A friend asked Hua Zi that his blood uric acid was 460μmol/L, should he take medicine, and what medicine should he take? Hua Zi told him that there is no need to rush to take medicine for the time being. His blood uric acid is not particularly high, and he can control his diet and drink more water. However, you need to observe more. If you have gout symptoms, or if your blood uric acid level continues to rise, you may need drug treatment.
Uric acid is a normal substance in the human body and has the physiological functions of maintaining blood pressure, anti-oxidation, and protecting cell DNA. Maintaining a certain level of blood uric acid is beneficial to the human body, but when the blood uric acid is too high, it will be more harmful to the human body.
I. What is hyperuricemia
The human body’s blood uric acid level fluctuates to a certain extent. When the blood uric acid level exceeds 420μmol/L twice on different days, it is called hyperuricemia strong>.
The uric acid content in the blood is too high, and when its solubility exceeds its solubility, it is easy to precipitate uric acid crystals or form tophi in the joints, induce an inflammatory reaction, cause damage to surrounding tissues, and cause unbearable severe pain, which is also known as gout.
If blood uric acid deposits and crystallizes in the kidneys, it can cause acute kidney injury, interstitial nephritis, and uric acid stones, damaging the kidneys.
Second, what level of blood uric acid needs to take medicine
If healthy people do not have gout symptoms and mildly elevated serum uric acid does not require drug treatment, they only need to diet to reduce purine intake, control body weight, and drink plenty of water to promote uric acid excretion. However, if blood uric acid level exceeds 540μmol/L, drug therapy is recommended, and the control goal is to reduce it to below 420μmol/L.
If you have gout symptoms and the blood uric acid level exceeds 480 μmol/L, drug treatment is recommended to control the blood uric acid level below 360 μmol/L.
If you have chronic diseases such as “three high” chronic diseases, stroke, coronary heart disease, obesity, renal insufficiency, but no symptoms of gout, the blood uric acid level exceeds 480μmol/L It is recommended to carry out drug treatment to control the blood uric acid level below 360μmol/L. For patients with gout symptoms, drug treatment is required when the blood uric acid level exceeds 420 μmol/L, and the control target is below 300 μmol/L.
III. Precautions for different uric acid-lowering drugs
There are 3 kinds of commonly used uric acid-lowering drugs, among which allopurinol and febuxostat are drugs that inhibit uric acid synthesis; benbromarone strong>It is a drug that promotes uric acid excretion. Drinking a lot of water when taking uric acid-lowering drugs can promote uric acid excretion and prevent kidney stones.
It should be noted that during the acute attack of gout, it is not recommended to use uric acid-lowering drugs, otherwise the blood uric acid level will drop rapidly, which will cause the surface of the tophi to dissolve and release Uric acid increases local irritation, causing gout symptoms to worsen. Therefore, uric acid-lowering drugs are usually used for asymptomatic hyperuricemia, or for uric acid-lowering therapy in stable gout patients.
Allopurinol: It is the longest-running, cheapest and most widely used uric acid-lowering drug. However, people with HLA-B5801 positive gene may have severe hypersensitivity reactions when taking allopurinol, and even exfoliative dermatitis with a mortality rate of 20%, while HLA-B5801 positive in Asian populations The rate is high, so it is recommended to do HLA-B5801 genetic testing before taking it. Those who cannot test should start from the minimum dose.
Febuxostat: Not recommended for hyperuricemia without gout symptoms, the US FDA suggests that taking Febuxostat may increase Cardiovascular mortality risk. It is recommended that people at risk of cardiovascular disease should be evaluated by a doctor before taking the drug.
Benzbromarone: Increase the excretion of uric acid in the urine. Drink a lot of water (more than 3000ml of water per day) when taking it. It is contraindicated in patients with severe renal insufficiency (glomerular filtration rate less than 20ml/min) and patients with kidney stones. The liver function should be paid attention to when taking the medicine, and the medicine should be stopped immediately when there is loss of appetite, nausea, vomiting, and diarrhea.
4. How long should I take uric acid-lowering drugs
There is a positive correlation between body weight and blood uric acid levels, so weight loss in obese people can reduce blood uric acid levels. Uric acid is mainly produced by purine metabolism in the human body, and only about 30% is affected by diet, and 70% is related to personal constitution and genes. If the blood uric acid level cannot reach the target level through weight loss and diet control, drug treatment is required.
Uric acid-lowering drugs generally reduce the blood uric acid level steadily within 2 to 4 weeks, so it is recommended to review the blood uric acid level after one month of medication, and adjust the medication according to the actual situation. People with gout symptoms need long-term medication to maintain blood uric acid levels at a low level.
Asymptomatic hyperuricemia patients can take intermittent medication, such as one month of medication, one month interval, and one month of medication to prevent the occurrence of gout .
To sum up, people with mildly elevated blood uric acid but no gout symptoms can reduce blood uric acid by losing weight and controlling their diet. If the blood uric acid level exceeds 540 μmol/L, or those who have gout symptoms, they need to use uric acid-lowering drugs for treatment under the guidance of a doctor. If you have any doubts about the medication, please consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.