A number of drugs commonly used in clinical practice can affect the serum concentration of uric acid. Some raise serum uric acid level by an increase in uric acid production or a decrease in uric acid excretion, while others lower serum uric acid level by an increase in uric acid excretion or decrease in uric acid absorption from intestine. In addition, salicylate shows so-called “biphasic effect”. At small doses it raises serum uric acid level, while at higher doses it lowers serum uric acid concentration. To understand the effects of those pharmacological agents on uric acid metabolism will help to avoid unexpected side effect of hyperuricemia and gout flare. In addition, hypouricemic property of some drugs may obviate the need for polypharmacy and improve the medication compliance.