High‑dose aspirin impairs renal uric acid excretion, raising serum urate levels and precipitating gout flares. Patients with gout should avoid regular high‑dose aspirin or use alternative analgesics.
High‑dose aspirin raises serum urate and can trigger gout flares.
Low‑dose aspirin (<100 mg) has minimal effect on uric acid but still requires monitoring.
Substitute with non‑aspirin NSAIDs or acetaminophen when possible.
If aspirin cannot be stopped, intensify urate‑lowering therapy and monitor uric acid levels.
Aspirin at doses ≥325 mg competitively inhibits renal tubular secretion of uric acid by blocking the organic anion transporter (OAT1) and reduces urate reabsorption. This leads to decreased uric acid clearance and an increase in serum urate concentration, creating a pro‑gout environment.
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