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Febuxostat and allopurinol are both xanthine oxidase inhibitors used primarily to lower serum uric acid levels in patients with gout and hyperuricemia. Allopurinol is often considered the first-line therapy, while febuxostat is typically reserved for patients who cannot tolerate or do not respond adequately to allopurinol. Both drugs act by inhibiting the enzyme xanthine oxidase, which is responsible for converting hypoxanthine to xanthine and then to uric acid. By blocking this pathway, they reduce uric acid production and help prevent gout flares. Febuxostat may be more effective at lowering serum urate at higher doses but has been associated with a higher risk of cardiovascular death compared to allopurinol. Allopurinol can cause hypersensitivity reactions in some individuals, particularly those with certain genetic backgrounds[1][2][3][4].
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