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Uricosuric
Aka: Uricosuric, Probenecid, Sulfapyrazine, Lesinurad, Zurampic, Duzallo- Indication
- Rarely used now due to toxicity
- Allopurinol used most often for gout prophylaxis
- Gout for Uric Acid under-excreter
- Indicated for Urine Uric Acid < 700 mg/24h
- Rarely used now due to toxicity
- Mechanism
- Indications: Requirements for use
- Age <60 years
- Normal Renal Function
- No history of renal stone
- No overproduction of Uric Acid
- Preparations
- Use concurrent NSAID or Colchicine when starting
- Probenecid (Consider Allopurinol instead)
- Dose: 250 mg PO bid
- Maximum: 1500 mg PO bid
- Sulfapyrazine (Rarely used)
- Dose: 50 mg PO bid
- Maximum: 100 mg PO bid
- Lesinurad (Zurampic)
- Dose: 200 mg orally each morning
- Risk of Acute Renal Failure (should not be used as Uric Acid monotherapy)
- Must be taken with Xanthine Oxidase Inhibitor (Allopurinol or Febuxostat)
- Allopurinol dose must be at least 300 mg/day (at least 200 if CrCl <60 ml/min)
- Available as Duzallo (Allopurinol with Lesinurad)
- As of 2017, costs $12/day (compared with $3/day for Allopurinol and probenacid)
- (2017) Presc Lett 24(11): 64
- Adverse effects
- Dermatitis
- Cytopenias
- Reduces excretion of other drugs (e.g. Penicillin)
| Medication Costs | ||
|---|---|---|
| probenecid (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
| PROBENECID 500 MG TABLET | Generic | $0.49 each |
| PROBENECID-COLCHICINE TABS | Generic | $0.75 each |
| FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. | ||
Probenecid (C0033209) |
|
|---|---|
| Definition (NCI_NCI-GLOSS) | A drug that is used to treat gout and is used together with some antibiotics to make them work better. It is being studied in the treatment of cancer. It belongs to the family of drugs called antibiotic therapy adjuncts. |
| Definition (NCI) | A benzoic acid derivative with antihyperuricemic property. Probenecid competitively inhibits the active reabsorption of urate at the proximal tubule in the kidney thereby increasing urinary excretion of uric acid and lowering serum urate concentrations. This prevents urate deposition and promotes resolution of existing urate deposits. In addition, probenecid modulates the transport of organic acids and acidic drugs at the proximal and distal renal tubule, thereby increasing the drug serum concentration. |
| Definition (CSP) | USP lists as a uricosuric, an agent that promotes uric acid secretion in urine. |
| Definition (MSH) | The prototypical uricosuric agent. It inhibits the renal excretion of organic anions and reduces tubular reabsorption of urate. Probenecid has also been used to treat patients with renal impairment, and, because it reduces the renal tubular excretion of other drugs, has been used as an adjunct to antibacterial therapy. |
| Definition (PSY) | Agent that promotes the urinary excretion of uric acid. |
| Definition (PDQ) | A benzoic acid derivative with antihyperuricemic property. Probenecid competitively inhibits the active reabsorption of urate at the proximal tubule in the kidney thereby increasing urinary excretion of uric acid and lowering serum urate concentrations. This prevents urate deposition and promotes resolution of existing urate deposits. In addition, probenecid modulates the transport of organic acids and acidic drugs at the proximal and distal renal tubule, thereby increasing the drug serum concentration. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40223&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40223&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C772" NCI Thesaurus) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D011339 |
| SnomedCT | 387365004, 66094001 |
| LNC | LP16260-9, MTHU007603 |
| English | probenecid, Benzoic acid, 4-((dipropylamino)sulfonyl)-, Major Brand of Probenecid, Martec Brand of Probenecid, Parmed Brand of Probenecid, Probenecid Major Brand, Probenecid Martec Brand, Probenecid Parmed Brand, Probenecid Zenith Brand, Zenith Brand of Probenecid, PROB, probenecid (medication), Probenecid [Chemical/Ingredient], PROBENECID, Probenecid (product), Probenecid (substance), Probenecid |
| Swedish | Probenecid |
| Czech | probenecid |
| Finnish | Probenesidi |
| Russian | PROBENETSID, PROBETSID, ПРОБЕНЕЦИД, ПРОБЕЦИД |
| Japanese | プロベネシッド, プロベシド, プロベネシド |
| Spanish | Probenecid, Probenecida, probenecid (producto), probenecid (sustancia), probenecid |
| Polish | Probenecyd |
| French | Probénécide |
| German | Probenecid |
| Italian | Probenecid |
| Portuguese | Probenecid |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Uricosuric Agents (C0041983) |
|
|---|---|
| Definition (MSH) | Gout suppressants that act directly on the renal tubule to increase the excretion of uric acid, thus reducing its concentrations in plasma. |
| Concepts | Pharmacologic Substance (T121) |
| MSH | D014528 |
| SnomedCT | 371344006, 372758007, 49157004 |
| English | Agents, Uricosuric, Uricosuric Agents, uricosuric agents, Uricosuric product (product), Uricosuric agent, Uricosuric agent (substance), Uricosuric agent (product), Uricosuric product, uricosuric agent, Uricosuric agent, NOS, Hyperuricaemia Agents, Uricosuric Agent |
| French | Médicaments uricosuriques, Agents uricosuriques, Uricosuriques |
| Swedish | Utsöndring av urinsyra, medel för |
| Czech | urikosurika |
| Finnish | Urikosuurisesti vaikuttavat aineet |
| Russian | MOCHEVOI KISLOTY VYVEDENIE, LEKARSTVENNYE SREDSTVA, SREDSTVA, SNIZHAIUSHCHIE KONTSENTRATSIIU MOCHEVOI KISLOTY, МОЧЕВОЙ КИСЛОТЫ ВЫВЕДЕНИЕ, ЛЕКАРСТВЕННЫЕ СРЕДСТВА, СРЕДСТВА, СНИЖАЮЩИЕ КОНЦЕНТРАЦИЮ МОЧЕВОЙ КИСЛОТЫ |
| Polish | Leki moczanopędne |
| Portuguese | Uricosúricos, Agentes Uricúricos, Agentes Uricosúricos, Uricúricos |
| Spanish | Uricosúricos, producto con agente uricosúrico, producto con agente uricosúrico (producto), Agentes Uricosúricos, agente uricosúrico (sustancia), agente uricosúrico, agente uricosúrico (producto) |
| German | Urikosurika |
| Italian | Preparati favorenti l'escrezione di acido urico |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
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