非布索坦怎么使用？

It is a xanthine enzyme inhibitor, mainly used to control hyperuricemia by inhibiting uric acid excretion. Febuxostat is mainly used in patients with stable or chronic gout. The dosage usually starts with a small dose, 20 mg each time, and then the dosage can be gradually increased according to the level of blood uric acid. If you are in an acute attack of gout and have not taken uric acid-lowering drugs before, febuxostat cannot be used at this time. It can only be used two weeks after the gout attack ends. And because the use of febuxostat may cause another acute attack of gout, it is usually used together with analgesics.

The initial dose of febuxostat is 20 to 40 mg/time, once a day. If the blood uric acid does not reach the standard after 2 weeks, the dose can be gradually increased, with the maximum dose of 80 mg/day. Adverse reactions of febuxostat include liver damage, nausea, rash, etc. Hepatic safety: Febuxostat is mainly metabolized by the liver and can be used by patients with mild to moderate liver damage. It is not recommended for patients with severe liver damage. Renal safety: Febuxostat is not excreted by the kidneys and has a high safety profile in patients with renal insufficiency and kidney transplantation. Patients with mild to moderate renal insufficiency whose glomerular filtration rate is above 30ml/min do not need to adjust the dose. Patients with severe renal insufficiency whose glomerular filtration rate is below 30ml/min should use it with caution. The recommended starting dose is 20mg, once a day. The rapid decrease in blood uric acid concentration can cause urate deposited in tissues to be released into the blood and induce gout attacks. Therefore, in the early stages of taking febuxostat, the frequency of gout attacks may increase. In this case, there is no need to discontinue febuxostat treatment, and nonsteroidal anti-inflammatory drugs (antipyretic and analgesics) or colchicine can be taken at the same time.

A study of more than 6,000 gout patients treated with febuxostat or allopurinol found an increase in heart-related deaths with febuxostat. Therefore, the FDA made a notification on the cardiac safety of febuxostat. However, in this study, the dosage of febuxostat was more than 80 mg per day, and half of the patients took more than 120 mg or even 240 mg per day. In the latest study released on October 4, 2017, the incidence of cardiovascular events was not high with febuxostat doses of 40 mg to 80 mg per day. Therefore, the cardiovascular safety of febuxostat may be dose-related. Therefore, 40mg to 80mg per day is relatively safe. If the dosage exceeds 80mg, the risk of cardiovascular disease will increase.