An anticholinergic agent, glycopyrrolate, produced an increase in the fractional excretion of uric acid of greater than 20% in eight of 19 subjects with hyperuricemia or gout but in none of the 15 normouricemic control subjects. Glycopyrrolate placebo had no effect. A similar uricosuric effect was observed in several subjects following the administration of a second anticholinergic agent, tridihexethyl chloride, but not with the administration of a third agent, L-hyoscyamine. The uricosuric effect of glycopyrrolate and tridihexethyl chloride was not associated with a change in the binding of urate to plasma proteins in vitro. The autonomic nervous system may contribute to the regulation of uric acid excretion in some patients.
Postlethwaite AE, Ramsdell CM, Kelley WN. Uricosuric Effect of an Anticholinergic Agent in Hyperuricemic Subjects. Arch Intern Med. 1974;134(2):270–275. doi:10.1001/archinte.1974.00320200080010
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