Uricosuric

The primary uricosuric drugs include probenecid, benzbromarone and sulfinpyrazone. ==Secondary uricosurics==

Drugs with other primary uses, that have known uricosuric properties, include losartan, atorvastatin, and fenofibrate. Although these drugs may have significant uricosuric action, their other significant pharmacological actions in off-label use as a uricosuric requires careful assessment of the patient to achieve the most benefit and least risk. • Amlodipine • Atorvastatin (lowers cholesterol) • Fenofibrate (lowers triglycerides, raises HDL) • Losartan • Adrenocorticotropic hormone • Cortisone Abdominal surgery also has a uricosuric effect, as well as the potential to precipitate an acute attack of gout. ==Pharmacology==

In general, uricosuric drugs act on the proximal tubules in the kidneys, where they interfere with the absorption of uric acid from the kidney back into the blood. Several uricosurics are known to act in vitro by blocking the function of a protein encoded by the gene SLC22A12, also known as urate transporter 1 or URAT1. URAT1 is the central mediator in the transport of uric acid from the kidney into the blood. In some persons with loss-of-function mutations of URAT1, the uricosurics benzbromarone and losartan had no effect, suggesting these drugs act on URAT1 in vivo. The NSAID diclofenac has an antiuricosuric action, which may be partly responsible for the extraordinary toxicity of this drug in vultures. Pyrazinamide, a drug indicated only for treatment of tuberculosis, is a potent antiuricosuric and, as a consequence, has an off-label use in the diagnosis of causes of abnormal uric acid clearance. It acts on URAT1. Antiuricosuric drugs are useful for treatment of hypouricemia and perhaps also hyperuricosuria, but are contraindicated in persons with conditions including hyperuricemia and gout. ==See also==