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MUSCULO-SKELETAL SYSTEM › ANTIGOUT PREPARATIONS › ANTIGOUT PREPARATIONS › Preparations increasing uric acid excretion
dotinurad
M04AB06
Forms & Strengths
- Oral tablets: 0.5 mg
- Oral tablets: 1 mg
- Oral tablets: 2 mg
- Oral tablets: 4 mg
Adult Dosing
- Initial dose: 0.5 mg orally once daily
- Maintenance dose: Titrated based on serum uric acid levels, up to a maximum of 4 mg orally once daily
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Treatment of hyperuricemia in patients with gout
Mechanism of Action
- Selective urate reabsorption inhibitor (SURI)
- Inhibits URAT1 (uric acid transporter 1) in the renal proximal tubules, decreasing reabsorption and increasing urinary excretion of uric acid
Contraindications
- Severe renal impairment (e.g., eGFR < 30 mL/min/1.73 m² or patients on dialysis)
- Severe hepatic impairment
- Known hypersensitivity to dotinurad or any component of the formulation
- Urolithiasis history with active stone formation
- Secondary hyperuricemia (e.g., tumor lysis syndrome, Lesch-Nyhan syndrome)
Adverse Reactions
- Nasopharyngitis
- Blood uric acid fluctuation and gout flares upon initiation
- Elevated liver enzymes (ALT, AST)
- Arthralgia
- Urinary tract infection
- Rash
Drug Interactions
- Pyrazinamide: May antagonize the uricosuric effect
- Salicylates (high doses): May decrease the uricosuric efficacy of dotinurad
- Organic anion transporter (OAT) substrates: Potential for pharmacokinetic interactions due to transporter inhibition
Curated Content: Needs Vetting Before Put to Clinical Use