probenecid

REMS

Prevention of recurrences of gouty arthritis.
Treatment of hyperuricemia secondary to thiazide therapy.
Used to increase and prolong serum levels of penicillin and related anti-infectives.

Contraindicated in:

Hypersensitivity
Chronic high-dose salicylate therapy
Pedi: Children <2 yr.

Use Cautiously in:

Peptic ulcer
Blood dyscrasias
Uric acid kidney stones
Renal impairment (dosage ↓ recommended; may not be effective if CCr 30 mL/min)
OB: Has been used safely during pregnancy
Lactation: Safety not established.

CNS: headache, dizziness.

GI: nausea, vomiting, abdominal pain, diarrhea, drug-induced hepatitis, sore gums.

GU: uric acid stones, urinary frequency.

Derm: flushing, rashes.

Hemat: APLASTIC ANEMIA, anemia.

Drug-Drug:

↑blood levels of acyclovir, allopurinol, barbiturates, benzodiazepines, cephalosporins, dapsone, dyphylline, methotrexate, NSAIDs, penicillamine, penicillins, rifampin, sulfonamides, sulfonylureas, or zidovudine.
Large doses of salicylates may ↓ uricosuric activity.

(Generic available)

Tablets: 500 mg;
In combination with: colchicine (Col-Probenecid). See Appendix [not included in this PDA edition].

PO (Adults and Children >50 kg): Hyperuricemia — 250 mg twice daily for 1 wk; ↑ to 500 mg twice daily, then may ↑ by 500 mg/day every 4 wk (not to exceed 3 g/day).Augmentation of penicillins/cephalosporins — 500 mg 4 times daily. Single-dose therapy of gonorrhea — 1 g with amoxicillin or penicillin.
PO (Children 2–14 yr and 50 kg): 25 mg/kg (700 mg/m²) initially; then 10 mg/kg (300 mg/m²) 4 times daily.

Inhibits renal tubular reabsorption of uric acid, thus promoting its renal excretion.

Therapeutic Effects:

Reduction of serum uric acid levels.

Therapeutic Classification: antigout agents, uricosurics

Absorption: Well absorbed following oral administration.

Distribution: Crosses the placenta.

Protein Binding: 75–95%.

Metabolism/Excretion: Mostly metabolized by the liver; 10% excreted unchanged in the urine.

Half-life: 4–17 hr.

(effects on serum uric acid levels)

ROUTE	ONSET	PEAK	DURATION
PO	30 min	2–4 hr	8 hr

Instruct patient to take medication exactly as directed, not to discontinue without consulting health care professional. Irregular dosage schedules may cause elevation of uric acid levels and precipitate an acute gout attack.
Explain purpose of the medication to patients taking probenecid with penicillin.
Advise patient to follow recommendations of health care professional regarding weight loss, diet, and alcohol consumption.
Caution patient not to take aspirin or other salicylates, because they decrease the effects of probenecid.
Instruct patient to report nausea, vomiting, loss of appetite, abdominal pain, unusual bleeding or bruising, sore throat, fatigue, malaise, or yellowing of the skin or eyes promptly.

NDC Code^*

0378- Mylan Pharmaceuticals Inc.
0378-0156- Probenecid 0378-0156-01- 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0156-01)

0527- Lannett Company, Inc.
0527-1367- Probenecid 0527-1367-01- 100 TABLET, FILM COATED in 1 BOTTLE (0527-1367-01)

0527- Lannett Company, Inc.
0527-1367- Probenecid 0527-1367-10- 1000 TABLET, FILM COATED in 1 BOTTLE (0527-1367-10)

0591- Actavis Pharma, Inc.
0591-5347- Probenecid 0591-5347-01- 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-5347-01)

0591- Actavis Pharma, Inc.
0591-5347- Probenecid 0591-5347-10- 1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0591-5347-10)

10135- Marlex Pharmaceuticals Inc
10135-541- Probenecid 10135-541-01- 100 TABLET, FILM COATED in 1 BOTTLE (10135-541-01)

10135- Marlex Pharmaceuticals Inc
10135-541- Probenecid 10135-541-10- 1000 TABLET, FILM COATED in 1 BOTTLE (10135-541-10)

43353- Aphena Pharma Solutions - Tennessee, LLC
43353-839- Probenecid 43353-839-60- 90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43353-839-60)

43353- Aphena Pharma Solutions - Tennessee, LLC
43353-991- Probenecid 43353-991-60- 90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (43353-991-60)

63629- Bryant Ranch Prepack
63629-8213- Probenecid 63629-8213-1- 30 TABLET, FILM COATED in 1 BOTTLE (63629-8213-1)

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