Age 53, overweight, complicated Dx: coronary artery disease (stents in LAD, no MIs); Type II diabetes; malignant hypertension; gout; sleep apnea; mild proteinuria. I am on many drugs for those problems, so held off on HIV meds from infection summer 2005 until CD4 <250 (VL 20-100K). Have good internal medicine/HIV expert docs and will discuss your answer with them. Started Atripla 9/25/09. Constant gout attacks ever since from mild (resolve with celery seed extract & hydration) to severe (prednisone which drives glucose way up besides making me mildly manic). Allergy to allopurinol, and have been steered away from NSAIDS & colchicine due to proteinuria. Should I consider adding the pretty new febuxostat/Uloric? No discussion of interactions in Uloric info I find, but if starting it triggers attacks, colchicine risky because of proteinuria. I don't understand information on metabolization of various meds. Have seen rheumatologist & nephrologist in past; it's clear nobody is sure what to say.

Good question. I am unaware of any actual pharmcokinetic data on the interaction between Uloric and efavirenz. Urolic (febuxostat) is glucuronidated in the liver with the CYP 450 pathway so there is a potential interaction with efavirenz (which might result in lower levels= less efficacy for the Urolic). If any reader has any first hand experience with the matter please post! KH