some drugs have a paradoxical effect on the renal tubular handling of urate, low doses causing retention and high doses uricosuria
biphasic response is most readily demonstrated with salicylate
salicylates in low dose inhibit the renal tubular secretion of uric acid, whereas in higher doses they inhibit both secretion and reabsorption. With the high doses, interference with reabsorption predominates so that the net effect is uricosuric
the hyperuricaemic effect of small doses of salicylates is probably of little practical importance, although of course a careful drug history must always be taken for diagnostic purposes
small doses of aspirin (75 mg daily) are given to patients at high cardiovascular risk
plasma and urinary levels of salicylate in these subjects must be extremely low and their effect upon uric acid levels has not been documented; it is unlikely to be significant
Reference:
(1) Scott JT.Drug-induced gout. Baillière's Clinical Rheumatology 1991;5 (1): 39-60.
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