II. Indication
- Rarely used now due to toxicity
- Allopurinol used most often for gout prophylaxis
-
Gout for Uric Acid under-excreter
- Indicated for Urine Uric Acid < 700 mg/24h
IV. Indications: Requirements for use
- Age <60 years
- Normal Renal Function
- No history of renal stone
- No overproduction of Uric Acid
V. Preparations
- Use concurrent NSAID or Colchicine when starting
- Probenecid (Consider Allopurinol instead)
- Dose: 250 mg PO bid
- Maximum: 1500 mg PO bid
- Sulfapyrazine (Rarely used)
- Dose: 50 mg PO bid
- Maximum: 100 mg PO bid
- Lesinurad (Zurampic)
- Dose: 200 mg orally each morning
- Risk of Acute Renal Failure (should not be used as Uric Acid monotherapy)
- Must be taken with Xanthine Oxidase Inhibitor (Allopurinol or Febuxostat)
- Allopurinol dose must be at least 300 mg/day (at least 200 if CrCl <60 ml/min)
- Available as Duzallo (Allopurinol with Lesinurad)
- As of 2017, costs $12/day (compared with $3/day for Allopurinol and probenacid)
- (2017) Presc Lett 24(11): 64
VI. Adverse effects
- Dermatitis
- Cytopenias
- Reduces excretion of other drugs (e.g. Penicillin)
Images: Related links to external sites (from Bing)
Related Studies
probenecid (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
PROBENECID 500 MG TABLET | Generic | $0.55 each |
PROBENECID-COLCHICINE TABLET | Generic | $0.99 each |