probenecid
pro·ben·e·cid
P0574600 (prō-bĕn′ĭ-sĭd)probenecid
(prəʊˈbɛnɪsɪd)| Noun | 1. | probenecid - a uricosuric drug that reduces the level of uric acid in the blood; used to treat gout |
probenecid
probenecid
[pro-ben´ĕ-sid]probenecid
Pharmacologic class: Sulfonamide-derived uricosuric
Therapeutic class: Antigout drug, tubular blocking agent
Pregnancy risk category B
Action
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)
Availability
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
➣ Gonorrhea
Adults: 1 g P.O. as a single dose given with or immediately before prescribed ampicillin dose
Dosage adjustment
• Renal impairment
Off-label uses
• Hyperuricemia secondary to thiazide therapy
Contraindications
• 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
Precautions
Use cautiously in:
• peptic ulcer, renal impairment
• pregnant or breastfeeding patients.
Administration
See Don't give until acute gout attack subsides.
• Ensure high fluid intake and alkaline urine during therapy.
Adverse reactions
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
Interactions
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
Patient monitoring
• 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.
Patient teaching
• 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.
pro·ben·e·cid
(prō-ben'ĕ-sid),probenecid
(prō-bĕn′ĭ-sĭd)probenecid
A drug used to prevent kidney damage during treatment with the antiviral drug cidofovir.Probenecid
pro·ben·e·cid
(prō-ben'ĕ-sid)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
probenecid
- noun
Words related to probenecid
noun a uricosuric drug that reduces the level of uric acid in the blood
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