Probenecid

Registered South African indications

• Gout

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Blood dyscrasias
• Uric acid kidney stones
• Children < 2 years
• Initiation during an acute gout attack
• Coadministration with aspirin therapy

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Glucose-6-phosphatase dehydrogenase deficiency
• Peptic ulcer disease

Forms avail. in SA and covered in this monograph: tab

Gout
-Reduce frequency of acute attacks
-Prevent formation of new tophi

• Oral (tab): Initial: 250mg, 12hrly for 1 week; Titrate by 500mg at intervals of 4 weeks; Maintenance: 500mg, 12hrly; Max: 2g/24hrs, in 2-4 divided doses

Not established for use in children

Pregnancy

• Caution
• Probenecid has been found to cross the placenta. Probenecid use during pregnancy has not been associated with adverse events

Breastfeeding

• Caution
• Safety of use during breastfeeding has not been established

Renal Impairment

• Caution; no dose adjustment recommended
  GFR < 30ml/min: Use is not recommended 

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Prohibited - At all times

Central Nervous System Disorders

• Dizziness
• Headache
• Pain 

Cardiovascular Disorders

• Flushing

Gastrointestinal Disorders

• Anorexia
• Dyspepsia
• Gastroesophageal reflux disease
• Gingival pain
• Nausea and vomiting

Hepatobiliary Disorders

• Hepatic necrosis

Genitourinary Disorders

• Hematuria
• Nephrotic syndrome
• Polyuria
• Renal colic

Endocrine and Metabolic Disorders

• Gouty arthritis

Skin and Subcutaneous Tissue Disorders

• Alopecia
• Dermatitis
• Pruritus
• Skin rash

Immune, Blood and Lymphatic System Disorders

• Anaphylaxis
• Hypersensitivity
• Anemia
• Aplastic anemia
• Hemolytic anemia
• Leukopenia
• Fever

• Methotrexate
• Penicillin
• Salicylates
• Acetaminophen
• Avibactam
• Cefotaxime
• Doripenem
• Ketorolac 
• Lorazepam
• Meropenem
• Oseltamivir
• Pegloticase
• Propacetamol

• Serum uric acid
• Urinary uric acid
• Renal function
• Full blood count

Probenecid is a uricosuric agent which is rapidly absorbed when given by mouth. In the treatment of gout it promotes excretion of urates by inhibiting tubular resorption, which results in lowering of the elevated plasma uric acid levels and a slow depletion of urate deposits (tophi) in the tissue.

Tablet 500mg

• Proben (Pharmacare) originator