| Probenecid |
Inhibits URAT1, reducing uric acid reabsorption in the kidneys. |
Underexcretion of uric acid; adjunct to XOI if monotherapy is insufficient. |
500 mg twice daily |
Gastrointestinal distress, nephrolithiasis (kidney stones), hypersensitivity reactions. |
| Allopurinol |
Xanthine oxidase inhibitor (XOI); reduces production of uric acid. |
Hyperuricemia, gout, prevention of tumor lysis syndrome. |
100–300 mg daily |
Rash, gastrointestinal upset, liver enzyme elevation, hypersensitivity reactions. |
| Febuxostat |
Xanthine oxidase inhibitor (XOI); reduces production of uric acid. |
Chronic gout in patients who cannot tolerate allopurinol. |
40–80 mg daily |
Liver enzyme elevation, rash, and cardiovascular events in some patients. |
| Rasburicase |
Uricase analog; converts uric acid into allantoin for easier excretion. |
Hyperuricemia associated with tumor lysis syndrome. |
0.15–0.2 mg/kg IV |
Hypersensitivity, fever, gastrointestinal symptoms, anaphylaxis in rare cases. |
| Lesinurad |
Inhibits URAT1 and OAT4 transporters, reducing uric acid reabsorption. |
Used with XOI in patients not achieving target SU levels with XOI alone. |
200 mg daily |
Increased serum creatinine, renal events (mainly if used as monotherapy), headache. |
| Benzbromarone |
Inhibits URAT1, promoting uric acid excretion. |
Underexcretion of uric acid. |
50–100 mg daily |
Hepatotoxicity, gastrointestinal discomfort, liver enzyme elevation. |
| Arhalofenate |
Dual action: Inhibits URAT1 and has anti-inflammatory effects via NLRP3 inflammasome inhibition. |
Dual urate-lowering and anti-inflammatory prophylaxis. |
600–800 mg daily |
Gastrointestinal issues, reduced flare rates in gout patients. |
| Verinurad |
Selective URAT1 inhibitor, used in combination with XOIs. |
Adjunct to XOI therapy. |
2.5–20 mg daily |
Renal events and elevated serum creatinine. |
