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Benzbromarone increases the urinary excretion of uric acid, but the use of benzbromarone is limited due to reduced effects in patients with renal insufficiency and the risk of severe hepatotoxicity. As shown in Figure 5, a total of 22, 7, and 7 altered genera were observed in the control vs model, allopurinol vs model, and benzbromarone vs model comparisons, respectively. Réduction moyenne des taux d’uricémie entre l’inclusion et la semaine 28 - étude APEX Placebo Fébuxostat 80 mg Fébuxostat 120 mg Allopurinol 300/100 mg N Uricémie à l’inclusion (mg/l) 134 98,0 262 Tableau 2. It is a member of 1-benzofurans and an aromatic ketone. No APTC events were reported in any of the three studies. It is one of the most prevalent causes of arthritis [4–7] and recent studies suggest that the prevalence and incidence of gout has increased in the last decades [2, 8, 9]. Allopurinol / Benzbromarone is used for Primary or secondary gout, Leukemia, Lymphoma, Malignancies, Recurrent calcium oxalate calculi, Gout and other conditions. There were no significant differences in age, uric acid levels in urine, or serum urate levels at the beginning of the treatment (Table 2). Gout is a form of inflammatory arthritis characterized by the formation of monosodium urate crystals in the joints, synovial liquid, and other tissues [1–4]. 3. This finding is especially important in treating patients who cannot control hyperuricemia with monotherapy. The entire patient group experienced a significant drop in serum urate levels, from 8.5 ± 1.8 mg/dL (0.472 ± 0.1 mmol/L) to 6.7 ± 2.1 mg/dL (0.372 ± 0.116 mmol/L) (), regardless of the prescribed medication. The number of patients taking both drugs whose serum urate values were within normal range (men <7 mg/dL and women <6 mg/dL) was 85.7% (6/7), while for the group taking benzbromarone alone this value was 75% (3/4), and in the group taking allopurinol alone it was 51.8% (14/27). According to the Framingham study, 9.2% of men and 0.4% of women had hyperuricemia and 19% of them developed gout [4]. Dailymed. In a study performed by Yamamoto and collaborators, an interaction between allopurinol and benzbromarone was analysed. Reduction in serum uric acid level to <6.0 mg/dL (357 µmol/L) was noted by the Week 2 visit and was maintained throughout treatment. Benzbromarone is 1-Benzofuran substituted at C-2 and C-3 by an ethyl group and a 3,5-dibromo-4-hydroxybenzoyl group respectively. In a study conducted by Perez-Ruiz et al., 53% of patients who received allopurinol and 100% of patients who received benzbromarone achieved plasma urate levels considered optimal for disease control [15]. Risk factors include family history, excessive consumption of alcohol, use of diuretics, kidney disease [1, 2, 6, 9], dietary factors such as elevated consumption of seafood, meat, and vegetables rich in purines [1, 2, 4, 6, 9], elevated body mass index (BMI) [1, 4, 6, 9], age, and gender [1]. However, it has been withdrawn because it causes fulminant hepatotoxicity. Two studies compared the efficacy and safety of febuxostat with allopurinol and 1 study compared with benzbromarone. Benzbromarone is metabolised in the liver by the cytochrome P450 system [11], and as a result should be used with caution in patients with hepatobiliary diseases. Detailed Allopurinol dosage information for adults and children. This salt combination may also be used for purposes not listed in this medication guide. A. Singh, S. G. Reddy, and J. Kundukulam, “Risk factors for gout and prevention: a systematic review of the literature,”, C. Kunishima, I. Inoue, T. Oikawa, H. Nakajima, T. Komoda, and S. Katayama, “Activating effect of benzbromarone, a uricosuric drug, on peroxisome proliferator-activated receptors,”, N. Dubchak and G. F. Falasca, “New and improved strategies for the treatment of gout,”, S. Kumar, J. Ng, and P. Gow, “Benzbromarone therapy in management of refractory gout,”, M. M. van der Klauw, P. M. Houtman, B. H. C. Stricker, and P. Spoelstra, “Hepatic injury caused by benzbromarone,”, S. Sutaria, R. Katbamna, and M. Underwood, “Effectiveness of interventions for the treatment of acute and prevention of recurrent gout—a systematic review,”, F. Perez-Ruiz, A. Alonso-Ruiz, M. Calabozo, A. Herrero-Beites, G. García-Erauskin, and E. Ruiz-Lucea, “Efficacy of allopurinol and benzbromarone for the control of hyperuricaemia. Drugs such as colchicine, anti-inflammatories, and analgesics are part of the therapeutic regime for gout [6]. Open in new tab Download slide. With benzbromarone 100 mg/day, treatment target was reached in 13 out of 25 (52%); after increase of dosage, overall treatment target with benzbromarone 100-200 mg/day was reached in 18 out of 23 (78%). Patients exhibiting hepatic dysfunction were not prescribed benzbromarone. The patients were divided into three groups: patients using only allopurinol (A), only benzbromarone (B), and both in combination (A + B). Allopurinol is a medicine used to lower levels of uric acid in your blood. Patients and doctors enter symptoms, answer questions, and find a list of matching causes – sorted by probability. Comparison of uric acid reduction and renal outcomes of febuxostat vs allopurinol in patients with chronic kidney disease ... (benzbromarone, probenecid, or … Translation indicates not all subjects had gout. dailymed is the official provider of fda label information (package inserts). The current urate-lowering therapy (ULT) includes xanthine oxidase inhibitors (XOIs), such as allopurinol and febuxostat, and uricosuric agents, such as benzbromarone⦠Patients should be selected carefully to take benzbromarone, and those with liver disease or advanced chronic kidney disease should be excluded. Almost half of the patients had chronic tophaceous gout (Table 1). Statistical analysis was performed using SygmaStat 3.5. Data are mean ± SD; n = 6. Similarly, patient followup was not blind; that is, doctors and patients were aware of which medication was being used in each case. Description: Benzbromarone is a uricosuric agent and non-competitive inhibitor of xanthine oxidase used in the treatment of gout, especially when allopurinol, a first-line treatment, fails or produces intolerable adverse effects. Share on Facebook Tweet LinkedIn Things to know before you start febuxostat. In Brazil, sales are permitted by the Brazilian Health Surveillance Agency (ANVISA) and benzbromarone seems to have a safety profile identical to sulfinpyrazone [14]. Methods. Results: Compared with allopurinol, benzbromarone therapy was associated with a reduced risk of progression to dialysis, the adjusted hazard ratio was 0.50 (95% confidence interval, 0.25-0.99). Symptoma is a Digital Health Assistant & Symptom Checker. Eighty percent (38/48) received hypouricemics. Thirty-eight patients used hypouricemics: allopurinol was prescribed to 27 patients and benzbromarone to four patients, and these two drugs were combined in seven cases. About 10% of people with hyperuricemia develop gout and 90% of patients with gout are hyperuricaemic [1]. However, we believe that benzbromarone, alone or in combination with allopurinol, has an important clinical role in controlling uricaemia of patients with gout. There was one study each examining allopurinol vs rasburicase , benzbromarone vs allopurinol and benzbromarone vs probenecid . As stated by Lee and collaborators in a recent revision [22], “availability of benzbromarone to treat selected cases of gout would be especially interesting, particularly to patients in whom allopurinol produces insufficient response or toxicity.”. With regard to the medications used, 31 (64.5%) patients used colchicine, with daily doses between 0.5 and 1 mg. ". Although this drug is less effective in patients with lower creatinine clearance, an important reduction in uric acid levels was observed in these patients [15]. Benzbromarone was used in this study, suggesting that this effect is independent of xanthine-oxidase inhibition. The following data were collected: age; gender; profession; personal history of alcohol, tobacco, or drug use; comorbidities such as obesity, high blood pressure (HBP), diabetes mellitus (DM), hypertriglyceridemia, nephrolithiasis, and osteoarthritis; family history of gout; year of onset (first attack), total number of attacks, average duration of attacks (days), triggering factors, joint affected in the first attack, and other joints involved as the disease evolved; presence or absence of tophi; daily dosage; and how long each medication had been used. Besides hepatotoxicity [15], at times of the intense uric acid excretion benzbromarone causes may lead to the formation of uric acid kidney stones [4]. Author: Manger B, Journal: Deutsche medizinische Wochenschrift (1946)[2015/04] Methods: A randomised, controlled, open-label, multicentre trial in gout patients with renal function defined as a calculated creatinine clearance ⩾50 ml/min. only recommended for patients with mild-to-moderate renal insufficiency. There was one study each examining allopurinol vs rasburicase , benzbromarone vs allopurinol and benzbromarone vs probenecid . Overall, the pooled analysis did not show a significant difference between the two [febuxostat vs allopurinol: RR 1.69 (95% CI 0.54, 5.34), P = 0.37]. Elsewhere, particularly in Europe, benzbromarone is also used. Clearance of creatinine, ml/minute/1.73 m … (B) ULT vs placebo. benzbromarone; What happens if take allopurinol when I'm having cancer treatment? The lack of serious adverse effects associated with benzbromarone in our study is probably related to the selection of suitable patients. Primary therapy with allopurinol for 2 months was effective in normalizing serum urate levels with patient tolerance in only 20 out of 82 (24%) of cases, the authors report. Serum uric acid level pre-and posttreatment (í µí± = 48). Patients who received allopurinol or febuxostat exhibited a comparable risk of ESRD [adjusted hazard ratio, 0.99 (0.40-2.44)]. * p<0,001 vs allopurinol Les variations moyennes d’uricémie dans chaque groupe sont présentées dans le tableau 2 ci-après. The results were analysed by variance analysis, -test, paired -test, and nonparametric tests (Wilcoxon and Mann-Whitney), when necessary. It is taken by mouth or injected into a vein. The entire patient group experienced a significant drop in uric acid levels, from to mg/dL (), regardless of the prescribed medication class (Figure 1). Moreover, according to a recent meta-analysis, benzbromarone is a more potent drug (75% more effective in reducing serum urate levels than allopurinol at regular doses). In addition, allopurinol and benzbromarone caused respective unique changes in genera. After drug treatment, both allopurinol and benzbromarone caused an increase of the genera Bifidobacterium and Collinsella and a decrease of the genera Adlercreutzia and Anaerostipes. There are few studies in the medical literature evaluating the metabolism of benzbromarone, its side effects, and also its risks and benefits. Approximately half of the patients identified factors that triggered acute attacks, and the majority of acute attacks were triggered by dietary factors (31.2%) and alcohol consumption (29.1%). Allopurinol reduces urine uric acid levels as well. The treatment of an acute gout crisis focuses on controlling pain and inflammation [4, 6]. 2014;11:CD010457. Gout is a disease that occurs by the deposition of monosodium urate crystals (MSU) in body tissues, especially around joints 7. Allopurinol Accession Number DB00437 Description. We believe that benzbromarone plays an important role in controlling hyperuricemia and clinical remission of patients with refractory gout. Low-quality evidence from one trial (65 participants) indicated there may be no difference in the incidence of acute gout attacks with allopurinol up to 600 mg daily compared with benzbromarone up to 200 mg daily over a four-month period (0/30 with allopurinol versus 1/25 with benzbromarone, RR 0.28, 95% CI 0.01 to 6.58). attainment of target serum urate concentrations. Of course, a prospective, randomized double-blind clinical trial involving multiple centres is still needed. Common side effects when ⦠"It seems that benzbromarone is a highly efficacious oral serum urate-lowering drug that has been excessively withdrawn from the market," the researchers point out. Objectives: To compare the efficacy and tolerability of allopurinol 300–600 mg/day versus benzbromarone 100–200 mg/day used to attain a target serum urate concentration (sUr) ⩽0.30 mmol/l (5 mg/dl). Benzbromarone 200 mg/day is biochemically equipotent to allopurinol 600 mg/day or febuxostat 80 mg/day, all in monotherapeutic settings. The median values of the mean daily for dosage Febuxostat, Benzbromarone and Allopurinol were 40.0âmg/day 88.9âmg/day 100.0âmg/day respectively, and the median estimated glomerular filtration rate (eGRF) was 22.3 (10.7â34.7) 37.7 (24.8â49.1) and ⦠Detailed Allopurinol dosage information for adults and children. Comment on Cochrane Database Syst Rev. Serum creatinine, basal and posttreatment serum levels of uric acid, transaminase, and bilirubin were measured. Only two altered genera were shared by the three comparisons: Anaerostipes was more abundant and Collinsella was less abundant in the model group compared to the other three groups. inhibitor) or benzbromarone (a uricosuric agent) was able to prevent or reverse features of metabolic syndrome. More than 70% of the individuals had acute monoarthritis in the first metatarsophalangeal joint at some point in the evolution of the disease and approximately 40% of them experienced their first gout attack in this joint. Objective. We did not measure the patients’ 24-hour creatinine clearance. Share This Section . It is structurally related to the antiarrhythmic amiodarone. All drugs were selected after a complete patient evaluation by the attending physician. Includes dosages for Gout, Hyperuricemia Secondary to Chemotherapy and Calcium Oxalate Calculi with Hyperuricosuria; plus renal, liver and dialysis adjustments. Benzbromarone alone or in combination with allopurinol has an important clinical role in controlling hyperuricemia in patients with gout. Author information: (1)Medizinische Klinik 3, Universitätsklinikum Erlangen. According to Perez-Ruiz et al., benzbromarone, used alone or combined with allopurinol, is superior to therapy with allopurinol in reducing gouty tophi [21]. The number of patients taking both drugs whose serum uric acid values fell within normal range (men <7 mg/dL (0.38 mmol/L) and women <6 mg/dL (0.33 mmol/L)) was 85.7% (6/7) while this value for the group taking benzbromarone alone was 75% (3/4) and for the group taking allopurinol alone this number was 51.8% (14/27). 203 ± 98‡ ‡ P < 0.05 for baseline vs. followup paired variables t‐test and P < 0.05 for allopurinol vs. benzbromarone. Approximately 25% of patients experienced nephrolithiasis at some stage of the disease. 2014, Article ID 263720, 5 pages, 2014. https://doi.org/10.1155/2014/263720, 1Faculty of Medicine, Hospital de Clínicas, Federal University of Paraná, Rua Alvaro Alvin 224, Casa 18, Seminário, 80740260 Curitiba, PR, Brazil, 2Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil. If you produce too much uric acid or your kidneys do not filter enough out, it can build up and cause tiny, sharp crystals to form in and around your joints. 51 Probenecid vs probenecid + colchicine Only data from 38 subjects, deemed to be compliant because of a fall in serum urate, were included in the analysis. Valderilio Feijó Azevedo, Pedro Grachinski Buiar, Laura Helena Giovanella, Carolina Rossetti Severo, Mauricio Carvalho, "Allopurinol, Benzbromarone, or a Combination in Treating Patients with Gout: Analysis of a Series of Outpatients", International Journal of Rheumatology, vol. The presence of urate crystals in the synovial fluid is considered the gold standard in diagnosing gout [1]. Change in serum uric acid (UA) with allopurinol, benzbromarone, or both drugs. Results. Data from the 48 patients studied are summarized in Table 1. The target sUA level of <6 mg/dL at 6 months (primary endpoint) was achieved by significantly more lesinurad plus allopurinol … Benzbromarone is an effective uricosuric agent available on a restricted basis only outside the United States. Allopurinol benzbromarone clinical presentation is commonly an acute inflammatory monoarthritis affecting the first metatarsophalangeal joint, known as podagra [ 124 ]. [18] compared efficacy and tolerability between allopurinol 300–600 mg/day and benzbromarone 100–200 mg/day. All patients continued to take their usual medications, including colchicine. The serum creatinine levels of patients using benzbromarone varied greatly, with values between 0.8 and 2.3 mg/dL. "It may be preferable to reintroduce benzbromarone in the market instead of using the new, costly drugs that carry a risk for unknown adverse drug reactions.". Allopurinol, Benzbromarone, or a Combination in Treating Patients with Gout: Analysis of a Series of Outpatients. However, benzbromarone is no longer commercially available in USA, and in 2003 it was withdrawn from the European market due to the risk of severe hepatotoxicity [12]. Cooccurrence of gout and osteoarthritis was identified in approximately 30% of patients. and probenecid in lowering urate levels in gout patients. normalizing serum urate levels with patient tolerance in only 20 out of Copyright © 2014 Valderilio Feijó Azevedo et al. 353(23):2450-61. Relative risks of CVEs (measured using APTC definition) in randomized trials of uricosuric medications in gout (A) Febuxostat vs allopurinol. Allopurinol is currently the drug of choice for long-term Allopurinol is used to treat gout and kidney stones. [Medline] . Benzbromarone is a uricosuric agent and non-competitive inhibitor of xanthine oxidase used in the treatment of gout, especially when allopurinol, a first-line treatment, fails or produces intolerable adverse effects. Patients were divided into three groups: patients given only allopurinol (A), only benzbromarone (B), and both in combined therapy (A + B). It is taken by mouth or injected into a vein.. Common side effects when used by mouth include itchiness and rash. This study has limitations: first of all, the choice of therapy was not randomized but was chosen by the attending physician according to each patient's profile. 82 (24%) of cases, the authors report. analysed, that benzbromarone is indeed effective in patients irresponsive to allopurinol, more than probenicid (responder rate 92% vs. 65%) (Reinders et al 20091). It inhibits the main renal urate transporter, URAT-1, an exchanger located in the luminal face of the proximal tubule of the kidney. Dr. Jansen also said that other head-to-head studies, such as of benzbromarone vs febuxostat in allopurinol-intolerant patients, are also needed. Benzbromarone also increases the metabolism of warfarin increasing the risk of bleeding in patients using both medications at the same time. Primary therapy with allopurinol for 2 months was effective in This disease has been well-documented in historical medical records and appears in the biographies of several prominent, historically recognized individuals 7. The efficacy of combined low dose of Allopurinol and benzbromarone compared to standard dose of Allopurinol in hyperuricemia. Some act by increasing the renal elimination of uric acid (uricosuric drugs, e.g., benzbromarone), or restrict its formation (e.g., allopurinol). Benzbromarone is 1-Benzofuran substituted at C-2 and C-3 by an ethyl group and a 3,5-dibromo-4-hydroxybenzoyl group respectively. Dr. M. K. Reinders from Medisch Centrum Leeuwarden and colleagues Patients should be advised to stop benzbromarone and seek urgent medical attention if they develop nausea, vomiting, abdominal pain, or jaundice. In contrast, 22 out of 24 (92%) of patients in the benzbromarone A pathogenic approach to the treatment of primary chronic gout,”, M. K. Reinders, E. N. van Roon, P. M. Houtman, J. R. B. J. Brouwers, and T. L. T. A. Jansen, “Biochemical effectiveness of allopurinol and allopurinol-probenecid in previously benzbromarone-treated gout patients,”, M. K. Reinders, E. N. van Roon, T. L. T. A. Jansen et al., “Efficacy and tolerability of urate-lowering drugs in gout: a randomised controlled trial of benzbromarone versus probenecid after failure of allopurinol,”, M. K. Reinders, C. Haagsma, T. L. T. A. Jansen et al., “A randomised controlled trial on the efficacy and tolerability with dose escalation of allopurinol 300-600 mg/day versus benzbromarone 100-200 mg/day in patients with gout,”, A. K. Tausche, C. Wunderlich, and M. Aringer, “Tophaceous gout and renal insufficiency: a new solution for an old therapeutic dilemma,”, T. Yamamoto, Y. Moriwaki, S. Takahashi, M. Suda, and K. Higashino, “Effects of pyrazinamide, probenecid, and benzbromarone on renal excretion of oxypurinol,”, F. Perez-Ruiz, M. Calabozo, J. I. Pijoan, A. M. Herrero-Beites, and A. Ruibal, “Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout,”, M.-H. H. Lee, G. G. Graham, K. M. Williams, and R. O. In our study, allopurinol brought serum urate levels to within normal range in 51.8% of the patients, benzbromarone alone reduced urates to normal levels in 75% of patients, and combination therapy normalized uricaemia in 85.7% of patients. Allopurinol, Benzbromarone, or a Combination in Treating Patients with Gout: Analysis of a Series of Outpatients, Faculty of Medicine, Hospital de Clínicas, Federal University of Paraná, Rua Alvaro Alvin 224, Casa 18, Seminário, 80740260 Curitiba, PR, Brazil, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil, Diabetes mellitus (fasting glucose > 126 mg/dL), E. U. R. Smith, C. Diaz-Torne, F. Perez-Ruiz, and L. M. March, “Epidemiology of gout: an update,”, E. Roddy and M. Doherty, “Epidemiology of gout,”, M. H. Pillinger, D. S. Goldfarb, and R. T. Keenan, “Gout and its comorbidities,”, A. K. Tausche, T. L. Jansen, H. E. Schröder, S. R. Bornstein, M. Aringer, and U. Müller-Ladner, “Gout-current diagnosis and treatment,”, E. Roddy, W. Zhang, and M. Doherty, “Concordance of the management of chronic gout in a UK primary-care population with the EULAR gout recommendations,”, D. Rothenbacher, P. Primatesta, A. Ferreira, L. Cea-Soriano, and L. A. G. Rodríguez, “Frequency and risk factors of gout flares in a large population-based cohort of incident gout,”, A. The average age of these patients was 56.6 ± 11.4 years, varying from 35 to 81 years. In a recent publication Reinders et al. Our study analysed 48 gouty patients followed in a specialised outpatient rheumatology clinic. The first alternative drug of choice was the xanthine oxidase inhibitor allopurinol. It has a role as a uricosuric drug. With higher doses, the success rate was similar: 78% for both drugs. urate-lowering therapy, the authors explain, whereas benzbromarone is treated successfully in terms of tolerance of study medication and Becker MA, Schumacher HR Jr, Wortmann RL, et al. Author information: (1)Department of Medicine, Faculty of Medicine, Chulalongkorn University, Thailand. Wang et al analyzed 11 trials with 753 patients and also evaluated the effect of urate-lowering agents, including allopurinol, rasburicase and benzbromarone, which showed a decrease in serum creatinine and increase in eGFR in the treatment arm, thereby proposing the beneficial effect of urate-lowering therapy in renal function. Benzbromarone was started at a dose of 50 mg/day during the first month and was increased later, if necessary, to 100 mg/day. Allopurinol is used to treat gout. The therapeutic combination of benzbromarone and allopurinol significantly decreased serum urate levels in patients with gout when compared to the individual use of each of these agents. This result can be considered superior when compared with the patient group taking allopurinol alone (Figure 2) and similar to the result obtained from the group taking benzbromarone alone. The authors concluded that the interaction did not affect the plasmatic concentration of oxipurinol (the main allopurinol metabolite) but caused an increase in oxipurinol clearance [20]. 58.3% of the patients were considered to be uric acid hypoexcretors (excretion below 400 mg/day). group and 20 out of 31 (65%) of patients in the probenecid group were "Worldwide, the treatment of gout may be more successful with better (restricted) availability of benzbromarone," they add. Allopurinol and benzbromarone are equally effective when optimal serum urate levels are achieved during therapy. Allopurinol was started in doses from 100 to 300 mg/day, with progressive increases according to therapeutic response. < =1.2 ="http://as.medscape.com/js.ng/transid%3D1231274088240&site%3D1&pos%3D121&pf%3D17&ct%3Dus&artid%3D586146&spon%3Drc-rheumarthritis&st%3Dmi&ssp%3D27&affiliate%3D1&leaf%3D0" =text/>. Benzbromarone was used in this study, suggesting that this effect is independent of xanthine-oxidase inhibition. Nevertheless, only three cases have been described since the early 1970s and it is debated whether banning benzbromarone was appropriate or if it was done too hastily. Dr. M. K. Reinders from Medisch Centrum Leeuwarden and colleagues compared the efficacy and tolerability of allopurinol, benzbromarone, and probenecid in lowering urate levels in gout patients. Urate overproducer and urate underexcretor were used in the past to find an indication for uricosurics. Using custom cytokine ELISA plate arrays, we further assessed the levels of several inflammatory cytokines in retinal extracts and … We evaluated 48 patients diagnosed with gout who were seen at the Outpatient Rheumatology Clinic at the Federal University of Paraná between January 2009 and November 2010. "Allopurinol; lesinurad: dailymed provides trustworthy information about marketed drugs in the united states. Two patients stopped allopurinol and 3 patients stopped benzbromarone because of adverse drug reactions (ADR). It has a role as a uricosuric drug. Allopurinol, sold under the brand name Zyloprim among others, is a medication used to decrease high blood uric acid levels. We evaluated 48 patients diagnosed with gout who were seen at the Outpatient Rheumatology Clinic of the Federal University of Paraná between January 2009 and November 2010. Allopurinol was 300 mg once daily and benzbromarone 100 mg orally once daily. Clinical data, creatinine serum levels, and basal and posttreatment levels of serum urates, transaminases, and bilirubins were recorded. In contrast, 22 out of 24 (92%) of patients in the benzbromarone group and 20 out of 31 (65%) of patients in the probenecid group were treated successfully in terms of tolerance of study medication and attainment of target serum urate concentrations. Common side effects when used by mouth include itchiness and rash. Symptoma empowers users to uncover even ultra-rare diseases. Allopurinol, sold under the brand name Zyloprim among others, is a medication used to decrease high blood uric acid levels.