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Review
. 2025 Feb;48(2):129-142.
doi: 10.1007/s40264-024-01485-7. Epub 2024 Sep 17.

Drug-Induced Hypouricemia

Chaker Ben Salem  1 , Myriam Agrebi  2 , Dhouha Sahnoun  2 , Neila Fathallah  2 , Houssem Hmouda  3
Affiliations
Review

Drug-Induced Hypouricemia

Chaker Ben Salem et al. Drug Saf. 2025 Feb.

Abstract

Hypouricemia is defined as a serum uric acid concentration of ≤ 2.0 mg/dL or 119 μmol/L. Hypouricemia may occur secondarily to a number of underlying conditions, including severe hepatocellular disease, neoplasia, defective renal tubular reabsorption of uric acid, inherited metabolic defect in purine metabolism, and drugs. Medications are an important cause of hypouricemia. They can cause hypouricemia by a variety of mechanisms. Drug-induced hypouricemia mostly occurs as overtreatment of hyperuricemia by urate-lowering therapies including xanthine oxidase inhibitors, uricosuric agents and uricases. Drugs not used in the treatment of gout may also lead to a decrease of uric acid levels. In this literature review, medications leading to hypouricemia are summarized with regard to their mechanism of action and clinical significance.

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Conflict of interest statement

Declarations. Funding: No funding. Conflict of interest: Authors have no conflicts of interest that are directly relevant to the content of this article. Ethics approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Availability of data and material: Upon reasonable request, data will be shared with qualified scientifc and medical researchers. All requests should be submitted in writing to the corresponding author. Code availability: Not applicable. Author contributions: CBS and MA performed the literature review and wrote the first draft of the manuscript. All authors made significant contribution to the writing, development, and editing of this manuscript. All authors read and approved the final version.

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