What should I do if I have gout after taking febuxostat with high uric acid? Pharmacist Li to explain
If you are a friend of gout and high uric acid, the drug febuxostat is generally not unfamiliar. Febuxostat is the most common drug for gout patients to control the level of uric acid. However, when some friends are taking febuxostat to control uric acid, the uric acid is obviously decreasing, but gout still occurs. Isn't gout caused by high uric acid? ? How can I take the medicine, the uric acid has dropped, and I still have gout? Today we will introduce the relevant knowledge in this area.
To explain this problem, we must first start with the principle of gout attack. The pathological basis of gout attack is indeed high uric acid, the level of urate in the blood exceeds the standard, urate crystallizes in the blood, and gradually forms deposits in the joints with the blood circulation, and the urate deposited in the joints, if Under the influence of certain incentives, the inflammatory reaction of the joints is further triggered, and when symptoms such as severe pain, redness and swelling occur, we call it an acute attack of gout.
During an acute attack of gout, generally through active analgesic and anti-inflammatory treatment, coupled with appropriate rest and maintenance of life, the pain symptoms of acute gout will gradually ease and gradually disappear, but the pain of gout does not mean that we have gout. Just cured, if the problem of high uric acid is not resolved, in some cases, gout will come back and recur.
Therefore, in the intermittent period when gout is not painful, if you want to control the risk of recurrent gout, you must control the level of uric acid in the body. In general, if it is a friend who has a gout attack for the first time, in the absence of tophi, The uric acid level is usually required to be controlled below 360 μmol/L, and for those with multiple gout attacks and those with tophi problems, it is generally considered to meet the standard when it falls below 300.
Usually, friends who have had gout have relatively high levels of uric acid, and it is difficult to reduce uric acid simply through conditioning intervention in life. In most cases, supplementation with drugs is required to strengthen the control of high uric acid. Febuxostat is one of the commonly used uric acid-lowering drugs. Among several common uric acid-lowering drugs, febuxostat is a drug that inhibits the production of uric acid, mainly by inhibiting the activity of purine oxidase related to synthesizing uric acid. To achieve the effect of reducing the production of uric acid and reducing the level of uric acid, generally speaking, febuxostat has a good uric acid-lowering effect on various types of hyperuricemic gout patients.
Some friends take febuxostat to lower uric acid during the intermittent period of gout, but gout occurs again during the period of taking the medicine. When they go to check the uric acid value, it has indeed decreased. What is going on? Briefly explain the principle: febuxostat does have the effect of controlling the production of uric acid and reducing uric acid, but we also mentioned earlier that in the high uric acid stage, urate crystals will form crystals and form deposits in the joints. If When the urate in our blood is reduced, the urate deposited in the joints may reversely dissolve and return to the blood again. If this process is carried out slowly, it usually does not cause gout. If the speed drops too fast, the level of urate deposited in the joints will be violently disturbed. During the process of urate redissolving, it may further induce the body's inflammatory response, resulting in gout symptoms of joint pain. Therefore, the gout symptoms that occur during the process of taking febuxostat to reduce uric acid are often caused by "dissolving crystal pain" caused by the faster the reduction of uric acid.
How should we deal with and solve this problem? Here are 3 suggestions for you -
Don’t be in a hurry to take medication, you must pay attention to starting medication at a low dose, and reduce uric acid slowly. risk. Starting with a low dose of medication, combined with the regulation of uric acid to determine whether it is necessary to increase the dosage, this way of gently lowering uric acid is the best way to be safer and less prone to gout.
You must keep up with the conditioning of your life. Don't think that you have taken medicine, and there are no taboos in life. If you want to avoid the problem of crystal dissolving pain during taking the medicine, you should not relax the conditioning intervention in your life, drink more water, drink milk every day, pay attention to a low-purine diet, do not be overly fatigued, and do not get cold in the joints. These aspects will help. Reduce further attacks of gout.
During the period of taking uric acid-lowering drugs, in order to avoid gout attacks caused by the dissolution of urate during the uric acid-lowering period, low-dose anti-inflammatory and analgesic drugs can be selected to prevent gout attacks, such as low-dose colchicine, Small doses of non-steroidal anti-inflammatory drugs are acceptable.