Febuxostat — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Febuxostat?
Febuxostat is a selective xanthine oxidase inhibitor used to reduce serum uric acid levels in patients with gout. This medication is funded by Pharmac under Special Authority for gout in patients intolerant of allopurinol.
What is Febuxostat Used For?
Used for chronic hyperuricaemia in gout patients who cannot tolerate or are inadequately controlled by allopurinol.
How Does Febuxostat Work?
Selectively inhibits both oxidised and reduced forms of xanthine oxidase, blocking uric acid production more potently than allopurinol in some patients.
How to Take Febuxostat
Once daily (80 mg or 120 mg) with or without food. Start colchicine or NSAID prophylaxis concurrently for 3–6 months. Target serum uric acid below 360 micromol/L.
Common Side Effects of Febuxostat
- Gout flares (first few months — use prophylaxis)
- Liver enzyme elevation
- Nausea
- Arthralgia
- Rash
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Cardiovascular events (higher CV mortality vs allopurinol in CARES trial — caution in CVD patients)
- Serious skin reactions
- Hepatotoxicity
- Stevens-Johnson syndrome (rare)
Drug Interactions
Febuxostat may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Azathioprine/mercaptopurine (DO NOT combine — life-threatening bone marrow suppression)
- Theophylline (increased levels)
New Zealand Prescribing Information
Febuxostat 80 mg tablets are funded under Special Authority for patients intolerant of, or inadequately controlled by, allopurinol. LFT monitoring recommended. Use with caution in established cardiovascular disease.
Frequently Asked Questions
Is febuxostat better than allopurinol?
Allopurinol remains first-line in NZ due to its safety record and lower cost. Febuxostat is reserved for those who cannot tolerate or do not respond adequately to allopurinol.
Why might my gout worsen initially?
Rapidly lowering uric acid can mobilise crystals from joints, triggering a flare. Prophylactic colchicine or anti-inflammatory cover for 3–6 months prevents this.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: