Febuxostat interactions
Full monograph for FebuxostatCheck it against another medicine
Medicines
18 documented
Mechanism
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Azathioprine | Major | Metabolism | Coadministration with febuxostat may significantly increase the plasma concentrations of xanthine oxidase substrates such as azathioprine, mercaptopurine, and… | 2 sources — open the full entry |
| Leflunomide | Major | Synergy | The recent, concomitant, or subsequent use (without the recommended leflunomide washout period or procedure) of other agents known to induce hepatotoxicity may… | 3 sources — open the full entry |
| Mercaptopurine | Major | Metabolism | Coadministration with febuxostat may significantly increase the plasma concentrations of xanthine oxidase substrates such as azathioprine, mercaptopurine, and… | 2 sources — open the full entry |
| Aminophylline | Moderate | Metabolism | Coadministration with febuxostat may alter the pharmacokinetics of theophylline. The proposed mechanism is inhibition of xanthine oxidase by febuxostat. | 1 sources — open the full entry |
| Efavirenz | Moderate | Synergy | Coadministration of efavirenz with other agents known to induce hepatotoxicity may potentiate the risk of liver injury. Efavirenz has been associated with… | 7 sources — open the full entry |
| Epirubicin Hydrochloride | Moderate | Synergy | The concomitant or sequential use of epirubicin with agents known to induce hepatotoxicity may potentiate the risk of liver injury. Epirubicin undergoes… | 4 sources — open the full entry |
| L-Asparginase | Moderate | Synergy | Concomitant use of asparaginase with other hepatotoxic agents may potentiate the risk of liver injury. Hepatomegaly, acute severe hepatotoxicity, and fatal… | 13 sources — open the full entry |
| Methotrexate | Moderate | Synergy | Coadministration of methotrexate with other agents known to induce hepatotoxicity may potentiate the risk of liver injury. Methotrexate, especially at higher… | 3 sources — open the full entry |
| Remdesivir | Moderate | Synergy | Concomitant use of remdesivir with other agents that are known to induce hepatotoxicity may theoretically increase the risk of liver injury. Data from… | 5 sources — open the full entry |
| Theophylline | Moderate | Metabolism | Coadministration with febuxostat may alter the pharmacokinetics of theophylline. The proposed mechanism is inhibition of xanthine oxidase by febuxostat. | 1 sources — open the full entry |
| Carbamazepine | Minor | Metabolism | Potent inducers of UGT enzymes (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, ritonavir) may increase the metabolism of febuxostat and decrease its… | 2 sources — open the full entry |
| Lopinavir + Ritonavir | Minor | Metabolism | Potent inducers of UGT enzymes (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, ritonavir) may increase the metabolism of febuxostat and decrease its… | 2 sources — open the full entry |
| Nirmatrelvir + Ritonavir | Minor | Metabolism | Potent inducers of UGT enzymes (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, ritonavir) may increase the metabolism of febuxostat and decrease its… | 2 sources — open the full entry |
| Phenobarbital | Minor | Metabolism | Potent inducers of UGT enzymes (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, ritonavir) may increase the metabolism of febuxostat and decrease its… | 2 sources — open the full entry |
| Phenytoin Sodium | Minor | Metabolism | Potent inducers of UGT enzymes (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, ritonavir) may increase the metabolism of febuxostat and decrease its… | 2 sources — open the full entry |
| Rifampicin | Minor | Metabolism | Potent inducers of UGT enzymes (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, ritonavir) may increase the metabolism of febuxostat and decrease its… | 2 sources — open the full entry |
| Rifampicin + Isoniazid | Minor | Metabolism | Potent inducers of UGT enzymes (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, ritonavir) may increase the metabolism of febuxostat and decrease its… | 2 sources — open the full entry |
| Rifampicin + Isoniazid + Pyrazinamide + Ethambutol | Minor | Metabolism | Potent inducers of UGT enzymes (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, ritonavir) may increase the metabolism of febuxostat and decrease its… | 2 sources — open the full entry |
Conditions
Conditions in which Febuxostat needs care, as documented in this source.
Hyperuricemia
MajorNo studies with febuxostat or lesinurad have been conducted in patients with secondary hyperuricemia (including organ transplant recipients). The use of these drugs is contraindicated in patients where the uric acid formation is greatly increased, such as patients with malignant disease, tumor lysis syndrome or Lesch-Nyhan syndrome.
2 sources
- "Product Information. Uloric (febuxostat)." Takeda Pharmaceuticals America (2009):
- "Product Information. Zurampic (lesinurad)." Astra-Zeneca Pharmaceuticals (2015):
Cardiovascular Diseases
ModerateMajor adverse cardiovascular events (cardiovascular deaths, non- fatal myocardial infarctions and non- fatal strokes), were reported during clinical trials with some antihyperuricemic agents, such as febuxostat and lesinurad. Although a causal relationship has not been established, caution is advised when used in patients with cardiovascular disease. Monitoring for signs or symptoms of myocardial infarction or stroke is recommended.
2 sources
- "Product Information. Uloric (febuxostat)." Takeda Pharmaceuticals America (2009):
- "Product Information. Zurampic (lesinurad)." Astra-Zeneca Pharmaceuticals (2015):
Hepatic Insufficiency
ModerateNo studies have been conducted in patients with severe hepatic impairment (Child-Pugh Class C), therefore caution should be exercised if using febuxostat or lesinurad on these patients. No dose adjustment is necessary in patients with mild or moderate hepatic impairment.
2 sources
- "Product Information. Uloric (febuxostat)." Takeda Pharmaceuticals America (2009):
- "Product Information. Zurampic (lesinurad)." Astra-Zeneca Pharmaceuticals (2015):
Kidney Diseases
ModerateThere are insufficient data on the use of febuxostat in patients with severe renal impairment (ClCr less than 30 mL/min), therefore caution should be exercised on these patients. No dose adjustment is needed in patients with mild or moderate renal impairment.
1 source
- "Product Information. Uloric (febuxostat)." Takeda Pharmaceuticals America (2009):