Overview
DESCRIPTION Probenecid and colchicine contains probenecid, which is a uricosuric agent, and colchicine, which has antigout activity, the mechanism of which is unknown. Probenecid is the generic name for p-(Dipropylsulfamoyl)benzoic acid. The structural formula is represented below: C 13 H 19 NO 4 S M.W.285.36 Probenecid is a white or practically white, fine, crystalline powder.
Mechanism of Action
CLINICAL PHARMACOLOGY Probenecid is a uricosuric and renal tubular blocking agent. It inhibits the tubular reabsorption of urate, thus increasing the urinary excretion of uric acid and decreasing serum urate levels. Effective uricosuria reduces the miscible urate pool, retards urate deposition, and promotes resorption of urate deposits. Probenecid inhibits the tubular secretion of penicillin and usually increases penicillin plasma levels by any route the antibiotic is given. A 2-fold to 4-fold elevation has been demonstrated for various penicillins. Probenecid also has been reported to inhibit the renal transport of many other compounds including amino hippuric acid (PAH), aminosalicylic acid (PAS), indomethacin, sodium iodomethamate and related iodinated organic acids, 17-ketosteroids,...
Indications
- INDICATIONS & USAGE For the treatment of chronic gouty arthritis when complicated by frequent, recurrent acute attacks of gout.
Common Doses
- 700 mg
- 30 mL
- 7.5 g
Dosage
DOSAGE & ADMINISTRATION Therapy with probenecid and colchicine should not be started until an acute gouty attack has subsided. However, if an acute attack is precipitated during therapy, probenecid and colchicine may be continued without changing the dosage, and additional colchicine or other appropriate therapy should be given to control the acute attack. The recommended adult dosage is 1 tablet of probenecid and colchicine daily for one week, followed by 1 tablet twice a day thereafter. Some degree of renal impairment may be present in patients with gout.
Contraindications
- CONTRAINDICATIONS Hypersensitivity to this product or to probenecid or colchicine. Probenecid and colchicine tablets are contraindicated in children under 2 years of age. Not recommended in persons with known blood dyscrasias or uric acid kidney stones. Therapy with probenecid and colchicine should not be started until an acute gouty attack has subsided. Pregnancy Probenecid crosses the placental barrier and appears in cord blood. Colchicine can arrest cell division in animals and plants. In certain species of animals under certain conditions, colchicine has produced teratogenic effects.
Side Effects
- ADVERSE REACTIONS The following adverse reactions have been observed and within each category are listed in order of decreasing severity. Probenecid Central Nervous System: headache, dizziness. Metabolic: precipitation of acute gouty arthritis. Gastrointestinal: hepatic necrosis, vomiting, nausea, anorexia, sore gums. Genitourinary: nephrotic syndrome, uric acid stones with or without hematuria, renal colic, costovertebral pain, urinary frequency. Hypersensitivity: anaphylaxis, fever, urticaria, pruritus.
Interactions
- DRUG INTERACTIONS When probenecid is used to elevate plasma concentrations of penicillin, or other beta-lactams, or when such drugs are given to patients taking probenecid therapeutically, high plasma concentrations of the other drug may increase the incidence of adverse reactions associated with that drug. In the case of penicillin, or other beta-lactams, psychic disturbances have been reported. The use of salicylates antagonizes the uricosuric action of probenecid (see WARNINGS ). The uricosuric action of probenecid is also antagonized by pyrazinamide.