النقرس لدى المرضى الذين يتناولون مدرات البول العروية أو الثيازيدية

References

When gout occurs in a patient receiving loop or thiazide diuretics, substitute the diuretic if possible; for hypertension consider losartan or calcium channel blockers; for hyperlipidaemia, consider a statin or fenofibrate.

This recommendation is supported by a large epidemiological study finding relative risks of incident gout associated with the current use of calcium channel blockers and losartan of 0.87 (95% CI 0.82 to 0.93) and 0.81 (95% CI 0.70 to 0.94), respectively.

Finally, the uricosuric property of fenofibrate and statins has been further documented.