Ortho-Preferred

Probenecid



- Discussion:
    - uricosuric agent;
    - for Gout, maintenance of serum levels of penicillin;
    - inhibits tubular secretion of penicillins;
    - adult:
          - gout: 0.25gm bid for 1 week, then 0.5 gm PO bid;
          - penicillin: 1-2 gm PO 30min prior to dose of penicillin;

- Contraindications:
    - acute gout (must wait to attack has subsided), caution w/ blood dyscrasias, uric acid kidney stones, h/o PUD;
    - avoid concomitant use of penicillin in patients with renal impairment;
    - note that salicylates antagonize the uricosuric action of probenecid;
    - probenecid may not be effective when the GFR is <30ml/min;
    - when probenecid is used for gout, patient should alkalinize urine with Na HCO3 (3--7.5gm qd) and have adequate fluid intake to avoid crystalization of uric acid in acid urine;
    - may cause hemolysis in pt w/ G6PD deficiency



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, December 6, 2012 4:20 pm