you could continue to have gout flares until all the crystals are dissolved.
Starting febuxostat or increasing the dose can sometimes cause a gout flare. This does not mean the medicine is not working and febuxostat should be continued during the flare. Your doctor will advise you on the appropriate medicines to treat the flare itself. Your doctor may also recommend a medicine to prevent flares during the first 6-12 months of treatment with febuxostat.
What happens if you have a gout flare?
Febuxostat is not a pain reliever. You should continue to take febuxostat during a gout flare, but your doctor will also recommend medicines to treat pain and inflammation. These may include colchicine, anti-inflammatory medicines such as naproxen,ibuprofen, indomethacin or steroids such as prednisolone. The choice of medicine will depend on your existing medicines and medical conditions. It is a good idea to plan with your doctor what to do if a gout flare occurs.
How is febuxostat taken?
Febuxostat is taken by mouth as a tablet, usually once a day. You should take your febuxostat at the same time each day.
It does not matter if you take febuxostat before or after food. It should be taken with a full glass of water.
Febuxostat should be taken regularly. If you forget to take a dose, restart the next day as you would normally. There is no need to double the dose at the next scheduled dose time.
What is the dosage?
Febuxostat tablets are available in one strength of 80mg. Treatment may start at 40mg (half a tablet) once a day. Over time your doctor may increase your dose to 80mg (one tablet) daily. The maximum is 120mg (one and one-half tablet) daily.
Can other medicines be taken with febuxostat?
Febuxostat may be taken in combination with other arthritis medicines, including:
- steroid medicines such as prednisolone or cortisone injections into the joint
- anti-inflammatory medicines (NSAIDs) such as naproxen or ibuprofen
- colchicine (Colgout)
- pain-relieving medicines such as paracetamol.
It is important that febuxostat is not taken together with other gout medicines including allopurinol and azathioprine.
Other medicines that may interfere with febuxostat include mercaptopurine theophylline, rosiglitazone and phenytoin.
How long is the treatment continued?
If there are no side-effects, febuxostat should be taken long term.
Even if all your gout flares and tophi resolve, febuxostat should be continued; stopping it will eventually lead to these symptoms returning.
Are there any side effects?
Most people do not experience side effects from febuxostat. Tell your doctor if you are concerned about any possible side effects.
Most common possible side effects
The most common side effects are headache and dizziness, nausea or diarrhoea, rash and itching. They are usually mild and only last for a short time. Febuxostat may also cause an increase in gout symptoms in the first few months. Your doctor will plan your gout treatment to help prevent this.
Less common or rare possible side effects
If you ever experience serious side effects such as chest pain, difficulty breathing, loss of consciousness or stroke symptoms, seek immediate medical attention.
- Skin problems: Febuxostat can cause a skin rash. Very rarely, an allergic reaction to febuxostat can occur. Signs of an allergic reaction include a severe skin rash with itching or hives, swelling of the face, lips, tongue or other parts of the body, and shortness of breath or trouble breathing. Mouth ulceration can also occur.
- Liver: Febuxostat can cause changes to liver function. Your doctor may do blood tests to check if this occurs. The dose of febuxostat may need to be reduced or it may need to be stopped if problems occur. Contact your doctor immediately if you notice yellowing of the skin and/or whites of
the eyes. - Other side effects not listed here may occur in some people.
Long term side effects
Long term use is not associated with an increase in the risk of death or serious events when compared with similar medicine such as allopurinol.
What precautions are necessary?
Blood tests
- The serum urate level in your blood will be checked to make sure the medicine is working.
- It is important to see your general practitioner (GP) regularly as they have an important role in monitoring your condition.
Use with other medicines
Febuxostat can interact with some other medicines. You should tell all of your doctors about all medicines you are taking or plan to take. This includes medicines that you buy without a prescription from your pharmacy, supermarket or health food shop. You should also mention your treatment when you see other health professionals.
Use with alcohol
Febuxostat does not interact with alcohol. However, excessive alcohol consumption is a risk factor for gout.
Use in pregnancy and when breastfeeding
- You should not take febuxostat if you are pregnant. It is not known whether febuxostat causes birth defects.
- If you are pregnant or are considering having a child, you should discuss this with your doctor before starting this medicine.
- You should not breastfeed if you are taking febuxostat. It is not known if febuxostat passes into breastmilk.
How to store febuxostat
- Store your febuxostat tablets in a cool, dry place, away from direct heat and light.
- Keep all medicines out of reach of children.
Important things to remember
In order for febuxostat to work effectively, it should be continued even when the symptoms of gout resolve. If it is stopped, gout flares and other gout symptoms may return.
You should also continue to take febuxostat during a gout flare.
This Information Sheet has been prepared using materials obtained from various sources which have been reviewed by the Australian Rheumatology Association (ARA). It contains general information only and does not contain a complete or definitive
statement of all possible uses, actions, precautions, side effects or interactions of the medicines referenced. This information is not intended as medical advice for individual conditions nor for making an individual assessment of the risks and benefits of taking a particular medicine. Decisions regarding the assessment and treatment of patients are the sole responsibility of the treating medical professional, exercising their own clinical judgment and taking into account all of the circumstances and the medical history of the individual patient.
ARA has used all reasonable endeavours to ensure the information on which this Information Sheet is based is accurate and up to date. However, the ARA accepts no responsibility or liability for the accuracy, currency, reliability and/or completeness
of the information contained in this Information Sheet. To the maximum extent permitted by law, the ARA expressly disclaims any liability for any injury, loss, harm or damage arising from or in connection with use of and reliance on the information contained in this Information Sheet. This information sheet is copyright and may be reproduced in its entirety but may not be altered without prior written permission from the ARA.
Page updated April 2026