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Pharmacologic class: Sulfonamide-derived uricosuric
Therapeutic class: Antigout drug, tubular blocking agent
Pregnancy risk category B
Promotes uric acid excretion from kidney by blocking tubular reabsorption; also inhibits tubular secretion of weak organic acids (most penicillins and cephalosporins, some beta-lactams)
Tablets: 0.5 g
Indications and dosages
➣ Hyperuricemia caused by gout Adults and children weighing more than 50 kg (110 lb): After acute gout attack subsides, 250 mg P.O. b.i.d. for 1 week, then 500 mg b.i.d.; may increase by 500 mg/day q 4 weeks (not to exceed 3 g/day)
➣ To prolong action or increase blood level of penicillins or cephalosporins
Adults: 500 mg P.O. q.i.d.
Children ages 2 to 14: Initially, 25 mg/kg or 0.7 g/m2, then a maintenance dosage of 40 mg/kg/day or 1.2 g/m2 in four divided doses
Adults: 1 g P.O. as a single dose given with or immediately before prescribed ampicillin dose
• Renal impairment
• Hyperuricemia secondary to thiazide therapy
• Hypersensitivity to drug
• Acute gout attack
• Uric acid calculi
• Blood dyscrasias
• Concurrent salicylate use
• Concurrent penicillin use in patients with renal impairment
• Children younger than age 2
Use cautiously in:
• peptic ulcer, renal impairment
• pregnant or breastfeeding patients.
☞ Don't give until acute gout attack subsides.
• Ensure high fluid intake and alkaline urine during therapy.
CNS: headache, dizziness
GI: nausea, vomiting, diarrhea, abdominal pain, anorexia
GU: urinary frequency, uric acid calculi, renal colic, nephrotic syndrome
Hematologic: anemia, hemolytic anemia, aplastic anemia
Hepatic: hepatitis, hepatic necrosis
Metabolic: gout exacerbation
Musculoskeletal: costovertebral pain
Skin: flushing, rash, pruritus
Other: sore gums, fever, hypersensitivity reactions including anaphylaxis
Drug-drug. Acyclovir, allopurinol, barbiturates, cephalosporins, pantothenic acid, penicillins: increased blood levels of these drugs, enhanced uric acid-reducing effect of probenecid
Benzodiazepines: faster onset and prolonged effects of these drugs
Clofibrate: increased clofibrate blood level
Dapsone: accumulation of dapsone and its metabolites
Dyphylline: increased half-life and decreased clearance of dyphylline
Methotrexate, nonsteroidal anti-inflammatory drugs, rifampin, sulfonamides: increased blood levels, therapeutic effects, and toxicity of these drugs
Oral hypoglycemics: increased half-life and effects of these drugs
Penicillamine: increased pharmacologic effect of penicillamine
Salicylates: decreased probenecid or salicylate activity
Thiopental: extended anesthetic effect of thiopental
Zidovudine: increased risk of zidovudine toxicity
Drug-diagnostic tests. Urine glucose tests using copper reduction method (such as Clinitest): false-positive result
• Monitor kidney and liver function tests, CBC, and blood urea nitrogen level.
• Assess fluid intake and output to ensure good hydration and reduce urinary side effects.
• During first 6 to 12 months of therapy, monitor pattern and severity of acute gout attacks to assess need for additional anti-inflammatory drugs.
• Advise patient to take with food or milk to minimize GI upset.
• Teach patient about causes of gout and proper use of drug. Stress that he must wait until acute attack subsides and then take drug regularly to prevent further attacks.
• Tell patient drug may exacerbate acute gout attacks for first 6 to 12 months, necessitating colchicine or other anti-inflammatory drug for 3 to 6 months.
• Instruct patient to drink 2 to 3 liters of fluids daily.
• Tell patient with gout to limit foods high in purine (such as anchovies, organ meats, and legumes).
• Instruct diabetic patient to test urine glucose level during therapy.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.
probenecidA drug used to prevent kidney damage during treatment with the antiviral drug cidofovir.
Patient discussion about probenecid
Q. SVT and AF, Hearts that go fast to slow or any others probs with the beats of any kind and Ablation of hearts I have had Ablation done once and I am still having passing out spells and still on 50mg toprol 2 times a day till two days ago, now I am on 150 to 200 aday again. Its not the first time I have had to up meds. I had ablation down 4/22/05. I can breath better now but but it didnt take it away as you can tell. Now Dr Leonardie would like to do it again . This is the big ????! Will it or can it work 100% this time, or will it hit and miss some again???? MTT