There are more than 180 million hyperuricemia patients among our compatriots. Hyperuricemia is the fundamental cause of gout and a risk factor for many chronic diseases. As we all know, foods rich in purine , as well as bad living habits such as drinking, will cause an increase in uric acid levels. However, many people don’t know that many common drugs can also cause or aggravate hyperuricemia. Therefore, when uric acid cannot be reduced, it is necessary to weigh the pros and cons and adjust the usage plan of relevant drugs in a timely manner.
uric acid level depends on the changes in uric acid production and excretion process. From the perspective of the source of uric acid, 80% is produced by catabolic metabolism in the body, and 20% is derived from food. The process of uric acid production requires the participation of two types of enzymes. The first category is an enzyme that promotes uric acid synthesis, such as purine nucleoside phosphorylase and xanthine oxidase. The second category is an enzyme that inhibits uric acid synthesis, such as hypoxanthine and guanine nucleoside transferase. If the drug can affect the activity of the enzyme, it will affect the uric acid level. In addition, uric acid is mainly excreted through the kidneys. If the drug can affect the filtration, secretion and absorption of the kidneys, it will lead to changes in uric acid levels.
Hyperuricemia often coexists with other metabolic-related diseases. For example, a typical patient may be obese, hypertension, , hyperglycemia, and hyperlipidemia. During the treatment process, they can only control some indicators. The uric acid may not have fallen, and they may have abnormal blood sugar and feel uncomfortable in the heart. In this case, you should be very cautious when choosing medicine to prevent the gourd from floating on the gourd. Because many common drugs, such as antihypertensive drugs, antihypertensive drugs, lipid-lowering drugs, and even vitamins, will affect uric acid levels.
drugs that can increase uric acid production are mainly four categories, namely fructose , inosine , cytotoxic drugs, glucocorticoid , and trypsin preparations. There are many drugs that can reduce uric acid excretion, and there are at least 10 common types, such as diuretics, salicylic acid , vitamin C, niacin , antituberculosis drugs, levodopa, drugs containing ethanol , hypoglycemic drugs, immunosuppressant , and β-blockers. These drugs can all cause elevated uric acid levels and lead to hyperuricemia.
diuretics, such as common hydrochlorothiazide, can reduce blood volume, concentrate extracellular fluid, reduce glomerular filtration rate , inhibit the secretion of renal tubular , and increase renal tubular reabsorption, resulting in an increase in blood uric acid. Studies have found that this uric acid accumulation effect is dose-dependent. The use of hydrochlorothiazide in small doses usually does not cause hyperuricemia. Long-term use of it will lead to a significant increase in uric acid levels. In addition, beta blockers will reduce uric acid excretion. If used in combination with potassium excretion, it will lead to abnormal increase in blood uric acid. Therefore, if patients with hypertension experience elevated uric acid or induce gout, they should pay attention to checking the cause from the perspective of drug regimen.
salicylic acid drugs, aspirin, have a relatively complex impact on uric acid levels. The current study concluded that taking 75 to 325 mg of aspirin daily will lead to a mild increase in uric acid levels. Taking 1 to 2 grams of aspirin per day will inhibit the excretion of uric acid by the renal tubules and cause a significant increase in blood uric acid levels. Therefore, patients with cardiovascular disease who take small doses of aspirin for a long time, especially elderly patients, need to check their uric acid levels regularly. However, it is not advisable to stop the medication blindly, but should accept guidance from a doctor to weigh the pros and cons. Low glycemic drugs have a significant impact on uric acid levels. For example, the widely used metformin will lead to accumulation of lactic acid during metabolism, inhibiting the secretion of uric acid in the prone to the renal tubules, leading to a reduction in uric acid excretion. Insulin will promote purine synthesis and increase the reabsorption of uric acid. Therefore, these two commonly used antidiabetic drugs will lead to an increase in uric acid levels.
Through the above examples, I believe everyone has understood that when choosing a drug treatment plan, you need to comprehensively consider your own health status and weigh the pros and cons.For example, the use of aspirin in small doses is the basic treatment plan for preventing cardiovascular events. However, if the patient experiences acute gout attacks, small doses of aspirin should be avoided. For example, compound resepine is a commonly used antihypertensive drug, which will cause an increase in uric acid level. Therefore, during the antihypertensive treatment process, regular checks are required to detect uric acid level. If the uric acid level is high, the antihypertensive treatment plan needs to be appropriately adjusted. In addition, the increase in uric acid caused by drugs needs to be viewed objectively and there is no need to be too nervous. At the same time, you should pay attention to adjusting your lifestyle. For example, try to arrange a low-purine diet to ensure sufficient water drinking, so that the urine volume remains above 1,500 ml, and help uric acid excretion.
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Your health, my attention. Professionals observe health from a scientific and humanistic perspective, including series such as express reports, details, reminders, doubts, opinions, historical remarks, etc. The content is original works of the author Wei Hongling and the team. Refusal of all forms of misappropriation and reproduction without permission, otherwise it will be pursued in accordance with relevant laws.
