Drug-induced hyperuricaemia and gout

Rheumatology (Oxford). 2017 May 1;56(5):679-688. doi: 10.1093/rheumatology/kew293.


Hyperuricaemia is a common clinical condition that can be defined as a serum uric acid level >6.8 mg/dl (404 µmol/l). Gout, a recognized complication of hyperuricaemia, is the most common inflammatory arthritis in adults. Drug-induced hyperuricaemia and gout present an emergent and increasingly prevalent problem in clinical practice. Diuretics are one of the most important causes of secondary hyperuricaemia. Drugs raise serum uric acid level by an increase of uric acid reabsorption and/or decrease in uric acid secretion. Several drugs may also increase uric acid production. In this review, drugs leading to hyperuricaemia are summarized with regard to their mechanism of action and clinical significance. Increased awareness of drugs that can induce hyperuricaemia and gout, and monitoring and prevention are key elements for reducing the morbidity related to drug-induced hyperuricaemia and gout.

Keywords: diuretics; drug-induced; gout; hyperuricaemia; management; organic anion transporters; prevention; uric acid.

Publication types

  • Review

MeSH terms

  • Androgens / adverse effects
  • Antitubercular Agents / adverse effects
  • Aspirin / adverse effects
  • Carbohydrates / adverse effects
  • Cytotoxins / adverse effects
  • Diuretics / adverse effects
  • Gout / chemically induced
  • Humans
  • Hyperuricemia / chemically induced*
  • Hyperuricemia / prevention & control
  • Immunosuppressive Agents / adverse effects
  • Niacin / adverse effects
  • Sodium Lactate / adverse effects
  • Testosterone / adverse effects
  • Uric Acid / metabolism


  • Androgens
  • Antitubercular Agents
  • Carbohydrates
  • Cytotoxins
  • Diuretics
  • Immunosuppressive Agents
  • Niacin
  • Uric Acid
  • Testosterone
  • Aspirin
  • Sodium Lactate