VA Class:MS400
Probenecid, a sulfonamide derivative, is a uricosuric agent and inhibitor of tubular secretion of weak organic acids (e.g., penicillins and certain other β-lactam antibacterials).
Hyperuricemia Associated with Gout
Probenecid is used to lower serum urate concentrations in the treatment of chronic gouty arthritis and tophaceous gout. The drug is indicated in patients with frequent disabling attacks of gout. The presence of elevated serum urate concentrations alone usually is not considered by most clinicians to be an indication for therapy. However, some clinicians believe that therapy should be initiated when serum urate concentrations exceed 9 mg/dL (by the colorimetric method) because these concentrations are often associated with increased joint changes and renal complications. Probenecid is also indicated when there are visible tophi or when serum urate concentrations are greater than 8.5-9 mg/dL in a patient with a family history of tophi or low uric acid excretion. The goal of probenecid therapy is to lower serum urate concentrations to about 6 mg/dL. By decreasing serum urate concentrations, probenecid prevents or reduces chronic joint changes and tophi formation, eventually reduces the frequency of acute gout attacks, and may improve renal function in gouty patients.
Since probenecid has no analgesic or anti-inflammatory activity, it is of no value in the treatment of acute gout attacks and will exacerbate and prolong inflammation during the acute phase. Probenecid should not be started until 2-3 weeks after an acute gout attack. The drug may increase the frequency of acute attacks during the first 6-12 months of therapy, even when normal or subnormal serum urate concentrations have been maintained. Therefore, prophylactic doses of colchicine should be administered concurrently during the first 3-6 months of probenecid therapy. The usefulness of the commercially available fixed combination of probenecid and colchicine (probenecid/colchicine) for such prophylaxis is limited, however, because the colchicine content in the fixed combination exceeds the amount required for prophylaxis in most patients. Acute gout attacks may occur in spite of prophylactic therapy, but usually become less severe and are of briefer duration after several months of probenecid therapy. During these acute attacks, probenecid should be continued without changing dosage and full therapeutic doses of colchicine or other anti-inflammatory agents should be administered.
In early uncomplicated gout, either a uricosuric agent or allopurinol may be used. Probenecid may be effective in gouty patients with mild renal impairment, but large doses may be required. The drug is not effective, however, when chronic renal insufficiency exists, particularly in patients with moderate to severe renal impairment (creatinine clearance of less than 50 mL/minute). Since uricosuric agents tend to increase urinary uric acid concentrations and the risk of stone formation, they should be avoided; allopurinol is preferred in patients with urinary uric acid excretion of greater than 900 mg/day or with gouty nephropathy, urinary tract stones or obstruction, or azotemia. Patients who are refractory to or cannot tolerate probenecid may respond to allopurinol. The activity of allopurinol and uricosurics is additive and when administered concomitantly, smaller doses of each drug can be used. Combined use of the 2 types of drugs is especially effective in the presence of tophaceous deposits.
Hyperuricemia Secondary to Other Causes
Probenecid has been used effectively and is commonly employed to promote uric acid excretion in hyperuricemia secondary to the administration of thiazide and related diuretics†, furosemide†, ethacrynic acid†, pyrazinamide†, or ethambutol†. Uricosurics should not be used to treat hyperuricemia secondary to cancer chemotherapy, radiation, or myeloproliferative neoplastic diseases because they may increase the risk of uric acid nephropathy.
Use with Anti-infective Agents
Probenecid is used concomitantly with certain β-lactam antibacterials (e.g., penicillin G procaine, cefoxitin)100, 110, 155, 344 to decrease clearance and increase plasma concentrations of the antibacterial.100, 110 Concomitant oral probenecid is recommended whenever IM penicillin G procaine is used for the treatment of neurosyphilis.155, 344 Concomitant oral probenecid also is recommended whenever IM cefoxitin is used for the treatment of mild to moderately severe acute pelvic inflammatory disease (PID) or the treatment of uncomplicated urogenital or anorectal gonorrhea.344
Probenecid also is used concomitantly with cidofovir to reduce clearance of the antiviral and decrease cidofovir-associated nephrotoxicity.109, 110 A regimen of oral probenecid must be used concomitantly with each dose of IV cidofovir whenever the antiviral is used for the management of cytomegalovirus (CMV) retinitis.109, 110, 155
Probenecid is administered orally.100
Adverse GI effects may be minimized by taking the drug with food or antacids; dosage reduction may be required.
Hyperuricemia Associated with Gout
In the treatment of gout, low doses of oral probenecid are used initially to reduce the possibility of flare-up of acute gouty attacks and to prevent massive uricosuria. However, patients previously controlled with other uricosuric therapy may begin probenecid at full maintenance dosage. Daily urine output should be maintained at a minimum of 2-3 L in all patients and alkalinization of the urine is desirable.
The usual adult dosage of probenecid in patients with gout is 250 mg twice daily during the first week of therapy, followed by 500 mg twice daily thereafter. Serum urate concentrations usually reach a minimum within a few days after beginning therapy. If lower dosages do not control gouty arthritis symptoms or if the 24-hour uric acid excretion is not above 700 mg, daily dosage of probenecid may be increased every 4 weeks by increments of 500 mg to a maximum of 2-3 g daily, especially in patients with mild renal impairment.
After acute attacks of gout have been absent for 6 months and serum urate concentrations have been controlled, it may be possible to reduce the dosage of probenecid. Daily dosage may be reduced by 500 mg every 6 months as long as serum urate concentrations remain controlled. Uricosuric therapy should be continued indefinitely; irregular dosage schedules may lead to increased serum urate concentrations.
If the fixed combination of probenecid and colchicine (probenecid/colchicine) is used for the treatment of gouty arthritis complicated by frequent, recurrent acute attacks of gout, the manufacturer recommends that adults receive 1 tablet (probenecid 500 mg and colchicine 0.5 mg) once daily for 1 week, followed by 1 tablet twice daily thereafter.101 If symptoms of gouty arthritis are not controlled or if the 24-hour uric acid excretion is not greater than 700 mg, daily dosage of the fixed combination may be increased by 1 tablet every 4 weeks as tolerated (usually not to exceed 4 tablets daily [probenecid 2 g and colchicine 2 mg daily]).101 If acute attacks have been absent for at least 6 months and serum urate concentrations are controlled, the manufacturer recommends reducing dosage of the fixed combination by 1 tablet every 6 months as long as serum urate concentrations remain controlled.101 Probenecid/colchicine has limited usefulness for prophylactic therapy because the colchicine content in the fixed combination exceeds the amount required for prophylaxis in most patients.
Use with Anti-infective Agents
If oral probenecid is used concomitantly with penicillin therapy in adults, the manufacturer recommends a probenecid dosage of 2 g daily given in divided doses and states that this dosage should be decreased in older patients with impaired renal function.100 In children 2-14 years of age, the manufacturer recommends an initial oral probenecid dose of 25 mg/kg or 700 mg/m2, followed by a maintenance probenecid dosage of 40 mg/kg daily or 1.2 g/m2 daily given in 4 divided doses.100 The manufacturer states that children weighing more than 50 kg may receive the recommended adult dosage of oral probenecid when the drug is used concomitantly with penicillin therapy.100
When IM penicillin G procaine is used for the treatment of neurosyphilis in adults, the US Centers for Disease Control and Prevention (CDC) and other clinicians recommend that oral probenecid be given in a dosage of 500 mg 4 times daily for 10-14 days in conjunction with the penicillin G procaine regimen (2.4 million units of penicillin G given IM once daily for 10-14 days).155, 344 Some clinicians recommend that this regimen be followed by penicillin G benzathine (2.4 million units of penicillin G given IM once weekly for up to 3 weeks) without probenecid.155
When IM cefoxitin is used for the treatment of acute pelvic inflammatory disease (PID) in adults, CDC states that a single 1-g dose of oral probenecid should be administered in conjunction with a single 2-g dose of IM cefoxitin, followed by oral doxycycline (100 mg twice daily for 14 days) with or without oral metronidazole (500 mg twice daily for 14 days).344
When IM cefoxitin is used for the treatment of uncomplicated urogenital or anorectal gonorrhea in adults, CDC states that a single 1-g dose of oral probenecid should be given in conjunction with a single 2-g dose of IM cefoxitin.344
When IV cidofovir is used for the treatment of cytomegalovirus (CMV) retinitis, a 3-dose regimen of oral probenecid must be administered with each cidofovir dose.109, 155 A 2-g dose of oral probenecid should be given 3 hours prior to initiation of each cidofovir IV infusion and 1-g doses of oral probenecid should be given 2 and 8 hours after completion of each cidofovir IV infusion (total of 4 g of oral probenecid for each cidofovir dose).109, 155
When probenecid is used for the treatment of hyperuricemia associated with gout and gouty arthritis in patients with renal impairment, increased dosage of the drug may be required.100 The manufacturer states that probenecid may not be effective in patients with chronic renal insufficiency, especially if the glomerular filtration rate is 30 mL/minute or less.100 It has been suggested that the drug should be avoided in patients with moderate to severe renal impairment (creatinine clearance of less than 50 mL/minute).
In therapeutic dosages, probenecid is usually well tolerated and has a low incidence of adverse effects. The most frequent adverse effects include headache, anorexia, nausea, and vomiting. Other reported adverse effects include dizziness, flushing, sore gums, alopecia, urinary frequency, leukopenia, and anemia. Nephrotic syndrome, hepatic necrosis, and aplastic anemia occur rarely. Mild to moderately severe hemolytic anemia, which in some patients could be related to genetic deficiency of glucose-6-phosphate dehydrogenase, has also been reported.102
Probenecid increases the concentration of uric acid in the renal tubules and, in some gouty patients, may promote development of uric acid stones which may cause renal colic, hematuria, and costovertebral pain. This is most likely to occur when probenecid therapy is initiated. Maintenance of a large volume of alkaline urine increases the solubility of uric acid and thus reduces the risk of stone formation in the kidneys. The drug may also increase the frequency of acute gouty attacks during the first 6-12 months of therapy.
Severe allergic reactions and anaphylaxis have been reported rarely in patients receiving probenecid.100 Hypersensitivity reactions may be characterized by dermatitis, pruritus, fever, sweating, and hypotension. Most cases of severe allergic reactions and anaphylaxis have been reported to occur within several hours after probenecid administration in patients who previously received the drug.100
Precautions and Contraindications
Probenecid is contraindicated in patients hypersensitive to the drug.100 Probenecid should be discontinued if a hypersensitivity reaction occurs.100
Probenecid is contraindicated in patients with blood dyscrasias or uric acid kidney stones.100
When probenecid is used for the treatment of hyperuricemia associated with gout and gouty arthritis, the drug should not be initiated until an acute gouty attack has subsided.100
Probenecid should be used with caution in patients with a history of peptic ulcer.100
Probenecid has been used for the treatment of hyperuricemia associated with gout in patients with some degree of renal impairment, but increased dosage may be required.100 Probenecid may not be effective in those with chronic renal insufficiency100 or moderate or severe renal impairment.
Because of its mechanism of action, the manufacturer states that probenecid is not recommended for use in conjunction with penicillin therapy in patients with known renal impairment.100
Probenecid is contraindicated in children younger than 2 years of age.100
Probenecid crosses the placenta and has been detected in cord blood.100 The risks and benefits of probenecid should be evaluated when considering use of the drug in women of childbearing potential.100
Probenecid is expected to be distributed into human milk; possible effects on nursing infants are not known.114 The drug should be used with caution in breast-feeding women because of potential risks to nursing infants.114
Drugs that Increase Serum Uric Acid
Many drugs may increase serum urate concentrations, including most diuretics, pyrazinamide, diazoxide, alcohol, and mecamylamine. If these drugs are administered during uricosuric therapy, probenecid dosage may need to be increased. Some antineoplastic agents also increase serum urate concentrations; however, uricosurics may increase the risk of uric acid nephropathy and should not be used in patients receiving cancer chemotherapy.
Probenecid inhibits renal tubular secretion of many weak organic acids, including penicillins, most cephalosporins, and some other β-lactam antibacterials, thereby increasing plasma concentrations of the anti-infectives.
Theoretically, hypoglycemia may result from probenecid-induced elevations of plasma concentrations of chlorpropamide and other oral sulfonylurea antidiabetic agents. In one patient, probenecid reportedly prolonged clotting time by inhibiting secretion of heparin during concomitant therapy. Elevated plasma concentrations of aminosalicylic acid may be caused by concomitant administration of probenecid, thus increasing the possibility of toxic effects. Probenecid also inhibits tubular secretion of pantothenic acid and riboflavin and intestinal absorption of riboflavin, but the importance of these interactions is not known.
Probenecid inhibits renal tubular secretion of penicillins (e.g., ampicillin, methicillin, nafcillin, oxacillin, penicillin G), most cephalosporins (e.g., cefoxitin), and some other β-lactam antibacterials, thereby increasing plasma concentrations of these anti-infectives.100, 110, 111, 112 Concomitant probenecid has been reported to result in a twofold to fourfold increase in plasma concentrations of various penicillins;100, 110 probenecid usually increases penicillin plasma concentrations regardless of the route of administration of the penicillin.100 When probenecid is used concomitantly with a β-lactam antibacterial, the possibility that increased plasma concentrations of the anti-infective may increase the incidence of adverse reactions associated with the anti-infective should be considered;100 psychic disturbances have been reported in patients receiving probenecid concomitantly with penicillin or other β-lactam antibacterials.100
Concomitant use of probenecid and sulfonamides results in increased total sulfonamide plasma concentrations, but does not affect free sulfonamide concentrations;100 therefore, concomitant use of these drugs is not therapeutically useful. If probenecid and a sulfonamide are used concomitantly for prolonged periods, plasma concentrations of the sulfonamide should be monitored.100
Concomitant use of probenecid and dapsone may result in increased dapsone plasma concentrations and may increase the possibility of dapsone-associated toxic effects.
Probenecid may inhibit renal tubular secretion of nitrofurantoin and decrease nitrofurantoin concentrations in urine, thereby reducing efficacy of the urinary tract anti-infective, and may also increase nitrofurantoin-associated toxicity because of increased serum concentrations of the drug.113 Concomitant use of nitrofurantoin and probenecid should be avoided whenever possible.
Tubular secretion and hepatic uptake of rifampin are inhibited by probenecid, but the small increase in plasma concentrations of the antituberculosis agent are not clinically important.
Probenecid does not affect plasma concentrations of aminoglycosides (e.g., neomycin, streptomycin), chloramphenicol, or tetracyclines.100
Concomitant use of oral probenecid and IV cidofovir decreases renal clearance of cidofovir to a level consistent with creatinine clearance, suggesting that probenecid blocks active renal tubular secretion of cidofovir.109
Administration of probenecid (500 mg every 6 hours) with oral ganciclovir has resulted in a 53% increase in the AUC of ganciclovir and a 22% decrease in renal clearance of ganciclovir,107, 108 which is consistent with an interaction involving competition for renal tubular secretion.108 Because valganciclovir is rapidly and extensively converted to ganciclovir, interactions associated with ganciclovir are expected to occur in patients receiving valganciclovir.107
Probenecid may inhibit renal elimination of methotrexate, resulting in increased serum concentrations of methotrexate.100 Concomitant use of probenecid and methotrexate in animals has resulted in methotrexate toxicity.100
If probenecid and methotrexate are used concurrently, dosage of methotrexate should be reduced and monitoring of serum methotrexate concentrations may be required.100
Nonsteroidal Anti-inflammatory Agents
The uricosuric actions of probenecid and salicylates are mutually antagonistic. Salicylate-induced uricosuria is inhibited by usual doses of probenecid. It has been suggested that probenecid-induced uricosuria appears to be inhibited principally when serum salicylate concentrations exceed 50 mcg/mL and that occasional doses of salicylates for analgesia or antipyresis in patients receiving probenecid may be insufficient to produce a clinically important interaction. However, the manufacturer of probenecid states that concomitant use of salicylates (either small or large doses) and probenecid is contraindicated and, if an analgesic or antipyretic is required during probenecid therapy, use of acetaminophen instead of small doses of salicylates is preferred.109 (See Drug Interactions: Other Drugs.)
When probenecid is used concomitantly with indomethacin, increased plasma concentrations, plasma half-life, and therapeutic effects of indomethacin have been reported. The mechanisms of this interaction remain unknown but have been attributed to blockade of renal tubular secretion of indomethacin and interference with biliary clearance of indomethacin. Although the clinical importance of the interaction has not been established, a decreased total daily dose of indomethacin may produce a satisfactory therapeutic response when indomethacin and probenecid are used concurrently and increases in indomethacin dosage, if necessary, should be made carefully and in small increments. Indomethacin does not interfere with the uricosuric action of probenecid.
Although the clinical importance has not been determined to date, concomitant use of probenecid with some other nonsteroidal anti-inflammatory agents (e.g., ketoprofen, meclofenamate, naproxen, sulindac) results in increased plasma elimination half-lives and plasma concentrations of these drugs.103, 104, 105 Concomitant use of probenecid and sulindac increases plasma concentrations of sulindac and its sulfone metabolite, but has only a slight effect on plasma concentrations of the sulfide metabolite.103 Sulindac causes a slight reduction in the uricosuric action of probenecid, but this effect is probably not clinically important in most patients.103 When probenecid is administered concomitantly with ketoprofen, total and free plasma concentrations of ketoprofen are substantially increased as a result of decreased protein binding of ketoprofen, decreased total apparent plasma clearance of ketoprofen, and decreased apparent plasma clearance of free ketoprofen.104, 106 In addition, probenecid appears to inhibit conjugation of ketoprofen and renal excretion of ketoprofen conjugates.106 The manufacturer of ketoprofen states that concomitant use of the drug and probenecid is not recommended.104
Although the clinical importance has not been determined, concomitant use of probenecid with acetaminophen or lorazepam reportedly results in increased plasma elimination half-lives and peak plasma concentrations of these drugs.
Probenecid increases urinary excretion of insulin, but this effect is not clinically important.
Furosemide and ethacrynic acid naturesis is inhibited by probenecid. Probenecid increases excretion of calcium, magnesium, and citrate in patients taking thiazide diuretics, but does not antagonize thiazide-induced naturesis.
It has been reported that patients receiving probenecid may require substantially lower amounts of thiopental sodium (no longer commercially available in the US) for induction of anesthesia.100 Ketamine and thiopental sodium anesthesia is substantially prolonged in rats receiving probenecid.100
A reducing substance in the urine of patients receiving probenecid may cause false-positive glucosuria when the test is performed with cupric sulfate reagent (Benedict's Qualitative Reagent, Clinitest®, Fehling's Solution), but not with glucose oxidase reagent (Clinistix®, Tes-Tape®).
Probenecid decreases urinary excretion of 17-ketosteroids, PSP, BSP, aminohippuric acid, and iodopyracet and related iodinated organic acids and may interfere with diagnostic procedures or laboratory tests that use these agents. Administration of probenecid 25-100 mg/kg to dogs decreases the elimination rate of indocyanine green and the possibility of this occurring in humans should be considered.
Limited information is available on the acute toxicity of probenecid in humans.
In one report of probenecid overdosage, toxic symptoms following ingestion of 47.5 g of the drug included copious vomiting followed by stupor and coma. Several tonic-clonic (grand mal) seizures occurred, each lasting approximately 30 seconds, and were treated with IV phenobarbital sodium and phenytoin. Serum urate decreased to very low concentrations.
In acute probenecid overdosage, it has been recommended that the stomach be emptied immediately by inducing emesis or by gastric lavage and that short-acting barbiturates be administered parenterally if signs of CNS stimulation occur.
Probenecid is a renal tubular blocking agent. The drug competitively inhibits active reabsorption of uric acid at the proximal convoluted tubule, thus promoting urinary excretion of uric acid and reducing serum urate concentrations. Probenecid may reduce plasma protein binding of urate and, in subtherapeutic doses, may inhibit renal secretion of uric acid. In healthy individuals, probenecid has no effect on the glomerular filtration rate or on the tubular reabsorption of normal urinary constituents such as glucose, arginine, urea, sodium, potassium, chloride, or phosphate.
At the proximal and distal tubules, probenecid competitively inhibits the secretion of many weak organic acids including penicillins, most cephalosporins, and some other β-lactam antibacterials. In general, the net effect of probenecid on the plasma concentration of weak acids depends on the ratio of the amount of organic acid secreted by the kidneys to that amount filtered at the glomeruli. Thus, probenecid substantially increases plasma concentrations of acidic drugs eliminated principally by renal secretion, but increases plasma concentrations only slightly if the drug is eliminated mainly by filtration. Plasma concentrations of penicillins are often more than doubled by probenecid; the concentration of penicillin in the CSF is also increased. Probenecid also substantially increases plasma concentrations of most cephalosporins and some other β-lactam antibacterials. In addition, half-lives of the penicillins and cephalosporins are prolonged and their volumes of distribution may be reduced by probenecid.
The cellular mechanism(s) responsible for the inhibition of renal tubular transport by probenecid is not known. The drug may inhibit transport enzymes that require a source of high energy phosphate bonds and/or nonspecifically interfere with substrate access to protein receptor sites on the kidney tubules.
Probenecid competes with some drugs such as rifampin and sulfobromophthalein for hepatic uptake and thus reduces their hepatic secretion. In addition, probenecid may inhibit the specialized intestinal absorption of riboflavin.
CSF concentrations of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), cyclic adenosine monophosphate (AMP), and 4-hydroxy-3-methoxyphenylglycol are elevated following administration of probenecid. It has been proposed that probenecid blocks the active transport of these organic acids from the CSF into blood. Probenecid-induced elevations of HVA (a dopamine metabolite) in the CSF of patients with parkinsonian syndrome and of 5-HIAA (a metabolite of serotonin) in the CSF of mentally depressed patients are substantially lower than those in healthy patients.
Probenecid exerts no analgesic or anti-inflammatory activity.
Probenecid is rapidly and completely absorbed from the GI tract. Plasma probenecid concentrations of 40-60 mcg/mL produce maximal inhibition of renal penicillin excretion, while concentrations of 100-200 mcg/mL produce a uricosuric effect. Plasma probenecid concentrations of 25 mcg/mL are reached 30 minutes after a single 1-g oral dose; plasma concentrations peak in 2-4 hours and remain above 30 mcg/mL for 8 hours. Following a single 2-g oral dose, peak plasma concentrations of 150-200 mcg/mL are reached in 4 hours and concentrations above 50 mcg/mL are sustained for 8 hours.
Probenecid usually produces maximal renal clearance of uric acid 30 minutes after being administered and exerts its effect on plasma penicillin concentrations after about 2 hours. Because blood probenecid concentrations are difficult to determine, serum urate concentrations should be used to monitor uricosuric therapy. The 15-minute IV phenolsulfonphthalein (PSP) excretion test can be used as an index to the probenecid dosage required to decrease penicillin excretion. Probenecid dosage is adequate when renal clearance of the dye is reduced to approximately 20% of the normal rate.
At a plasma concentration of 14 mcg/mL, about 75% of the drug is bound to proteins.
Probenecid concentrations in CSF are approximately 2% of plasma concentrations.
Probenecid crosses the placenta and appears in cord blood.100 It is not known whether probenecid is distributed into human milk, but distribution into milk is expected.114
Following oral administration of 2 g of probenecid, plasma half-life of the drug ranges from 4-17 hours; the half-life decreases as the dose decreases from 2 g to 500 mg.
Probenecid is slowly metabolized by the liver to probenecid monoacyl glucuronide, two monohydroxylated compounds, a carboxylated metabolite, and an N -depropylated compound. These metabolites may possess some uricosuric activity. Small amounts of probenecid are filtered at the glomeruli, but most of the drug is actively secreted at the proximal tubule. Renal tubular reabsorption of the drug is nearly complete in acidic urine; however, probenecid metabolites are not reabsorbed as extensively as the parent compound. Alkalinization of the urine decreases reabsorption of probenecid. Although this also increases excretion of the drug, probenecid's efficacy is not appreciably decreased. After 2 days, 5-11% of a single 2-g oral probenecid dose is excreted in urine as unchanged drug, 16-33% as its monoacyl glucuronide, and the remainder as approximately equal amounts of the 4 other metabolites.
Probenecid is a sulfonamide-derivative uricosuric agent. Probenecid occurs as a white or practically white, practically odorless, fine, crystalline powder. The drug is practically insoluble in water, soluble in alcohol, and has a pKa of 3.4.
Probenecid tablets should be stored in well-closed containers at 20-25°C.100
Fixed-combination tablets containing probenecid and colchicine (probenecid/colchicine) should be stored in well-closed, light-resistant containers at 20-25°C.101
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Oral | Tablets, film-coated | 500 mg* | Probenecid Tablets |
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Oral | Tablets | 500 mg Probenecid and Colchicine 0.5 mg* | Probenecid and Colchicine Tablets |
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Only references cited for selected revisions after 1984 are available electronically.
100. Actavis Pharma. Probenecid tablets prescribing information. Parsippany, NJ; 2016 Dec.
101. Actavis Pharma. Probenecid and colchicine tablets prescribing information. Parsippany, NJ; 2016 Dec.
102. Benemid® (probenecid) tablets prescribing information. In: Huff BB, ed. Physicians'; desk reference. 41st ed. Oradell, NJ: Medical Economics Company Inc; 1987 (Suppl B):B10-1.
103. Clinoril® (sulindac) tablets prescribing information. In: Huff BB, ed. Physicians'; desk reference. 41st ed. Oradell, NJ: Medical Economics Company Inc; 1987:1251-3.
104. Orudis® (ketoprofen) capsules prescribing information. In: Huff BB, ed. Physicians'; desk reference. 41st ed. Oradell, NJ: Medical Economics Company Inc; 1987:2179-81.
105. Naprosyn® (naproxen) prescribing information. In: Huff BB, ed. Physicians'; desk reference. 41st ed. Oradell, NJ: Medical Economics Company Inc; 1987(Suppl B):B22-4.
106. Upton RA, Williams RL, Buskin JN et al. Effects of probenecid on ketoprofen kinetics. Clin Pharmacol Ther . 1982; 31:705-12. [PubMed 7075118]
107. Roche. Valcyte® (valganciclovir hydrochloride) tablets prescribing information. Nutley, NJ; 2001 Mar.
108. Roche. Cytovene®-IV (ganciclovir sodium for injection) and Cytovene® (ganciclovir capsules) prescribing information. Nutley, NJ; 2000 Sep.
109. Mylan Institutional LLC. Cidofovir anhydrous injection prescribing information. Rockford, IL; 2012 Nov.
110. Grayson ML, ed. Kucers' the use of antibiotics: a clinical review of antibacterial, antifungal, antiparasitic, and antiviral drugs. 7th ed. Boca Raton, FL: CRC Press; 2018:23-90, 3531-71.
111. Pfizer Laboratories. Penicillin G procaine injectable suspension for deep IM injection only prescribing information. New York, NY; 2019 Nov.
112. Sagent Pharmaceuticals. Cefoxitin for injection for IV use prescribing information. Schaumburg, IL; 2018 Sep.
113. Procter and Gamble Pharmaceuticals. Macrobid® (nitrofurantoin) monohydrate/macrocrystals capsules prescribing information. Cincinnati, OH; 2009 Jan.
114. Probenecid. In: Briggs GG, Freeman RK, Yaffe SJ. Drug in pregnancy and lactation: a reference guide to fetal and neonatal risk. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2005:1342-3
155. Panel on Opportunistic Infection in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV. Accessed January 16, 2020. Updates may be available at HHS AIDS Information (AIDSinfo) website [Web]
344. Workowski KA, Bolan GA. Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR Recomm Rep . 2015; 64(RR-03):1-137. Updates may be available at CDC website. [PubMed 26042815]