Sulfinpyrazone for Gout
Another uric acid lowering drug is Sulfinpyrazone (spelled Sulphinpyrazone in the UK). Like other uricosuric drugs, Sulfinpyrazone reduces uric acid in the blood plasma by increasing its excretion in the urine. It does this by preventing the kidneys from reabsorbing the uric acid.
Sulfinpyrazone Precautions
Sulfinpyrazone should not be given to patients during an acute gout attack. In case an acute attack happens while already taking it, doctors advise continuation of the treatment and treating the attack separately. It must be given with care to patients with kidney and liver malfunction and must not be given at all to patients with severe impairment of both kidneys and liver.
It is contra-indicated in patients with blood coagulation disorders nor should it be given to patients with peptic ulcer or a history of peptic ulcer. It should also not be given to patients with allergies to it and any derivatives of pyrazole, the drug from which it is derived.
As with other uricosuric, the risk for uric acid kidney stone formation is high due to acidity from high uric acid in the urine. Patients taking Sulfinpyrazone are therefore advised to increase fluid intake to as much as 2 to 3 liters per day. Patients undergoing prolonged treatment with Sulfinpyrazone are also recommended to monitor their blood counts and renal functions.
Sulfinpyrazone for Gout – Dosage
In the UK, where Sulfinpyrazone is the only widely available uricosuric, the initial dosage is 100 to 200mg daily. In the US, it was allowed up to 200mg twice daily. It should be taken with water or milk. This can be gradually increased over the next 1 to 3 weeks until 600mg daily is reached. It is not recommended to increase the dosage beyond 800mg daily.
When the uric acid level has sufficiently lowered, maintenance dose of 200 mg daily may be given. The most common brand name for Sulfinpyrazone is Anturan (UK) or Anturane (US). This brand name is no longer available in the US but generic Sulfinpyrazone is still available. Sulfinpyrazone is administered in both tablets and capsules.
Sulfinpyrazone for Gout – Side Effects
Its most common side-effects are related to the stomach such as nausea, vomiting, diarrhea and abdominal pain. It has been known to worsen an existing peptic ulcer condition and can lead to severe gastric bleeding. On rare occasions, blood related side-effects like aplastic anemia and leucopenia have been reported.
Interactions with other drugs
Sulfinpyrazone reacts with salicylates like aspirin and should not be given with it. It is likewise antagonistic with coumarin anticoagulants such as warfarin which used to treat heart-related problems.
There are many uricosuric drugs available as well other alternative treatments that can lower uric acid. Before considering a specific drug or treatment, it is best that all options are laid out and a risk-benefit assessment is made by you and your doctor for every option available.