Febuxostat, as a uric acid lowering drug, mainly has side effects in the liver, cardiovascular system, and allergic reactions, which need to be prevented through regular monitoring and targeted measures. The following is an explanation from three aspects: common side effects, serious adverse reactions, and preventive measures.

1. Common side effects and alleviation

(1) Abnormal liver function: Approximately 4% -10% of patients experience elevated ALT levels. It is recommended to monitor liver function every 2-4 weeks during the initial stages of medication, and mild abnormalities can continue to be observed.

(2) Gastrointestinal reactions: Nausea (1.3% -7%), diarrhea (1.6% -4%), etc. can be relieved by taking medication after meals. If the symptoms persist, the dosage needs to be adjusted.

(3) Joint pain: Gout attacks caused by uric acid fluctuations can be treated with NSAIDs or colchicine prophylactic therapy for 6 months.

2. Prevention of serious adverse reactions

(1) Cardiovascular risk: may increase the risk of cardiac death, and patients with coronary heart disease need to closely monitor electrocardiogram and myocardial enzyme spectrum.

(2) Allergic reactions: If rash (0.1% -0.5%) or vascular edema occurs, the medication should be stopped immediately and antihistamine treatment should be given.

(3) Skin toxicity: Stevens Johnson syndrome requires permanent discontinuation of medication and specialized dermatological treatment.

3. Precautions for special populations

(1) Liver dysfunction: Child Pugh Class C patients are contraindicated, while Class B patients require a 50% reduction and weekly monitoring of liver function.

(2) Renal insufficiency: No need to adjust dosage, but patients with end-stage renal disease should be alert to the risk of drug accumulation.

(3) Pregnancy: Animal experiments have shown embryotoxicity, and women of childbearing age should take reliable contraceptive measures during medication.