In the last twenty years, in developed countries, there has been an increase in the number of patients with asymptomatic hyperuricemia and an increase in the number of patients who were introduced to urate-lowering drugs for asymptomatic hyperuricemia. The currently valid guidelines of the European League Against Rheumatism (EULAR) from 2016 and the 2020 American College of Rheumatology Guideline for the Management of Gout (ACR) also do not recommend the introduction of urate-lowering drugs in asymptomatic hyperuricemia. In elderly patients, who have a large number of comorbidities and take a large number of medications, this represents an additional problem because the risk of drug interactions and side effects increases. Research Objectives: To determine the proportion of patients with asymptomatic hyperuricemia in the total number of patients included in the research, to determine whether the prescribed pharmacotherapy for lowering urate achieved serum uric acid concentrations within the reference values, and to determine potentially clinically significant drug interactions (X, D and C) used in treatment hyperuricemia with other prescribed pharmacotherapy. Patients and methods: A prospective study was conducted in the period from 1 May 2022 until 31 December 2022, in the Special Hospital for Medical Rehabilitation in Varaždinske Toplica at the Department for Rehabilitation of Orthopedic Trauma Patients. The study included patients over 18 years of age with a diagnosis of hyperuricemia, gout and/or urate nephrolithiasis who, in addition to urate-lowering drugs, have at least one other drug in their pharmacotherapy. General data including age and sex, established diagnoses, prescribed pharmacotherapy and serum uric acid concentration were taken from the patients medical records. Within 24 hours of receiving the patient, with signed informed consent, an interview was conducted and the best possible medication history was taken. The Lexi-Comp®Online database was used to identify potential clinically significant drug interactions. Results: 58 patients with a median age of 75 years were included in the study, of which 53,4 % were men. A total of 623 drugs were prescribed to the patients, which is 10,7 drugs per patient. A total of 41,4 % of patients had asymptomatic hyperuricemia that was treated with allopurinol. Less than half of the patients (48,3 %) had serum uric acid concentration within the reference values. A total of 95 potentially clinically significant interactions of grade D and C of allopurinol with other prescribed drugs were identified, which means 1,8 potentially clinically significant interactions of allopurinol per patient. The share of drug interactions of significance level D was 12,6 %, and of significance level C 87,4 %. In patients who were prescribed febuxostat in pharmacotherapy, no potential clinically significant drug interactions were identified. Conclusion: The introduction of pharmacotherapy to lower urate in patients with asymptomatic hyperuricemia increases the risk of side effects and clinically significant drug interactions, which may endanger patient safety. More than half of the patients receiving uratelowering pharmacotherapy did not have a serum uric acid concentration within reference values. The results indicate the importance of optimizing pharmacotherapy in patients with hyperuricemia.