Gout attack
After starting the treatment with this product, an increase in gout attacks can be observed. This is due to decreased urate activity due to decreased serum uric acid levels.
To prevent the occurrence of gout attacks when administering this product, it is recommended to administer non-steroidal anti-inflammatory drugs or colchicine at the same time (see [Usage and Dosage]).
Cardiovascular disease
In a randomized controlled study, patients who used this product [0.74 per 100 PY (95% CI 0.36-1.37)] were more likely to develop cardiovascular thrombosis than those who were given allopurinol [0.60 per 100 PY (95% CI 0.16-1.53)] Events (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke) (see [Adverse Reactions]). The reason is not clear. The signs and symptoms of myocardial infarction (MI) and stroke should be monitored.
Increased liver enzymes
In randomized controlled studies, it was observed that the level of transaminase was higher than 3 times the upper limit of normal (increased in patients administered this product and allopurinol, AST: 2%, 2%, ALT: 3%, 2%). No increase in transaminase has a dose-effect relationship. Laboratory analysis of liver function recommends that this product be used for 2 months and 4 months, and thereafter periodic treatment.