Febuxostat

Febuxostat

File:Febuxostat Structural Formulae V.1.svg
Systematic (IUPAC) name
2-(3-cyano-4-isobutoxyphenyl)-4-methyl- 1,3-thiazole-5-carboxylic acid
Clinical data
[[Regulation of therapeutic goods |Template:Engvar data]]	EU EMA: Adenuric US FDA: Febuxostat
Pregnancy category	C
Routes of administration	oral
Legal status
Legal status	US: ℞-only
Pharmacokinetic data
Bioavailability	~49% absorbed
Protein binding	~99% to albumin
Metabolism	via CYP1A2, 2C8, 2C9, UGT1A1, 1A3, 1A9, 2B7
Biological half-life	~5-8 hours
Excretion	urine (~49% mostly as metabolites, 3% as unchanged drug); feces (~45% mostly as metabolites, 12% as unchanged drug)
Identifiers
CAS Number	144060-53-7
ATC code	M04AA03 (WHO)
PubChem	CID 134018
Chemical data
Formula	C16H16N2O3S
Molar mass	316.374 g/mol[[]]

Febuxostat (INN; brand names Adenuric (EU) and Uloric (US)) is an inhibitor of xanthine oxidase that is indicated for use in the treatment of hyperuricemia and gout.. The drug is marketed by Menarini.

Febuxostat received marketing approval by the European Medicines Agency on April 21, 2008 and was approved by the U.S. Food and Drug Administration on February 16, 2009.

A study comparing febuxostat to allopurinol found that more individuals treated with febuxostat had decreased levels of uric acid, but there was no difference in the amount of initial gout flares or the surface area of gout tophi.

A committee of the British National Institute for Health and Clinical Excellence concluded that although febuxostat had been shown to be more effective than fixed-dose (300mg) allopurinol in lowering serum uric acid concentration, it had not been shown to be clinically or cost effective compared with the more appropriate comparator of allopurinol increased as required to control uric acid levels (up to 900mg). However, it recommended febuxostat for people who are intolerant of allopurinol.

Mechanism of action

Febuxostat is a non-purine selective inhibitor of xanthine oxidase. It works by non-competitively blocking the channel leading to the active site on xanthine oxidase. Xanthine oxidase is needed to successively oxidize both hypoxanthine and xanthine to uric acid. Hence, febuxostat inhibits xanthine oxidase, therefore reducing production of uric acid.

Side-effects

The adverse effects associated with febuxostat therapy include nausea, diarrhea, arthralgia, headache, increased hepatic serum enzyme levels and rash.

References

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