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probenecid (Oral route)

Pronunciation

proe-BEN-e-sid

Commonly used brand name(s)

In the U.S.

  • Benemid
  • Probalan

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antigout

Uses For probenecid

Probenecid is used in the treatment of chronic gout or gouty arthritis. These conditions are caused by too much uric acid in the blood. The medicine works by removing the extra uric acid from the body. Probenecid does not cure gout, but after you have been taking it for a few months it will help prevent gout attacks. probenecid will help prevent gout attacks only as long as you continue to take it.

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Probenecid is also used to prevent or treat other medical problems that may occur if too much uric acid is present in the body.

Probenecid is sometimes used with certain kinds of antibiotics to make them more effective in the treatment of infections.

Probenecid is available only with your doctor's prescription.

Before Using probenecid

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For probenecid, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to probenecid or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Probenecid has been tested in children 2 to 14 years of age for use together with antibiotics. It has not been shown to cause different side effects or problems than it does in adults. Studies on the effects of probenecid in patients with gout have been done only in adults. Gout is very rare in children.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. There is no specific information comparing use of probenecid in the elderly with use in other age groups.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking probenecid, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using probenecid with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Ketorolac

Using probenecid with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Citalopram
  • Deferiprone
  • Doripenem
  • Methotrexate
  • Pegloticase
  • Zalcitabine

Using probenecid with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amoxicillin
  • Aspirin
  • Bismuth Subsalicylate
  • Cefditoren Pivoxil
  • Cefotaxime
  • Cefpodoxime Proxetil
  • Cefprozil
  • Choline Magnesium Trisalicylate
  • Ciprofloxacin
  • Enprofylline
  • Ertapenem
  • Gatifloxacin
  • Lorazepam
  • Magnesium Salicylate
  • Meropenem
  • Norfloxacin
  • Phenprocoumon
  • Piretanide
  • Pralatrexate
  • Sodium Salicylate
  • Sodium Thiosalicylate
  • Zidovudine
  • Zomepirac

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of probenecid. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood disease or
  • Cancer being treated by antineoplastics (cancer medicine) or radiation (x-rays) or
  • Kidney disease or stones (or history of) or
  • Stomach ulcer (history of)—The chance of side effects may be increased

Proper Use of probenecid

If probenecid upsets your stomach, it may be taken with food. If this does not work, an antacid may be taken. If stomach upset (nausea, vomiting, or loss of appetite) continues, check with your doctor.

For patients taking probenecid for gout:

  • After you begin to take probenecid, gout attacks may continue to occur for a while. However, if you take probenecid regularly as directed by your doctor, the attacks will gradually become less frequent and less painful than before. After you have been taking probenecid for several months, they may stop completely.
  • probenecid will help prevent gout attacks but it will not relieve an attack that has already started. Even if you take another medicine for gout attacks, continue to take probenecid also. If you have any questions about this, check with your doctor.

For patients taking probenecid for gout or to help remove uric acid from the body:

  • When you first begin taking probenecid, the amount of uric acid in the kidneys is greatly increased. This may cause kidney stones or other kidney problems in some people. To help prevent this, your doctor may want you to drink at least 10 to 12 full glasses (8 ounces each) of fluids each day, or to take another medicine to make your urine less acid. It is important that you follow your doctor's instructions very carefully.

Dosing

The dose of probenecid will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of probenecid. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For treating gout or removing uric acid from the body:
    • Adults: 250 mg (one-half of a 500-mg tablet) two times a day for about one week, then 500 mg (one tablet) two times a day for a few weeks. After this, the dose will depend on the amount of uric acid in your blood or urine. Most people need 2, 3, or 4 tablets a day, but some people may need higher doses.
    • Children: It is not likely that probenecid will be needed to treat gout or to remove uric acid from the body in children. If a child needs probenecid, however, the dose would have to be determined by the doctor.
  • For helping antibiotics work better:
    • Adults: The amount of probenecid will depend on the condition being treated. Sometimes, only one dose of 2 tablets is needed. Other times, the dose will be 1 tablet four times a day.
    • Children: The dose will have to be determined by the doctor. It depends on the child's weight, as well as on the condition being treated. Older children and teenagers may need the same amount as adults.

Missed Dose

If you miss a dose of probenecid, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using probenecid

If you will be taking probenecid for more than a few weeks, your doctor should check your progress at regular visits.

Before you have any medical tests, tell the person in charge that you are taking probenecid. The results of some tests may be affected by probenecid.

For diabetic patients:

  • Probenecid may cause false test results with copper sulfate urine sugar tests (Clinitest®), but not with glucose enzymatic urine sugar tests (Clinistix®). If you have any questions about this, check with your health care professional.

For patients taking probenecid for gout or to help remove uric acid from the body:

  • Taking aspirin or other salicylates may lessen the effects of probenecid. This will depend on the dose of aspirin or other salicylate that you take, and on how often you take it. Also, drinking too much alcohol may increase the amount of uric acid in the blood and lessen the effects of probenecid. Therefore, do not take aspirin or other salicylates or drink alcoholic beverages while taking probenecid, unless you have first checked with your doctor.

probenecid Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare
  • Fast or irregular breathing
  • puffiness or swellings of the eyelids or around the eyes
  • shortness of breath, troubled breathing, tightness in chest, or wheezing
  • changes in the skin color of the face occurring together with any of the other side effects listed here
  • or skin rash, hives, or itching occurring together with any of the other side effects listed here

Check with your doctor as soon as possible if any of the following side effects occur:

Less common
  • Bloody urine
  • difficult or painful urination
  • lower back or side pain (especially if severe or sharp)
  • skin rash, hives, or itching (occurring without other signs of an allergic reaction)
Rare
  • Cloudy urine
  • cough or hoarseness
  • fast or irregular breathing
  • fever
  • pain in back and/or ribs
  • sores, ulcers, or white spots on lips or in mouth
  • sore throat and fever with or without chills
  • sudden decrease in the amount of urine
  • swelling of face, fingers, feet, and/or lower legs
  • swollen and/or painful glands
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • yellow eyes or skin
  • weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Headache
  • joint pain, redness, or swelling
  • loss of appetite
  • nausea or vomiting (mild)
Less common
  • Dizziness
  • flushing or redness of face (occurring without any signs of an allergic reaction)
  • frequent urge to urinate
  • sore gums

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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