Drug & supplement interaction

Inosine + Pegloticase

Pegloticase brand name: Krystexxa.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Inosine has a moderate interaction with Pegloticase. 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
Facebook Post Reddit Email
On this page
Interaction report

Inosine and Pegloticase

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

Moderate

ANTIGOUT DRUGS

Why this applies to Pegloticase

Pegloticase 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: Pegloticase (Krystexxa) is an infusion that works hard to pull your uric acid levels down and keep your gout under control. Inosine pushes in the opposite direction, because your body breaks it down into uric acid, raising the very thing pegloticase is trying to lower. So adding inosine could work against your treatment and make it harder to keep uric acid where it needs to be.

I'll be honest, this concern is mostly theoretical and based on how these substances behave, not on hard studies in people. Still, for a gout drug it makes plain sense to avoid a supplement that boosts uric acid. Please check with your doctor or pharmacist before using inosine while on pegloticase.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Pegloticase one above is one of them. If you take anything else, check it against the full list below.

Moderate 8 No known interaction 2,822 (incl. Pegloticase)
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 Pegloticase

This page covers Inosine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pegloticase page lists 1 supplement it has a documented interaction with, worst first, each one explained.

By severity: 1 moderate.

From our pharmacist’s overview on the Pegloticase page

“Inosine is the one supplement on record that can work against pegloticase (Krystexxa), the IV enzyme infused for severe gout that has stopped responding to standard treatment. Inosine raises uric acid in the blood and urine, which is precisely what pegloticase exists to lower, so combining the two could blunt the very benefit those inf…”

Reviewed by 2 · Jul 18, 2026

Open the Pegloticase 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 Pegloticase 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 Pegloticase 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

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

29 days ago today
Medication Pegloticase
Steady interest

#2,739 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 Pegloticase Injection

What Is Pegloticase Injection Used For?

Brand name: Krystexxa

Krystexxa is used to treat chronic gout in adults whose condition has not been controlled by standard uric-acid-lowering medicines — either because those medicines stopped working, couldn't be used at the full dose needed, or are contraindicated for that person.

Krystexxa is not recommended for people who have high uric acid levels but no gout symptoms (a condition called asymptomatic hyperuricemia).

See full Pegloticase Injection 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
8 Moderate 2,821 No interaction
Moderate

8 interactions

No interaction 2,821 drugs checked — show the list

We also checked Inosine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,821 medications checked with no known interaction — see the full Inosine list.

See the full Inosine interactions page
See every supplement checked against Pegloticase, ranked by severity
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
Inosine monograph › Uses, safety, and every drug interaction in one place Pegloticase supplement interactions › Every supplement checked against Pegloticase, ranked by severity Pegloticase Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Inosine and Pegloticase Together: Common Questions

Can you take Inosine with Pegloticase?
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 Pegloticase 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 Pegloticase 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.