Febuxostat is recommended as a possible treatment for chronic hyperuricaemia in people with gout only if:
- they can't take the medicine allopurinol for medical reasons or
- the side effects of allopurinol are so bad that the person either has to stop taking it or can't be given the most effective dose.
People who were already taking febuxostat when the guidance was issued should be able to carry on taking it until they and their healthcare professional(s) decide that it is the right time to stop treatment.
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.