Therapy/dosing			Cautions	Comments	Monthly cost (generic)*
Allopurinol (Zyloprim), 50 to 300 mg daily (maximal daily dosage: 800 mg)			May precipitate acute gout, hypersensitivity syndrome, or mild rash; avoid using with azathioprine (Imuran); interacts with warfarin (Coumadin)	Do not initiate until four to six weeks after an acute attack; concurrent prophylaxis with colchicine (0.6 mg once or twice daily for six months) may prevent flare-ups; titrate dose until the uric acid level is less than 6 mg per dL (355 μmol per L); continue therapy during acute flare-ups	Thirty 300-mg tablets: $34 (6 to 18)
	Suggested initial daily renal dosing (based on creatinine clearance):
		≥ 90 mL per minute (1.50 mL per second): 300 mg
		60 to 89 mL per minute (1.00 to 1.49 mL per second): 200 mg
		30 to 59 mL per minute (0.50 to 0.98 mL per second): 100 mg
		10 to 29 mL per minute (0.16 to 0.48 mL per second): 50 to 100 mg
		< 10 mL per minute (0.16 mL per second): use very cautiously
Probenecid, initially 250 mg twice daily, gradually titrated to 500 mg to 2 g per day			May precipitate acute gout, nephrolithiasis, gastrointestinal upset, or rash; modifies renal handling of other drugs; use cautiously with heparin	Maintain hydration (about 2 L per day); avoid using with low-dose aspirin; ineffective if creatinine clearance is less than 50 mL per minute	Sixty 500-mg tablets†: (59 to 131)
Febuxostat, 80 mg daily			Avoid in patients with hepatic impairment	Investigational medication not yet approved by the U.S. Food and Drug Administration	—