The article considers a comparative analysis of two main drugs for the treatment of gout – febuxostat and allopurinol. The mechanisms of action of each agent are described: febuxostat is a selective inhibitor of xanthine oxidase, which leads to a decrease in uric acid synthesis, while allopurinol acts as a structural analog of hypoxanthine, inhibiting xanthine oxidase and reducing the formation of urates. Special attention is paid to the profile of side effects, hepatotoxicity, allergic reactions and effects on the cardiovascular system are described. The article discusses the advantages and limitations of each drug, as well as recommendations for choosing therapy based on the individual characteristics of the patient. The presented data contribute to optimizing the treatment of gout and improving the safety of the use of anti-inflammatory drugs.