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1. Eat one or two uric acid-lowering drugs?

The currently used uric acid-lowering drugs fall into two categories: reducing uric acid production and promoting uric acid excretion. The former includes allopurinol and febuxostat, the latter including benzbromarone.

Special note: ibuprofen, futaline and other antipyretic analgesics, colchicine, hormones, etc. are painkillers in the onset of gouty arthritis, not uric acid; baking soda tablets are alkaline drugs, can reduce uric acid kidney stones The formation is not a uric acid drop.

In general, the above-mentioned uric acid-lowering drug can be used. If a drug does not meet the standard (standards: general patient blood uric acid <360μmol / L, recurrent gout, or chronic gouty arthritis, or tophi patients, blood uric acid <300μmol / L), reduce uric acid production and promote uric acid Excreted drugs can be combined, such as febuxostat combined with benzbromarone.


2. I have not had allergies before eating allopurinol. Is it less likely that I will eat allergies?

Allopurinol reduces blood uric acid by reducing uric acid production. However, allopurinol is prone to allergic reactions. In severe cases, hypersensitivity reactions such as exfoliative dermatitis may occur. Such hypersensitivity reactions have a high mortality rate and should be used with caution.

The study found that HLA-B5801 gene-positive people are prone to exfoliative dermatitis, while Chinese (Han), Korean, Thai people have significantly higher HLA-B5801 gene positive rate than Caucasians, so it is recommended that these people before taking allopurinol treatment The genetic screening was performed and the positive was disabled.

Although allergies used in the past are not allergic, according to expert consensus, the gene should be screened before use.


3. When uric acid falls to the target level, should I continue taking the medicine or stopping the medicine?

The expert consensus on this issue is not clearly affirmed, and there should be different opinions.

Clinically, it was found that when gout no longer occurred, the tophi stone disappeared, and blood uric acid reached the standard, patients were still required to take uric acid-lowering drugs for life, which is difficult for patients to accept.

The 2012 US guidelines recommend that after the symptoms of gout have disappeared, blood uric acid should be kept below 360 μmol/L and treatment should be taken for life, including medications and non-drug treatments such as diet control. In other words, you should fight for life and high uric acid. If you can’t meet the standard through non-pharmacological measures such as diet control, you may need to take it for life.

However, if you have tophi, recurrent gout or chronic gouty arthritis, you should take uric acid-lowering drugs for life.


4. If uric acid is controlled at a normal level, will gout arthritis still occur?

The answer is uncertain. Gouty arthritis may also occur, but sustained blood uric acid compliance will definitely reduce the number of episodes.

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