is initiated at 250 to 500 mg daily and increased until the goal range sUA level of <6.
Alternative parenteral single-dose regimens for urogenital and anorectal gonorrhea include 500 mg ceftizoxime, 2 g cefoxitin with I g oral probenecid
, or 500 mg cefotaxime.
Uricosuric agents, such a probenecid
, and the xanthine oxidase inhibitor allopurinol are used for reducing urate levels, but uricosuric agents increase the risk of uric acid crystallization in the urine and associated stone formation.
However, limitations of allopurinol therapy (Table 1) are being increasingly appreciated in gout, particularly for subjects with renal insufficiency or uric acid overproduction who are not candidates for uricosuric therapy such as probenecid
If you have recurring gout, you may need lifelong treatment with preventative drugs such as allopurinol to reduce production of uric acid, or probenecid
to increase excretion of uric acid.
Patients who have normal renal function and cannot tolerate allopurinol may do well with a uricosuric drug such as probenecid
Patients with normal renal function who cannot tolerate allopurinol may do well with a uricosuric drug such as probenecid
Drug Cost/Day * Dosage What the Experts Say ** URICOSURICS probenecid
Pharmacologic therapies include 1) uricosurics, such as probenecid
, sulfinpyrazone and benzbromarone (used mostly in Europe), which increase the renal clearance of uric acid, 2) xanthine oxidase inhibitors such as allopurinol, which limit the formation of uric acid to yield a more water soluble chemical, and 3) anti-inflammatory medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine.
Having long taken a back seat to allopurinol because of its weaker urate-lowering effect, probenecid
is being rediscovered by physicians.
Underexcretion hyperuricemia; and allergy, intolerance, or contraindications to both probenecid
Penicillin toxicity could occur if probenecid
is administered with large doses of penicillin.