Drug & supplement interaction

Inosine + Lesinurad

Lesinurad brand name: Zurampic.

Moderate Interaction
The bottom line Moderate

Inosine has a moderate interaction with Lesinurad. Inosine might reduce the effects of antigout medications.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Inosine and Lesinurad

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIGOUT DRUGS

Why this applies to Lesinurad

Lesinurad falls under ANTIGOUT DRUGS — the group Inosine interacts with.

Inosine might reduce the effects of antigout medications.
Inosine increases uric acid levels in the serum and urine, potentially resulting in hyperuricemia and reducing the effects of medications used for the prevention and treatment of gout.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: Lesinurad (Zurampic) lowers your uric acid by helping your kidneys flush it out. Inosine works in the opposite direction. When your body breaks inosine down, one of the leftovers is uric acid, so taking it can push your uric acid back up. That can work against what Lesinurad is trying to do and may make gout flares (the sudden joint redness, swelling, and pain) harder to control.

I'll be honest that this concern is mostly based on how these two behave on paper, not strong human studies. Still, if you're on Lesinurad for gout, adding a uric-acid-raising supplement doesn't make much sense. Please run it by your pharmacist or doctor before combining them.

References
  1. Parkinson Study Group SURE-PD Investigators. Inosine to increase serum and cerebrospinal fluid urate in Parkinson disease: a randomized clinical trial. JAMA Neurol. 2014;71(2):141-50.
  2. Muñoz García D, Midaglia L, Martinez Vilela J, et al. Associated inosine to interferon: results of a clinical trial in multiple sclerosis. Acta Neurol Scand. 2015;131(6):405-10. PubMed
  3. Gonsette RE, Sindic C, D'hooghe MB, et al. Boosting endogenous neuroprotection in multiple sclerosis: The association of inosine and interferon beta in relapsing-remitting Multiple Sclerosis (ASIIMS) trial. Mult Scler. 2010;16(4):455-62.
  4. Watanabe H, Hattori T, Kume A, et al. Improved Parkinsons disease motor score in a single-arm open-label trial of febuxostat and inosine. Medicine (Baltimore) 2020;99(35):e21576. PubMed
  5. Parkinson Study Group SURE-PD3 Investigators, Schwarzschild MA, Ascherio A, et al. Effect of Urate-Elevating Inosine on Early Parkinson Disease Progression: The SURE-PD3 Randomized Clinical Trial. JAMA 2021;326(10):926-939.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Inosine Also Interacts With Other Medications

Inosine has 8 moderate known drug interactions in our database — the Lesinurad one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Inosine

Covers the 2,830 medications we’ve checked against Inosine. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Lesinurad

This page covers Inosine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lesinurad page lists 97 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Adrafinil (moderate), African Wild Potato (moderate), Alkanna (moderate) and Alpine Ragwort (moderate).

By severity: 1 major · 74 moderate · 22 minor.

From our pharmacist’s overview on the Lesinurad page

“Activated charcoal is the one major-rated entry among the 97 supplements and herbs on file for lesinurad (Zurampic), and it undermines the drug directly. Charcoal binds medicines in the gut and can cut how much lesinurad you absorb, letting uric acid climb and gout flare.”

Reviewed by 2 · Jul 18, 2026

Open the Lesinurad interaction page

One more smart check

Taking Inosine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 93 real supplement products containing Inosine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Inosine. Your product may carry other ingredients that interact with Lesinurad too, on top of Inosine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Inosine and Lesinurad Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Inosine
Top half

#581 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Lesinurad
Top half

#904 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Inosine

What is Inosine?

  • Athletic performance and energy
  • Multiple sclerosis (raising uric acid)
  • Parkinson's disease (raising uric acid)
  • General health and recovery

Inosine is a nucleoside (a building block of DNA and RNA) that the body makes on its own and is also sold as a supplement, mostly marketed for athletic performance. Solid evidence that it boosts exercise performance is lacking, and because it raises uric acid levels, it may pose risks for people with gout or kidney problems. Talk with your pharmacist or doctor before using it.

Read the full Inosine monograph & all interactions
Medication

About Lesinurad

What Is Lesinurad Used For?

Brand name: Zurampic

  • Lesinurad is used in combination with a xanthine oxidase inhibitor to treat hyperuricemia (high levels of uric acid) in people with gout (sudden attacks of redness, swelling, pain, and heat in one or more joints) whose disease is not controlled with their current medication. Lesinurad is in a class of medications called selective uric acid reabsorption inhibitors. It works by helping the kidneys to remove uric acid from the body.

See full Lesinurad drug information
Keep checking

Other Drugs & Inosine

Browse every other medication we’ve checked against Inosine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
8Moderate
0Minor
2,821No known interaction
Moderate

8 interactions

No interaction 2,821 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Pharmacist Counseling Corner

Taking Inosine and Lesinurad Together: Common Questions

Can you take Inosine with Lesinurad?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Inosine and Lesinurad interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Lesinurad and Inosine?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.