Probenecid

Brand names of probenecid

  • Ampicin PRB [CD]
  • Benemid
  • Benuryl
  • Colabid [CD]
  • Col-Benemid [CD]
  • Polycillin-PRB [CD]
  • Probalan
  • Probampacin [CD]
  • Proben-C [CD]
  • Pro-Biosan 500 Kit [CD]
  • SK-Probenecid

Probenecid is an oral medication that belongs to the class of drugs called uricosurics. This medication is prescribed for lowering the level of uric acid in the bloodstream in patients suffering from hyperuricemia (elevated levels of uric acid). It may be noted that several conditions, like gout and kidney stones, are attributable to high uric acid levels. Probenecid helps to prevent gout attacks by means of lowering the levels of uric acid in the bloodstream. This medication works by thwarting the kidney from taking in the uric acid again as well as by augmenting the elimination of uric acid from the body through urine. Besides, lowering the uric acid level in the blood, probenecid prevents the kidney from eliminating penicillin as well as associated antibiotics and, hence, is used to augment the intensity of antibiotics in the blood as well as enhancing the efficiency of the antibiotics, especially when they are use to cure infections.

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Things you need to tell your physician before taking probenecid

Prior to beginning treatment with probenecid, you need to tell your physician or pharmacist if the use of this medicine, any of its ingredients or any other medicine causes allergic reactions in you. Also tell your physician about all the prescription and over-the-counter drugs you are taking currently, particularly aspirin, antibiotics, aminosalicylic acid, any cancer chemotherapy agent (such as methotrexate), diuretics ('water pills'), difunisal (Dolobid), daposone, any medication for treating nervousness, indomethacin (Indocin), heparin, oral diabetes medicines, nitrofurantoin (Macrobid, Macrodantin), salsalate (Disalcid), and pyrazinamide. It is important to note that aspirin has an impact in the manner your body responses to probenecid and, hence, you should keep away from this medicine while undergoing treatment with probenecid. Instead, you should use any other medicine, for instance acetaminophen (Tylenol) to provide relief from pain and/ or fever. It is advisable that you consult your physician or pharmacist to suggest a suitable substitute for aspirin. In addition, inform your physician regarding the herbal products, vitamins and dietary supplements that are being used by you.

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Before you start using probenecid, tell your physician about your medical history, especially if you are suffering from or have ever suffered from kidney ailments, had kidney stones, ulcers or any blood disorder. Women who intend to use probenecid should essentially tell their physician if they are pregnant, planning to get pregnant or are nursing mothers. In case a woman becomes pregnant while undergoing treatment with probenecid, she should immediately contact her physician for advice on what needs to be done next.

Also tell your physician if you are scheduled to undergo any surgery that will involve regular anaesthetic. On the other hand, if you have to undergo a urine test, tell your physician as well as the laboratory staff that you are taking probenecid. This is important because probenecid has the aptitude to have an effect on the findings of the laboratory tests.

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Usage

Probenecid is generally used to cure chronic gout as well as arthritis related to gout, especially to reduce the level of uric acid in the bloodstream with a view to avoid occurrence of gout attacks in future. In addition, probenecid is employed to lower the uric acid levels in the bloodstream owing to a number of treatments, for instance radiation therapy.

As aforementioned, probenecid is a member of the uricosuric class of drugs. This medication helps to reduce the intensity of uric acid in the body by making it easier for the kidneys to eliminate uric acid from the body. Elevated levels of uric acid in the body may result in the formation of crystals in the joints, which eventually causes gout. Reducing the level of uric acid is helpful for the kidneys. Occasionally, probenecid is used in conjunction with penicillin antibiotics (for instance, penicillin, nafcillin and ampicillin) with a view to augment the levels of antibiotics in the bloodstream. When the level of antibiotics in the bloodstream is augmented, they work better to cure infections. It is worth mentioning here that probenecid works by lessening the ability of the kidneys to eliminate the antibiotics from the body. Here is a word of caution: never give probenecid to children below the age of two years.

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How to use probenecid

Probenecid should be taken orally to prevent the occurrence of gout attacks. This medication is generally taken twice every day either with foods or antacids with a view to lessen the risks of stomach upset. You may also take probenecid as prescribed by your physician. Ideally, people taking probenecid should drink one full glass of water (8 ounces) while taking the medication and a further eight glasses (each glass containing 8 ounces) of water throughout the day to avoid developing kidney stones. In case there is some restriction regarding your fluid intake, you should talk to your physician regarding more instructions. In such cases, it is likely that your physician will provide you with guidelines on diminishing acidity in your urine (for instance, he/ she may ask you to keep away from taking large quantities of vitamin C/ ascorbic acid) with a view to avoid kidney stones. In addition, your physician may also prescribe some other medicines, such as citrate or sodium bicarbonate, to lessen the acidity of your urine. It may be noted that the dosage of probenecid is dependent on the condition of the patient as well as his/ her response to the treatment with this medication. It is also likely that your physician will initially ask you to begin treatment with low doses of probenecid and adjust your dose gradually depending on the levels of uric acid in your bloodstream as well as the symptoms of your gout.

Your physician will gradually lower your dose of probenecid when you are free of the gout symptoms for several months and the level of uric acid in your bloodstream has returned to normal. Eventually, he/ she will prescribe you the lowest dose of this medication. It is important that you follow the instructions of your physician strictly as well as carefully. You should never take probenecid when a sudden, severe gout attack has already started, but wait till the attack subsides and then take the medicine. Once you start taking probenecid, it is likely that you will experience an increase in the frequency of gout attacks, at least for the initial several months. This is primarily because your body has started the process of eliminating the excessive uric acid in your bloodstream following the commencement of treatment with probenecid.

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In case you experience an attack of gout while you are already taking probenecid, you should still continue taking the medication along with other drugs that have been prescribed by your physician to provide relief from the pain caused by gout. Remember, probenecid treats gout by lowering the intensity of uric acid in your bloodstream, but it does not provide relief from the pain caused by gout. In order to get relief from gout pain, you need to take other medications prescribed by your physician (such as, ibuprofen, colchicine and/ or indomethacin).

Provided you are taking probenecid to augment the level as well as effectiveness of antibiotics in your body, follow the instructions of your physician carefully regarding when you should take the antibiotics and when you ought to take probenecid. It is important that you use probenecid on a regular basis to get the utmost benefit of using this medication. In order to remember when you should take probenecid, take the medicine around the same time every day. If your condition does not improve or worsens even after taking this medication for quite some time, contact your physician for further advice.

How probenecid works

Probenecid works by preventing the body from reabsorbing the excessive uric acid in the bloodstream, and by helping the kidneys to get rid of the high levels of uric acid from the body through urination. It may be noted that gout develops due to the presence of excessive amount of uric acid in the bloodstream. This, in turn, results in the formation of uric acid crystal which is deposited in the joints causing inflammation as well as a prickly and throbbing pain of a gout attack. Probenecid encourages the elimination of surplus uric acid from the body through urine and, thereby, helps to prevent gout attacks.

Side effects

Serious
  • back pain
  • bleeding
  • bruising
  • changes in skin color
  • cloudy or bloody urine
  • decrease in urine
  • difficult urination
  • fatigue
  • fever
  • hives
  • irregular heartbeat
  • itching
  • rash
  • sore throat
  • swelling around eyes
  • swollen face, feet, legs or fingers
  • tightness in chest
  • trouble breathing
  • ulcers
  • weight gain
  • white spots on lips or in mouth
  • yellow discoloration of the skin or eyes
Common
Less common

Possible interactions

Herbal medicines or minerals:
Specific herbal remedies and/ or minerals may interact with probenecid and, hence, they should never be used in conjunction. For instance, people suffering from gout should keep away from aspen while the use of lipase is likely to aggravate the gout attacks. In addition, acerola contains high amounts of vitamin C and, similar to acerola, use of inosine may possibly augment the uric acid levels in the bloodstream.
Foods:
Some foods may interact with probenecid and, therefore, it is suggested that you strictly follow the advice of your physician regarding the necessity of having a low-purine diet.
Beverages:
People taking probenecid should avoid taking beverages like tea, coffee or cola, as these may possibly blunt the efficiency of treating high levels of blood uric acid using probenecid.
Alcohol:
Consumption of large amounts of alcoholic beverages usually raises the level of uric acid in the bloodstream and, at the same time, lessens the efficacy of probenecid in curing the condition.

Discontinuation

People taking probenecid should never stop using this medication suddenly, especially without consulting their physician.

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