Johnson M W, Mitch W E
Drugs. 1981 Mar;21(3):220-5. doi: 10.2165/00003495-198121030-00003.
Introduction of new uricosuric diuretics will be accompanied by the unknown risk factors associated with the use of any new drug, as demonstrated by reports of hepatic toxicity associated with ticrynafen. In addition to unexpected reactions, there are potential risks related to induction of uricosuria, which are serious and have been reported to occur. More importantly, the risk of developing clinical gout or coronary heart disease due to mild asymptomatic hyperuricaemia appears minimal, so indications for the use of uricosuric diuretics are limited. If a uricosuric diuretic is thought necessary (and is available), it would seem prudent to measure the daily excretion rate of uric acid to identify those patients with hyperuricaemia related to overproduction of uric acid. A uricosuric diuretic should be avoided in those patients, as well as in patients with uric acid stones, and possibly in those with calcium stones. A uricosuric diuretic might be useful for patients with hypertension who also have hyperuricaemia due to a low excretion of uric acid.
新的促尿酸排泄利尿剂的引入会伴随着使用任何新药所带来的未知风险因素，正如与替尼酸相关的肝毒性报告所显示的那样。除了意外反应外，还存在与促尿酸尿症诱导相关的潜在风险，这些风险很严重且已有报道发生。更重要的是，因轻度无症状高尿酸血症而发展为临床痛风或冠心病的风险似乎极小，因此促尿酸排泄利尿剂的使用指征有限。如果认为有必要使用促尿酸排泄利尿剂（且有该药物），测量尿酸的每日排泄率以识别那些因尿酸生成过多而患有高尿酸血症的患者似乎是谨慎之举。在这些患者以及患有尿酸结石的患者中应避免使用促尿酸排泄利尿剂，对于患有钙结石的患者可能也应避免使用。促尿酸排泄利尿剂可能对患有高血压且因尿酸排泄低而同时患有高尿酸血症的患者有用。
