VS: BP 164/84, P 72, RR 15, T 37.2°C (99°F) Ext: Trace edema in both ankles

Labs: Serum uric acid 11.5 mg/dL (684 ^mol/L); serum creatinine 0.9 mg/dL (80 ^mol/L); uric acid crystals were identified on arthrocentesis of the ankle 6 weeks ago.

Given this additional information, what is your assessment of the patient's condition?

Is the patient a candidate for antihyperuricemic therapy? If so, which agent would you choose?

Other Uricosuric Agents

Sulfinpyrazone was used in the past; it is no longer available in the United States. Several other medications have mild uricosuric effects and may be appropriate adjunctive therapy in some patients. Losartan increases both uric acid excretion and urine pH and may be an option in hypertensive patients with gout.30 Fenofibrate is also a uricosuric and may be appropriate in selected dyslipidemic patients with gout.

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