Febuxostat (Uloric)
Febuxostat (Uloric) is a medication used to treat gout by lowering uric acid in the body. If blood levels of uric acid are too high, it can turn into crystals which are then stored in different parts of the body. When uric acid crystals develop in joints, they can cause sudden and severe pain and swelling, known as gout attacks or flares.
Uric acid is normally found in blood and comes from the breakdown or digestion of certain proteins called purines by an enzyme called xanthine oxidase. Febuxostat works by blocking xanthine oxidase from turning purines into uric acid.
How To Take It
Febuxostat comes as a pill taken once a day by mouth. The recommended starting dose for most people is 40 mg once a day but this can be increased up to a maximum daily dose of 120 mg. The dose may be increased after a few weeks if your blood uric acid level is higher than 6 mg/dL or if you have continue having gout symptoms.
People who are starting gout treatment with febuxostat should also be prescribed a second medication, such as colchicine or low dose prednisone, to prevent gout attacks that can occur when febuxostat is started or when the dose is changed.
Febuxostat should be taken every day or as prescribed; skipping doses or stopping this medication may increase the risk of having more gout attacks.
Side Effects
People who take febuxostat may experience diarrhea or nausea, rashes, allergic reactions, and abnormal liver tests. Febuxostat contains lactose and gastrointestinal side effects may be more common in people who are lactose intolerant. If gout attacks occur while on febuxostat, these symptoms can be treated with colchicine or NSAIDs or steroids but febuxostat should not be stopped. Regular blood tests are recommended during treatment with febuxostat.
This medication should not be used if you are taking azathioprine or mercaptopurine as febuxostat can increase the blood levels of these medicines which may lead to serious side effects. Additionally, in one clinical trial, more deaths from heart related causes, including heart attacks and strokes, were seen in people with gout and heart disease who took febuxostat compared to a similar group who took allopurinol. However, other clinical trials designed to look for heart complications and deaths from heart disease have not shown similar findings in people taking febuxostat.
Tell Your Rheumatology Provider
Before starting this medication, let your provider know if you have a history of heart disease or strokes. Let your provider also know if you are pregnant, considering pregnancy or breastfeeding because febuxostat has not been studied in people who are pregnant or breastfeeding; it is not recommended for use in these groups. You should also make sure to review all your medications and any supplements with your rheumatology provider.
If you are taking febuxostat and develop chest pain, chest pressure, shortness of breath, weakness or numbness in an arm, leg, or one side of your face, or symptoms of an allergic reaction, tell your rheumatology provider immediately or seek emergency medical care.
Updated June 2026 by Elizabeth Graef, DO, and reviewed by the American College of Rheumatology Communications and Marketing Committee.
This information provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.