Benemid Disease Interactions

The manufacturer does not recommend the use of probenecid in patients with known blood dyscrasias. Aplastic anemia, leukopenia, hemolytic anemia and other anemia have been reported infrequently during administration of probenecid. Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency may increase the risk of probenecid-induced hemolytic anemia.

Probenecid may promote lithiasis by increasing uric acid concentration in the renal tubules. Adequate hydration is necessary during therapy. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk for the development of uric acid kidney stones and should be encouraged to consume additional amounts of liquid or given intravenous fluid. In general, fluid intake sufficient to yield a daily urinary output of at least 2 liters is recommended. Maintenance of a slightly alkaline or neutral urine is also desirable.

The use of probenecid is not recommended in patients with a history of uric acid nephrolithiasis or a urinary urate excretion greater than 750 mg/24 hr. Probenecid may promote lithiasis by increasing uric acid concentration in the renal tubules. Adequate hydration is necessary during treatment. In general, a fluid intake sufficient to yield a daily urinary output of at least 2 liters is recommended. Maintenance of a slightly alkaline urine is also desirable.

The manufacturer states that probenecid should be used with caution in patients with a history of peptic ulcer. Uricosuric agents can cause upper gastrointestinal irritation and aggravate or reactivate peptic ulcer. However, these effects have primarily been reported with another uricosuric agent, sulfinpyrazone. GI effects associated with probenecid are usually limited to nausea, vomiting, and anorexia.

Probenecid may not be effective in patients with chronic renal insufficiency, particularly when glomerular filtration rate is 30 mL/min or less. Probenecid has been used in patients with some renal impairment but dosage requirements may be increased.