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|Probalan

PROBENECID (Systemic)

Some commonly used brand names are:

In the U.S.—

• Benemid
• Probalan

In Canada—

• Benemid
• Benuryl

Generic name product may be available in the U.S.

Category

• Antibiotic therapy adjunct
• Antigout agent
• Antihyperuricemic

Description

Probenecid (proe-BEN-e-sid) is used in the treatment of chronic gout or gouty arthritis. These conditions are caused by too much uric acid in the blood. The medicine works by removing the extra uric acid from the body. Probenecid does not cure gout, but after you have been taking it for a few months it will help prevent gout attacks. This medicine will help prevent gout attacks only as long as you continue to take it.

Probenecid is also used to prevent or treat other medical problems that may occur if too much uric acid is present in the body.

Probenecid is sometimes used with certain kinds of antibiotics to make them more effective in the treatment of infections.

Probenecid is available only with your doctor"s prescription, in the following dosage form:

• Oral
• Tablets (U.S. and Canada)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For probenecid, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to probenecid. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Probenecid has not been shown to cause birth defects or other problems in humans.

Breast-feeding—Probenecid has not been reported to cause problems in nursing babies.

Children—Probenecid has been tested in children 2 to 14 years of age for use together with antibiotics. It has not been shown to cause different side effects or problems than it does in adults. Studies on the effects of probenecid in patients with gout have been done only in adults. Gout is very rare in children.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. There is no specific information comparing use of probenecid in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking probenecid, it is especially important that your health care professional know if you are taking any of the following:

• Antineoplastics (cancer medicine)—The chance of serious side effects may be increased

• Aspirin or other salicylates—These medicines may keep probenecid from working properly for treating gout, depending on the amount of aspirin or other salicylate that you take and how often you take it

• Heparin—Probenecid may increase the effects of heparin, which increases the chance of side effects

• Indomethacin (e.g., Indocin) or
• Ketoprofen (e.g., Orudis) or
• Methotrexate (e.g., Mexate)—Probenecid may increase the blood levels of these medicines, which increases the chance of side effects

• Medicine for infection, including tuberculosis or virus infection—Probenecid may increase the blood levels of many of these medicines. In some cases, this is a desired effect and probenecid may be used to help the other medicine work better. However, the chance of side effects is sometimes also increased

• Nitrofurantoin (e.g., Furadantin)—Probenecid may keep nitrofurantoin from working properly

• Zidovudine (e.g., AZT, Retrovir)—Probenecid increases the blood level of zidovudine and may allow lower doses of zidovudine to be used. However, the chance of side effects is also increased

Other medical problems—The presence of other medical problems may affect the use of probenecid. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood disease or
• Cancer being treated by antineoplastics (cancer medicine) or radiation (x-rays) or
• Kidney disease or stones (or history of) or
• Stomach ulcer (history of)—The chance of side effects may be increased

Proper Use of This Medicine

If probenecid upsets your stomach, it may be taken with food. If this does not work, an antacid may be taken. If stomach upset (nausea, vomiting, or loss of appetite) continues, check with your doctor.

For patients taking probenecid for gout :

• After you begin to take probenecid, gout attacks may continue to occur for a while. However, if you take this medicine regularly as directed by your doctor, the attacks will gradually become less frequent and less painful than before. After you have been taking probenecid for several months, they may stop completely.
• This medicine will help prevent gout attacks but it will not relieve an attack that has already started. Even if you take another medicine for gout attacks, continue to take this medicine also . If you have any questions about this, check with your doctor.

For patients taking probenecid for gout or to help remove uric acid from the body :

• When you first begin taking probenecid, the amount of uric acid in the kidneys is greatly increased. This may cause kidney stones or other kidney problems in some people. To help prevent this, your doctor may want you to drink at least 10 to 12 full glasses (8 ounces each) of fluids each day, or to take another medicine to make your urine less acid. It is important that you follow your doctor"s instructions very carefully.

Dosing—The dose of probenecid will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of probenecid. If your dose is different, do not change it unless your doctor tells you to do so.

• For treating gout or removing uric acid from the body :
  • Adults: 250 mg (one-half of a 500-mg tablet) two times a day for about one week, then 500 mg (one tablet) two times a day for a few weeks. After this, the dose will depend on the amount of uric acid in your blood or urine. Most people need 2, 3, or 4 tablets a day, but some people may need higher doses.
  • Children: It is not likely that probenecid will be needed to treat gout or to remove uric acid from the body in children. If a child needs this medicine, however, the dose would have to be determined by the doctor.
• For helping antibiotics work better :
  • Adults: The amount of probenecid will depend on the condition being treated. Sometimes, only one dose of 2 tablets is needed. Other times, the dose will be 1 tablet four times a day.
  • Children: The dose will have to be determined by the doctor. It depends on the child"s weight, as well as on the condition being treated. Older children and teenagers may need the same amount as adults.

Missed dose—If you are taking probenecid regularly and you miss a dose, take the missed dose as soon as possible. However, if you do not remember until it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If you will be taking probenecid for more than a few weeks, your doctor should check your progress at regular visits.

Before you have any medical tests, tell the person in charge that you are taking this medicine. The results of some tests may be affected by probenecid.

For diabetic patients :

• Probenecid may cause false test results with copper sulfate urine sugar tests (Clinitest[reg ]), but not with glucose enzymatic urine sugar tests (Clinistix[reg ]). If you have any questions about this, check with your health care professional.

For patients taking probenecid for gout or to help remove uric acid from the body :

• Taking aspirin or other salicylates may lessen the effects of probenecid. This will depend on the dose of aspirin or other salicylate that you take, and on how often you take it. Also, drinking too much alcohol may increase the amount of uric acid in the blood and lessen the effects of this medicine. Therefore, do not take aspirin or other salicylates or drink alcoholic beverages while taking this medicine , unless you have first checked with your doctor.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 12/21/1999

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