Probenecid for Gout
An effective, long term treatment of gout should answer the underlying cause of gout: high uric acid level in the body or hyperuricemia. The primary goal then is to lower the uric acid to normal levels, lower than 6mg/ml. In terms of medication, there are two ways of doing this: one is by using uric acid inhibitors, drugs that reduce the production of uric acid during normal metabolic functions and the other is by using uricosurics, those drugs that increase its excretion or removal by the kidneys. Since efficient removal of uric acid by the kidneys is the cause for hyperuricemia in most patients developing gout, the use of uricosurics is indeed a very important mode of treatment.
One commonly prescribed uricosuric for gout patients is Probenecid. It prevents the kidneys from re-absorbing uric acid thereby increasing its excretion or removal in the urine. By doing so, uric acid in the blood is lowered, consequently lowering the risk for crystallization around the joints and helping uric acid crystals already in the joints to re-dissolve into the blood.
Aside from this uric-acid lowering property of Probenecid, it has also been proven to help certain antibiotics become more effective in the treatment of infection. In fact, it has been used to extend limited supplies of penicillin during World War II and is still being used now to increase its concentration during treatment of serious infections. In another study, Probenecid is also able to do the same with antiviral medications such as oseltamivir (also known as Tamiflu), used for treatment of influenza.
Probenecid for Gout – brand names
Probenecid is marketed under the following brand names: Probecid, Benuryl, Pro-Cid, Benecid, Probalan and Benemid. For treatment of gout in adults, the recommended dosage of Probenecid is 250mg two times a day for one week followed by 500mg twice daily for a few weeks. Subsequent dosages will depend on the amount of uric acid still remaining.
These are just average numbers and in actuality, dosage may vary from person to person. A missed dose must be taken right away, if it is very close to the next dose, it is advised to skip the missed dose and continue with the next one. This is very important because lowering uric acid to fast can trigger acute gout attacks.
Probenecid Precautions
Probenecid’s effect is known to be lessened by salicylates like aspirin and alcohol. It has also been to clinically interact with other gout medications like Indomethacin and Naproxen. In terms of side-effects, as a uricosuric, Probenecid increases uric acid in the urine increasing the risk for uric acid kidney stone formations. Patients are advised to take 10-12 glasses of water daily when taking this medication. Other patients even complement Probenecid medication with an alkalizing diet. There are also other side-effects like extreme headaches and dizziness, vomiting, nausea, sore gums, dermatitis and flushing.
Always clarify with your doctor on any reactions felt when taking it as there are many medications that can interact adversely with Probenecid.