What medicine is best and quickest to reduce uric acid levels when it is high

Patients with high uric acid levels should choose uric acid lowering drugs under the guidance of a doctor. Commonly used drugs include allopurinol, febuxostat, benzbromarone, etc. Drug selection should comprehensively consider factors such as uric acid levels, liver and kidney function, and comorbidities. Rapid reduction of uric acid may induce acute attacks of gout, and it is recommended to slowly reach the target.

1. Allopurinol:

Allopurinol reduces uric acid production by inhibiting xanthine oxidase and is suitable for patients with hyperuricemia. Attention should be paid to the possibility of allergic reactions. It is recommended to undergo HLA-B * 5801 gene testing before medication. Common adverse reactions include rash, abnormal liver function, and dosage adjustment for patients with renal insufficiency.

2. Febuxostat:

Febuxostat is a selective xanthine oxidase inhibitor with a stronger uric acid lowering effect than allopurinol. Especially suitable for patients who are allergic to allopurinol or have renal dysfunction. Be alert to the risk of cardiovascular events, and monitor electrocardiogram and myocardial enzyme spectrum for long-term use.

3. Benzbromarone:

Benzbromarone promotes excretion by inhibiting renal tubular uric acid reabsorption and is suitable for patients with uric acid excretion disorders. During medication, it is necessary to drink a large amount of water to alkalize urine and avoid the formation of kidney stones. Prohibited for patients with moderate to severe renal insufficiency and uric acid kidney stones.

4. Combination therapy:

For refractory hyperuricemia, the combination of allopurinol and benzbromarone can be considered. The joint plan requires strict monitoring of liver and kidney function and uric acid levels to avoid gout attacks caused by sudden drops in uric acid. Usually used after evaluation by a rheumatologist when monotherapy is ineffective.

5. Auxiliary drugs:

Sodium bicarbonate can be used to alkalize urine and promote uric acid excretion, usually in combination with excretion promoting drugs. Colchicine or nonsteroidal anti-inflammatory drugs can be used to prevent gout attacks in the early stages of uric acid lowering treatment, but attention should be paid to gastrointestinal side effects and drug interactions.

Uric acid lowering treatment should be accompanied by a low purine diet, with daily water intake of at least 2000 milliliters, and restrictions on alcohol and high fructose beverages. It is recommended to engage in moderate aerobic exercise to control weight and avoid triggering gout through vigorous exercise. Regularly monitor blood uric acid levels, with a target value usually controlled below 360 μ mol/L, and for gouty stone patients, it needs to be reduced to below 300 μ mol/L. During the treatment period, if there is redness, swelling, heat and pain in the joints, it is necessary to seek medical attention in a timely manner to avoid adjusting the medication dosage on one's own.