How does it work?

Adenuric tablets contain the active ingredient febuxostat, which is a type of medicine called a xanthine oxidase inhibitor. Febuxostat is used to treat gout.

Gout is caused by too much uric acid in the blood that leads to a build-up of uric acid crystals in the joints. It is these crystals that cause the characteristic pain and inflammation of gout.

Uric acid is produced by an enzyme in the body called xanthine oxidase. Febuxostat inhibits the action of this enzyme and as a result lowers uric acid levels. By lowering the levels of uric acid in the blood, flare-ups of gout can be prevented.

Adenuric tablets are used for the long term treatment and prevention of gout, but not for immediate treatment of gout flare-ups. Other medicines are used for the rapid relief of gout symptoms.

What is it used for?

• Reducing high blood uric acid levels (hyperuricaemia) in gout and thus preventing gout attacks.

Warning!

• Treatment with febuxostat should not be started during an acute attack of gout, as it could initially worsen the attack. It should not be started until the attack has completely subsided. When you first start treatment your doctor should normally prescribe you a suitable anti-inflammatory medicine, or colchicine, for at least the first six months of treatment, as febuxostat may cause an attack of gout in the early stages of treatment. If you do get a new attack of gout after you have started treatment with febuxostat you should keep taking it while the attack is treated with a suitable anti-inflammatory medicine. This is because the febuxostat will still be working to lower uric acid. Over time, your attacks will become less frequent and less painful as long as you continue to take the febuxostat every day.
• You will need to have blood tests to check your liver function before starting and throughout treatment with this medicine.

Use with caution in

• People with reduced kidney function.
• People with reduced liver function.
• People with thyroid problems.
• People taking theophylline.

Not to be used in

• Pregnancy.
• Breastfeeding.
• People taking the medicines mercaptopurine or azathioprine.
• This medicine is not recommended for people with heart failure or ischaemic heart disease, eg angina or a history of heart attack.
• There is insufficient information regarding the safety and effectiveness of this medicine in children. Adenuric tablets are not recommended for children or adolescents.
• There is insufficient information regarding the safety and effectiveness of this medicine in people who have had an organ transplant. It is not recommended for people who have had an organ transplant.
• Adenuric tablets contain lactose and are unsuitable for people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine should not be used during pregnancy. If you do get pregnant or want ot plan a pregnancy while using this medicine you should consult your doctor.
• It is not known if febuxostat passes into breastmilk. It should not be used whilst breastfeeding.

Side effects

Medicines and their possible side effects can affect individualpeople in different ways. The following are some of the side effects that areknown to be associated with this medicine. Just because a side effect is statedhere does not mean that all people using this medicine will experience thator any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

• Headache.
• Diarrhoea.
• Nausea.
• Rash.
• Alteration in results of liver function tests.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

• Dizziness.
• Pins and needles.
• Changes in taste.
• Drowsiness.
• Disturbances of the gut such as vomiting, abdominal pain, indigestion, heartburn, constipation, flatulence.
• Dry mouth.
• Blood in the urine.
• Pain the in muscles and joints.
• Muscle cramps.
• Skin reactions, such as rash, dermatitis, hive-like rash, itching.
• Increased weight.
• Increased appetite.
• Excessive fluid retention in the body tissues, resulting in swelling (oedema).
• Kidney stones (nephrolithiasis).
• High blood pressure.
• Hot flushes.
• Decreased sex drive.
• Fatigue.
• Flu-like symptoms.
• Increased urine production.

Rare (affect between 1 in 1000 and 1 in 10,000 people)

• Awareness of your heart beat (heart palpitations).
• Feeling thirsty.
• Weakness or loss of strength (asthenia).
• Decreased kidney function.
• Nervousness.
• Difficulty sleeping (insomnia).

The side effects listed above may not include all of the sideeffects reported by the medicine'smanufacturer.

For moreinformation about any other possible risks associated with this medicine,please read the information provided with the medicine or consult your doctoror pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

Febuxostat increases the effects of azathioprine and mercaptopurine. This medicine should not be used in combination with azathioprine or mercaptopurine.

Febuxostat may increase the blood level of theophylline. If you are taking theophylline your doctor should check your theophylline blood level after you start treatment with this medicine.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain febuxostat as the active ingredient.