Probenecid

Brand names

• Ampicin PRB [CD]
• Benemid
• Benuryl
• Colabid [CD]
• Col-Benemid [CD]
• Polycillin-PRB [CD]
• Probalan
• Probampacin [CD]
• Proben-C [CD]
• Pro-Biosan 500 Kit [CD]
• SK-Probenecid

Usage

To treat chronic gout and gouty arthritis-specifically, to lower the uric acid level in hopes of preventing future gout attacks. Also used to lower uric acid levels that are elevated by certain therapies, such as radiation.

How it works

Gout occurs when excessive amounts of uric acid build up in the blood. This leads to the formation of uric-acid-based crystals that are deposited in the joints, causing inflammation and leading to the sharp, excruciating pain of a gout attack. Probenecid promotes excretion of excess uric acid from the body and so helps to prevent gout attacks.

Side effects

Serious

Rapid or irregular heartbeat; puffiness or swelling around eyes; trouble breathing; tightness in chest; changes in skin color; rash, hives, or itching; bloody or cloudy urine; difficult urination; lower back or side pain; sores, ulcers, or white spots on lips or in mouth; sore throat and fever; sudden decrease in urine; swollen face, fingers, feet, or lower legs; swollen or painful glands; unusual bleeding or bruising; unusual fatigue; yellow discoloration of the eyes or skin; unusual weight gain.

Common

Headache, loss of appetite, nausea or vomiting.

Less common

Dizziness, reddened face, frequent urge to urinate, red or sore gums.

Possible interactions

Other medicaments:

Probenecid may increase the effects of:

• acetaminophen (Tylenol), increasing risk of toxicity.
• acyclovir (Zovirax) and result in toxicity unless doses are reduced.
• ciprofloxacin (Cipro) and gatifloxacin (Tequin), increasing toxicity risk.
• clofibrate (Atromid-S).
• dyphylline (Neothylline).
• ketoprofen and perhaps other NSAIDs.
• ketorolac (Toradol) and increase toxicity risk.
• methotrexate (Mexate) and increase its toxicity.
• midazolam (Versed) and increase CNS depression.
• oral antidiabetic agents.
• oseltamivir (Tamiflu).
• thiopental (Pentothal) and prolong its anesthetic effect.
• valacyclovir (Valtrex) and result in toxicity unless doses are reduced.
• zalcitabine (Hivid).
• zidovudine (Retrovir) and increase toxicity risk.

Probenecid taken concurrently with:

• allopurinol (Zyloprim) may result in extended allopurinol half-life.
• cephalosporins may cause a doubling of antibiotic levels.
• dapsone may cause up to a 50% increased dapsone level and result in toxicity unless dapsone doses are decreased.
• penicillins may cause a threefold to fivefold increase in penicillin blood levels, greatly increasing the effectiveness of each penicillin dose.
• rifampin (Rifadin, others) may result in increased blood levels of rifampin.
• ritonavir (Norvir) may lead to changes in probenecid blood levels.

The following medicaments may decrease the effects of probenecid:

• aspirin and other salicylates-may reduce its effectiveness in promoting the excretion of uric acid.
• bismuth subsalicylate (Pepto-Bismol, others).

Foods:

Follow your physician's advice regarding the need for a low-purine diet.

Herbal medicines or minerals:

Acerola is high in vitamin C. Inosine, like acerola, may increase uric acid levels. Aspen should be avoided in gout. Lipase may worsen gout.

Beverages:

A large intake of coffee, tea or cola beverages may reduce the effectiveness of treatment.

Alcohol:

Large amounts of alcohol can raise the blood uric acid level and reduce the effectiveness of treatment.

Discontinuation:

Do not stop this medicament without consulting your physician.

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