Probenecid

Probenecid is primarily used to treat chronic gout and gouty arthritis. It helps in increasing the excretion of uric acid through the kidneys, thereby reducing serum urate levels. It is also used to enhance the effectiveness of certain antibiotics by preventing their excretion in urine, thus maintaining higher plasma levels.

Probenecid works by inhibiting the reabsorption of urate in the renal tubules. This increases the urinary excretion of uric acid and decreases serum urate levels. This action helps reduce the miscible urate pool, retards urate deposition, and promotes the resorption of urate deposits, effectively managing conditions like gout.

For adults, the usual daily dose of Probenecid for treating gout is 250 mg twice a day for one week, followed by 500 mg twice a day. For children aged 2 to 14 years, the initial dose is 25 mg/kg body weight with a maintenance dose of 40 mg/kg body weight per day divided into 4 doses. Probenecid is contraindicated in children under 2 years of age.

Common side effects of Probenecid include headache, upset stomach, vomiting, and dizziness. Serious adverse effects can include severe skin rash, difficulty breathing, and unusual bleeding or bruising. Patients should report any severe or persistent side effects to their healthcare provider immediately.

Important warnings for Probenecid include the potential for exacerbation of gout attacks when starting therapy, hypersensitivity reactions, and interactions with other medications like methotrexate and salicylates. Contraindications include hypersensitivity to Probenecid, children under 2 years, and individuals with blood dyscrasias or uric acid kidney stones. Therapy should not start during an acute gout attack.