Benzbromarone

Benzbromarone is a medication in the class of uricosuric agents used to treat hyperuricemia and gout. It lowers serum urate by inhibiting renal reabsorption of uric acid in the proximal tubule, primarily through blockade of the URAT1 transporter, which increases urinary uric acid excretion.

Clinically, benzbromarone is most effective in patients who underexcrete uric acid rather than those who overproduce it. It may be considered for individuals who cannot tolerate or do not achieve target uric acid levels with xanthine oxidase inhibitors such as allopurinol or febuxostat, though renal function is an important consideration and the drug is generally avoided in significant renal impairment.

Safety and regulation of benzbromarone have been shaped by reports of serious hepatotoxicity, including cases of severe liver injury. Due to these risks, regulatory status varies by country; some jurisdictions have withdrawn or restricted its use, while others require careful monitoring. Patients receiving benzbromarone typically undergo regular liver function tests and monitoring for hepatic symptoms. Common adverse effects include gastrointestinal upset, rash, and hypersensitivity reactions.

Pharmacokinetically, benzbromarone is administered orally and is metabolized in the liver, with its effects on urate excretion reflected in the urine. Drug interactions may occur with other agents that affect renal urate transporters or hepatic metabolism, and concomitant use with hepatotoxic drugs should be approached with caution.

See also: gout, hyperuricemia, uricosuric agents; probenecid; allopurinol; febuxostat; lesinurad.