The efficacy and drug interactions of Japanese Emperor Febuxostat
Febuxostat, as a selective xanthine oxidase inhibitor, is mainly effective in uric acid lowering therapy, while potential interactions with other drugs should be considered. The following is an explanation from three aspects: pharmacological effects, clinical efficacy, and drug interactions, providing a reference for clinical medication.
1. Pharmacological mechanism of action
(1) Target inhibition: By selectively inhibiting xanthine oxidase, blocking the conversion of hypoxanthine to xanthine and uric acid, and reducing serum uric acid levels.
(2) Function characteristics: It has inhibitory effects on both oxidative and reductive enzymes, and its therapeutic effect is not affected by purine diet, nor does it interfere with purine nucleotide metabolism.
2. Clinical efficacy performance
(1) Uric acid lowering effect: Treatment for 2 weeks can reduce blood uric acid by 40% -50%, and 80% of patients can reach the standard within 4 weeks (<6mg/dL).
(2) Gout control: Continuous medication can reduce the frequency of gout attacks, but initial treatment may trigger acute attacks and require the use of anti-inflammatory drugs for prevention.
3. Drug interactions
(1) Thiopurine/mercaptopurine: Febuxostat may enhance its toxicity, and when used in combination, the dosage needs to be adjusted to 1/4-1/3 of the original dose, and bone marrow suppression should be closely monitored.
(2) Theophylline: It may increase the blood concentration of theophylline. When used in combination, theophylline concentration and adverse reactions should be monitored.
(3) Warfarin: No significant interaction was observed, but regular monitoring of INR values is recommended.
(4) CYP metabolic drugs: Febuxostat is metabolized by UGT and has no significant interaction with CYP inhibitors/inducers.
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