probenecid
Probenecid is commonly used to prevent gout attacks in the long run, but it doesn't help relieve pain and swelling during a sudden gout attack. It's also sometimes used with certain antibiotics, such as penicillin, to boost their ability to fight infections. Probenecid comes as tablets that are taken by mouth twice daily for gout. Some side effects of this medication include headache, dizziness, and sometimes kidney stones. Probenecid might also have a few interactions with other medications.
What is Probenecid?
What is Probenecid used for?
- Gout (joint pain and swelling caused by high uric acid levels)
- Boosting antibiotic activity to fight infections
How Probenecid works
Probenecid is an antigout medication. Gout is a form of joint pain and swelling caused by high uric acid levels in your body. Probenecid works in your kidney to get rid of extra uric acid in the body. It helps move the extra uric acid into your urine so you can urinate it out. This helps lower the uric acid levels in your body to treat gout.
Probenecid also blocks the kidney from getting rid of certain antibiotics. As a result, the antibiotics stay in your body for a longer period of time, and their ability to fight infections gets boosted.
Drug facts
Side effects of Probenecid
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache
- Dizziness
- Sudden gout attack (sharp pain and swelling at the joints)
- Nausea
- Vomiting
- Kidney stones
Probenecid serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Kidney stone: severe back pain, stomach pain, blood in your urine, fever, chills
The following Probenecid side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Fast or irregular breathing
puffiness or swellings of the eyelids or around the eyes
shortness of breath, troubled breathing, tightness in chest, or wheezing
changes in the skin color of the face occurring together with any of the other side effects listed here
or skin rash, hives, or itching occurring together with any of the other side effects listed here
Check with your doctor as soon as possible if any of the following side effects occur:
Less common
Bloody urine
difficult or painful urination
lower back or side pain (especially if severe or sharp)
skin rash, hives, or itching (occurring without other signs of an allergic reaction)
Rare
Cloudy urine
cough or hoarseness
fast or irregular breathing
pain in back and/or ribs
sores, ulcers, or white spots on lips or in mouth
sore throat and fever with or without chills
sudden decrease in the amount of urine
swelling of face, fingers, feet, and/or lower legs
swollen and/or painful glands
unusual bleeding or bruising
unusual tiredness or weakness
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Dizziness
flushing or redness of face (occurring without any signs of an allergic reaction)
frequent urge to urinate
sore gums
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Probenecid
Pros
- Helps treat the cause of gout
- Can use for children 2 years and older (for treatment of infections with certain antibiotics only)
- Available as a lower-cost generic medication
Cons
- Not a first-choice option for gout
- Can't take aspirin at the same time because it might raise the risk for a gout attack
- Might not work as well for people with severe kidney problems
Pharmacist tips for Probenecid
- Drink plenty of water while taking probenecid. Being well hydrated helps prevent kidney stones that might form during treatment.
- If you're having a gout attack and you haven't started your probenecid treatment yet, wait until you're feeling better to start the medication. Probenecid doesn't work well to relieve sudden, sharp pain and swelling in your joints.
- Gout attacks can happen when you first start taking probenecid. If you have an attack while taking probenecid, continue the medication at the same dose. Make sure to talk to your healthcare provider about taking additional medication (e.g., ibuprofen (Advil), colchicine (Colcrys)) that can treat these gout attacks.
- If you're still having gout attacks after using probenecid for a while, speak with your provider. They might order a blood test to check your uric acid levels. If your levels are still high, your provider might raise your dose of probenecid or they might switch you to different medication to help treat gout.
- Don't take aspirin (325 mg or 81 mg) with probenecid. Aspirin can make probenecid not work as well to get rid of uric acid from your body. As a result, taking aspirin with probenecid can raise your risk of gout attacks. Ask your provider for alternatives for aspirin or probenecid.
- Let your provider know about all the medications you're taking or planning to take. They can make sure they're safe for you to take with probenecid. Probenecid can block the kidney from getting rid of certain medications, such as methotrexate, from your body. This might raise your risk of side effects from these medications.
Common questions about Probenecid
Probenecid is sometimes prescribed along with penicillin or certain other antibiotics to help them stay in your body longer and fight infections better. Normally, your kidneys help get rid of some antibiotics from your body in the form of urine. But, probenecid blocks your kidneys from doing so, which helps boosts the activity of the antibiotics in the body.
No, probenecid isn't the same as colchicine (Colcrys). These two medications help with different aspects of gout. Colchicine (Colcrys) works short term to help prevent sudden gout attacks. It can also lower pain and swelling during these attacks. On the other hand, probenecid works long term to help get rid of the cause of gout by lowering uric acid in the body. Because probenecid and colchicine (Colcrys) work on different aspects of gout, it might be helpful to have both medications on hand. Speak with your provider if you need both medications to help manage your gout.
No, probenecid isn't the same as allopurinol (Zyloprim). Although they're both used to treat the cause of gout, the two medications work differently to lower uric acid levels in the body. Probenecid works by helping the body get rid of uric acid through the kidneys and into the urine. On the other hand, allopurinol (Zyloprim) works by blocking the body from making uric acid in the first place. Clinical guidelines also recommend allopurinol (Zyloprim) as a first-choice option rather than probenecid to lower uric acid levels. Speak with your provider about which gout medication is right for you.
Probenecid works by helping the body get rid of uric acid through the kidneys and into the urine. Sometimes, a kidney stone can form because of the way the medication works. Kidney stones might lead to urinary tract infections (UTIs) or raise your risk of kidney problems. If you're taking probenecid, make sure to drink plenty of fluids to prevent kidney stones. But contact your provider if you feel lower back or side pain, cloudy or bloody urine, or feel like you need to use the restroom often; you might have a kidney stone. Your provider can recommend ways to treat it to prevent possible kidney complications.
It's not known whether you can drink alcohol while you're taking probenecid. But in general, it's best to limit how much you drink or avoid drinking altogether if you have gout. Drinking any amount of alcohol can raise your risk of gout attacks. This is because alcoholic beverages contain purines, a chemical substance that the body breaks down into uric acid. By drinking alcohol, there's a higher amount of purines in your body and as a result, a higher amount of uric acid. This can worsen your gout. Speak with your healthcare provider about your drinking habits while you're taking probenecid and how it affects your gout.
It's important to talk to your healthcare provider about the risks and benefits of taking probenecid if you're pregnant or breastfeeding. Probenecid can be passed to your baby through the umbilical cord, but we don't know how this affects your baby. The medication can also be found in breast milk at low levels. It's thought that this low level of medication wouldn't be harmful to breastfed babies, but more research is needed in this area. Speak with your provider whether you need a different gout medication that might be safer for you and your baby.
Since probenecid can boost antibiotic activity, the CDC guidelines recommend using this medication along with certain antibiotics as an option to treat pelvic inflammatory disease (PID). The CDC guidelines also recommend probenecid as part of an alternative treatment regimen (meaning it's not a first-choice treatment option) for adults with syphilis if the sexually transmitted infection affects the brain, eyes, or ears. If you have PID or syphilis, ask your healthcare provider if probenecid is right for you.
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Risks and warnings for Probenecid
Probenecid can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Kidney stones
It's possible to get kidney stones while you're taking probenecid for gout. Make sure to drink plenty of water each day during treatment. Let your healthcare provider know if you have severe back pain, stomach pain, blood in your urine, or fever and chills. These symptoms might mean you have a kidney stone.
Risk of blood problems in certain people
- Risk factors: Glucose-6-phosphate dehydrogenase (G6PD) deficiency
People with a genetic condition called G6PD deficiency are at higher risk of developing rare, but serious blood problems while taking probenecid. These problems include low white blood cell counts and low red blood cell counts (anemia). A symptom of having low white blood cells is getting sick more often. Symptoms of anemia include feeling tired, weak, or dizzy, or having pale skin. If you have G6PD deficiency or experience these symptoms, talk to your provider to see whether there's another medication for gout that's right for you.
Probenecid dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 500mg | 180 tablets | $53.63 | $0.30 |
Typical dosage for Probenecid
Gout
- Adults: The typical starting dose is 250 mg by mouth twice per day for 1 week. Then, the dose will be raised to 500 mg twice per day. The maximum dose of probenecid is 2 grams per day.
Boosting the ability of antibiotics to fight infections
- People older than 14 years of age or children weighing more than 110 lbs (50 kg): The typical dose is 2 grams by mouth per day, separated into smaller doses and taken throughout the day. The dose might differ for adults 65 years or older with kidney problems.
- Children 2 to 14 years old or children who weigh 110 lbs (50 kg) or less: The dose will depend on your child's weight. The typical starting dose is 25 mg/kg of body weight by mouth as a single dose. Then, the dose will be raised to a maintenance dose of 40 mg/kg of body weight per day, split into 4 doses and taken throughout the day.
- Children under 2 years of age: Probenecid can't be used in children in this age group. Ask your child's healthcare provider about other medications that might be more appropriate for your child.
Boosting the ability of antibiotics to treat gonorrhea
- The dose of probenecid is 1 gram by mouth as a single dose, in addition to the antibiotic that's prescribed for your gonorrhea.
Interactions between Probenecid and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Avibactam
- Baricitinib
- Cephalexin
- Citalopram
- Deferiprone
- Doripenem
- Indomethacin
- Lumateperone
- Methotrexate
- Naproxen
- Pegloticase
- Pexidartinib
- Sacituzumab Govitecan-hziy
- Zalcitabine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amoxicillin
- Aspirin
- Bismuth Subsalicylate
- Cefditoren Pivoxil
- Cefotaxime
- Cefpodoxime Proxetil
- Cefprozil
- Choline Magnesium Trisalicylate
- Ciprofloxacin
- Enprofylline
- Ertapenem
- Gatifloxacin
- Lorazepam
- Magnesium Salicylate
- Meropenem
- Norfloxacin
- Phenprocoumon
- Piretanide
- Pralatrexate
- Sodium Salicylate
- Sodium Thiosalicylate
- Zidovudine
- Zomepirac
How much does Probenecid cost?
$53.63
Probenecid contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Probenecid will not be safe for you to take.
- Children younger than 2 years of age
- Blood problems
- Uric acid kidney stones
- Take aspirin
What are alternatives to Probenecid?
Probenecid images
