Do you prefer allopurinol or febuxostat for patients with chronic kidney disease who are receiving treatment for asymptomatic hyperuricemia?  

Allopurinol. For my Asian and sometimes African American patients, I consider HLA testing to make sure they are not at risk for allopurinol hypersensitivity. In which case, I will prescribe febuxostat. Most often, I find the insurance will not even cover febuxostat unless I have tried allopurinol fi...

I also prefer febuxostat over allopurinol. Febuxostat, in my opinion, has a safety advantage over allopurinol, contrary to popular belief and contrary to the black box warning on its package insert.My greatest concern with allopurinol has been the small risk it poses for Steven's Johnson Syndrome an...

I use both but prefer Febuxostat. Multiple recent studies have shown no additional cardiovascular risk of febuxostat compared to Allopurinol. The clear advantage for me is the ease of use compared to Allopurinol. The slow and tedious taper of Allopurinol (from 50 or 100mg, to 300-900 mg to hit the t...

I too find Febuxostat difficult to get but testing for allopurinol sensitivity is not that easy either. The question I have is in the stem of the question, why are you treating "asymptomatic" hyperuricemia in CKD in the first place?