Pharmacology · Class
Other antigout agents !
Medicines for gout that do not block xanthine oxidase: colchicine for flares, probenecid to pass more urate, and pegloticase to break it down.
Updated 2026-11-01
What they are
Gout is treated in two ways: calming the flare and lowering urate over the long term. Colchicine treats and prevents flares; probenecid is a uricosuric that makes the kidney excrete more urate; pegloticase is an enzyme infusion for severe gout that does not respond to other urate-lowering drugs.
Mechanism of action
Colchicine binds tubulin and stops microtubules forming, so neutrophils cannot migrate, degranulate or assemble the inflammasome that releases IL-1β. Probenecid blocks urate reabsorption in the proximal tubule (mainly through URAT1). Pegloticase is a pegylated uricase that oxidises uric acid to allantoin, which is more soluble.
Target: Tubulin (colchicine), URAT1 urate transporter (probenecid), uric acid itself (pegloticase)
Drugs in this class
- ColchicineAn old plant-derived tablet that calms gout flares and familial Mediterranean fever. Small margin: diarrhoea warns of…β-tubulin (microtubules)
- ProbenecidA uricosuric tablet that makes the kidneys pass more uric acid. It also keeps penicillin in the blood longer.Urate transporter URAT1 (and organic anion transporters OAT1 and OAT3)
- PegloticaseAn enzyme infusion that breaks down uric acid, for severe gout that does not respond to other drugs. G6PD is tested…Uric acid (the drug is the enzyme uricase)
Test yourself
Think of the answer, then tap the question to see it.
Which antigout drug works on neutrophils rather than on uric acid?
Colchicine: it blocks microtubule formation and so neutrophil migration and inflammasome activation.
Why is aspirin avoided with probenecid?
Salicylates antagonise its uricosuric action.
What does pegloticase turn uric acid into?
Allantoin, a more soluble product excreted in the urine.
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - COLCHICINE tablet (DailyMed (U.S. National Library of Medicine), 2024); DailyMed - PROBENECID tablet (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 42 (McGraw Hill, 2023).
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Representative model, for educational purposes only.