II. Indications

  1. Gouty Arthritis
    1. Uric Acid under-excreter (Urine Uric Acid < 700 mg/24h)

III. Contraindications

  1. Age >60 years
  2. Decreased Renal Function (esp. GFR <30 ml/min)
  3. Nephrolithiasis
  4. Over-production of Uric Acid

IV. Mechanism

  1. Uricosurics act at the renal tubule to decrease renal reabsorption and increase excretion of Uric Acid

V. Medications

  1. Use concurrent NSAID or Colchicine when starting
  2. Probenecid (Consider Allopurinol instead)
    1. Dose: 250 mg orally twice daily
    2. Maximum: 1500 mg orally twice daily
  3. Sulfapyrazine (Rarely used)
    1. Dose: 50 mg orally twice daily
    2. Maximum: 100 mg orally twice daily
  4. Lesinurad (Zurampic)
    1. Dose: 200 mg orally each morning
    2. Risk of Acute Renal Failure (should not be used as Uric Acid monotherapy)
    3. Must be taken with Xanthine Oxidase Inhibitor (Allopurinol or Febuxostat)
      1. Allopurinol dose must be at least 300 mg/day (at least 200 if CrCl <60 ml/min)
    4. Available as Duzallo (Allopurinol with Lesinurad)
      1. As of 2017, costs $12/day (compared with $3/day for Allopurinol and probenacid)
    5. (2017) Presc Lett 24(11): 64

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Ontology: Uricosuric Agents (C0041983)

Definition (MSH) Gout suppressants that act directly on the renal tubule to increase the excretion of uric acid, thus reducing its concentrations in plasma.
Concepts Pharmacologic Substance (T121)
MSH D014528
SnomedCT 371344006, 372758007, 49157004
English Agents, Uricosuric, Uricosuric Agents, uricosuric agents, Uricosuric product (product), Uricosuric agent, Uricosuric agent (substance), Uricosuric agent (product), Uricosuric product, uricosuric agent, Uricosuric agent, NOS, Hyperuricaemia Agents, Uricosuric Agent
French Médicaments uricosuriques, Agents uricosuriques, Uricosuriques
Swedish Utsöndring av urinsyra, medel för
Czech urikosurika
Finnish Urikosuurisesti vaikuttavat aineet
Russian MOCHEVOI KISLOTY VYVEDENIE, LEKARSTVENNYE SREDSTVA, SREDSTVA, SNIZHAIUSHCHIE KONTSENTRATSIIU MOCHEVOI KISLOTY, МОЧЕВОЙ КИСЛОТЫ ВЫВЕДЕНИЕ, ЛЕКАРСТВЕННЫЕ СРЕДСТВА, СРЕДСТВА, СНИЖАЮЩИЕ КОНЦЕНТРАЦИЮ МОЧЕВОЙ КИСЛОТЫ
Polish Leki moczanopędne
Portuguese Uricosúricos, Agentes Uricúricos, Agentes Uricosúricos, Uricúricos
Spanish Uricosúricos, producto con agente uricosúrico, producto con agente uricosúrico (producto), Agentes Uricosúricos, agente uricosúrico (sustancia), agente uricosúrico, agente uricosúrico (producto)
German Urikosurika
Italian Preparati favorenti l'escrezione di acido urico