Benzbromarone

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Benzbromarone is a gout medicine that works as a uricosuric agent and as a non-competitive inhibitor of xanthine oxidase. It is used mainly when the first-choice drug allopurinol cannot be used or causes problems. The drug is closely related in structure to the antiarrhythmic amiodarone and has been shown in trials to be very effective, sometimes outperforming allopurinol and probenecid.

Benzbromarone strongly inhibits the liver enzyme CYP2C9, which can affect how other drugs are processed in the body. Some research has explored analogues of benzbromarone as CYP2C9 and CYP2C19 inhibitors. There are also reports that it may affect tubulin polymerization.

The drug was introduced in the 1970s and was marketed in about 20 countries across Europe, Asia, and South America, but it was never approved in the United States. In 2003, it was withdrawn in Europe due to reports of serious liver toxicity, although it remains available in some countries and is still a popular first-line gout treatment in parts of Asia, especially China and Japan.