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probenecid

Pronunciation

Generic Name: probenecid (proe BEN a sid)
Brand Name: Benemid

What is probenecid?

Probenecid helps your body pass uric acid out through the urine, which lowers the levels of uric acid in the body.

Probenecid is used to treat gout and gouty arthritis. Probenecid is also sometimes given together with penicillin antibiotics to make them more effective.

Probenecid may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about probenecid?

You should not use this medication if you are allergic to probenecid, or if you have uric acid kidney stones, a gout attack that has already started, or a blood cell disorder such as anemia, or decreased white blood cells. Probenecid should not be given to a child younger than 2 years old.

Before taking probenecid, tell your doctor if you are allergic to any drugs, or if you have kidney disease, a history of stomach ulcer, or if you have ever had kidney stones.

Drink plenty of water to prevent kidney stones while you are taking probenecid.

Probenecid may be only part of a complete program of treatment that also includes diet, other medications, and mineral supplements. Follow your doctor's instructions.

Call your doctor at once if you have worsening gout symptoms, severe pain in your side or lower back, blood in your urine, swelling, fever, pale or yellowed skin, or dark-colored urine.

What should I discuss with my healthcare provider before taking probenecid?

You should not use this medication if you are allergic to probenecid, or if you have:

  • uric acid kidney stones;

  • a gout attack that has already started; or

  • a blood cell disorder such as anemia, or decreased white blood cells.

Before taking probenecid, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney disease;

  • a history of stomach ulcer; or

  • if you have ever had kidney stones.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take probenecid.

Probenecid may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether probenecid passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Probenecid should not be given to a child younger than 2 years old.

How should I take probenecid?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Drink plenty of water to prevent kidney stones while you are taking probenecid.

Probenecid may be only part of a complete program of treatment that also includes diet, other medications, and mineral supplements. Follow your doctor's instructions.

To be sure this medication is not causing harmful effects, your blood or urine may need to be tested on a regular basis. Do not miss any scheduled appointments.

If you are taking probenecid together with an antibiotic, be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking probenecid. This medication may affect your body's response to anesthesia.

Store probenecid at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include nausea, vomiting, or stomach upset.

What should I avoid while taking probenecid?

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are using probenecid.

Probenecid side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • worsening gout symptoms;

  • severe pain in your side or lower back;

  • blood in your urine;

  • swelling, especially in your face, stomach, ankles, or feet; or

  • pale or yellowed skin, dark colored urine, fever, confusion or weakness.

Less serious side effects may include:

  • urinating more than usual;

  • mild nausea, vomiting, loss of appetite;

  • headache, dizziness;

  • sore gums;

  • mild itching or skin rash;

  • hair loss; or

  • warmth, redness, or tingly feeling under your skin.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Probenecid dosing information

Usual Adult Dose for Gout:

Therapy should not be started until an acute gout attack has subsided:

Initial: 250 mg orally twice a day for 1 week
Maintenance: 500 mg orally twice a day
-If symptoms of gouty arthritis are not controlled or 24-hour uric acid excretion is not above 700 mg, may increase dose in 500 mg increments every 4 weeks as tolerated; continue at dose that maintains normal serum urate levels
Maximum dose: 2 g per day

Comments:
-If an acute attack is precipitated during therapy, this drug should be continued at same dose while appropriate therapy is given to control acute attack.
-To prevent crystallization of uric acid in urine, a liberal fluid intake (2 L/day) and alkalization of the urine should be encouraged; alkalization of urine may be relaxed when serum urate levels return to normal limits and tophaceous deposits disappear.
-Maintenance dose may be decreased in increments of 500 mg every 6 months when acute attacks have been absent for 6 months or more and serum urate levels remain within normal limits; maintenance dosage should not be reduced to the point serum urate levels start to rise.

Use: For the treatment of hyperuricemia associated with gout and gouty arthritis.

Usual Adult Dose for Gouty Arthritis:

Therapy should not be started until an acute gout attack has subsided:

Initial: 250 mg orally twice a day for 1 week
Maintenance: 500 mg orally twice a day
-If symptoms of gouty arthritis are not controlled or 24-hour uric acid excretion is not above 700 mg, may increase dose in 500 mg increments every 4 weeks as tolerated; continue at dose that maintains normal serum urate levels
Maximum dose: 2 g per day

Comments:
-If an acute attack is precipitated during therapy, this drug should be continued at same dose while appropriate therapy is given to control acute attack.
-To prevent crystallization of uric acid in urine, a liberal fluid intake (2 L/day) and alkalization of the urine should be encouraged; alkalization of urine may be relaxed when serum urate levels return to normal limits and tophaceous deposits disappear.
-Maintenance dose may be decreased in increments of 500 mg every 6 months when acute attacks have been absent for 6 months or more and serum urate levels remain within normal limits; maintenance dosage should not be reduced to the point serum urate levels start to rise.

Use: For the treatment of hyperuricemia associated with gout and gouty arthritis.

Usual Adult Dose for Adjunct to Antibiotic Therapy:

500 mg orally 4 times a day

Comment: The Centers for Disease Control and Prevention (CDC) no longer recommend this drug with oral cephalosporins or ampicillin as a treatment for gonococcal infections.

Use: As an adjuvant to therapy with penicillin or with ampicillin, methicillin, oxacillin, cloxacillin, or nafcillin, for elevation and prolongation of plasma levels by whatever route the antibiotic is given.

Usual Pediatric Dose for Adjunct to Antibiotic Therapy:

Age: 2 to 14 years and weight less than 50 kg:
Initial: 25 mg/kg (or 0.7 g/m2 ) orally once
Maintenance: 40 mg/kg (or 1.2 g/m2/) per day orally administered in 4 equally divided doses 4 times a day

Weight greater than 50 kg:
500 mg orally 4 times a day

Comment: The Centers for Disease Control and Prevention (CDC) no longer recommend this drug with oral cephalosporins or ampicillin as a treatment for gonococcal infections.

Use: As an adjuvant to therapy with penicillin or with ampicillin, methicillin, oxacillin, cloxacillin, or nafcillin, for elevation and prolongation of plasma levels by whatever route the antibiotic is give.

What other drugs will affect probenecid?

Many drugs can interact with probenecid. Below is just a partial list. Tell your doctor if you are using:

  • lorazepam (Ativan);

  • methotrexate (Rheumatrex, Trexall);

  • rifampin (Rifadin, Rifamate, Rimactane);

  • diabetes medication you take by mouth;

  • an NSAID (nonsteroidal anti-inflammatory drug) such as ketoprofen (Orudis, Oruvail), indomethacin (Indocin), meclofenamate (Meclomen), or naproxen (Aleve, Anaprox, Naprosyn);

  • salicylates such as aspirin, Novasal, Doan's Extra Strength, Salflex, Tricosal, and others; or

  • a sulfa drug such as Bactrim, Cotrim, Septra, SMX/TMP, and others.

This list is not complete and there may be other drugs that can interact with probenecid. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about probenecid.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.09. Revision Date: 2010-12-15, 5:01:39 PM.

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