Which drugs can raise uric acid levels or trigger gout attacks?

Hey, speaking of this topic, there are indeed some medications we commonly encounter that can subtly raise uric acid levels, and even inadvertently trigger a gout attack. Let me briefly outline them for you, so you have a general idea.

1. Certain Antihypertensive Drugs, especially Diuretics: This is probably one of the most common categories. Medications like hydrochlorothiazide (often referred to as "Shuangke" in China) and furosemide (Lasix) help you excrete excess water from your body to lower blood pressure. The problem is, while "draining water," they also inadvertently reduce the excretion pathways for uric acid, essentially "trapping" uric acid in the body. Over time, uric acid levels naturally rise.

2. Aspirin: This medication is a bit special. If you take high-dose aspirin for conditions like rheumatism, it actually helps excrete uric acid. However, most people, especially middle-aged and elderly individuals, take "low-dose" aspirin (e.g., 100 mg daily) to prevent cardiovascular and cerebrovascular diseases. This low-dose usage, precisely, inhibits the kidneys' ability to excrete uric acid, thereby raising uric acid levels. So, if you're taking low-dose aspirin and also have gout, be sure to mention this to your doctor during your visit.

3. Immunosuppressants: These are mainly used by individuals who have undergone organ transplant surgery or have specific autoimmune diseases (such as lupus erythematosus, rheumatoid arthritis). For example, cyclosporine and tacrolimus, which you mentioned, can affect kidney function, reducing the kidneys' ability to excrete uric acid. Therefore, doctors closely monitor uric acid levels in patients taking these medications.

4. Some Anti-tuberculosis and Chemotherapy Drugs: For instance, pyrazinamide, used to treat tuberculosis, is also a medication that significantly raises uric acid. Additionally, some chemotherapy drugs used to treat cancer can rapidly kill a large number of cancer cells. When these cells are destroyed, they release a lot of purines. The body's metabolism of these purines then produces a large amount of uric acid, a condition known as "tumor lysis syndrome," which can also trigger acute gout.

The most important point is this:

Never stop taking these medications on your own just because you're worried about high uric acid! These drugs are usually prescribed for very critical conditions, such as high blood pressure, heart disease, or tuberculosis. The risk of arbitrarily stopping them is far greater than that of high uric acid itself.

The correct approach is: When seeing a doctor or having a physical examination, proactively inform your doctor about all the medications you are currently taking, and also tell them if you have gout or high uric acid. The doctor will weigh the pros and cons based on your specific situation and may help you switch to a medication that doesn't affect uric acid, or add some uric acid-lowering drugs to complement your treatment. In short, leave professional matters to professionals; listening to your doctor is always the right choice.