Probenecid Medication: Uses, Dosage, Side Effects & Interactions

Summary of Key Points

Probenecid is a medication commonly used to treat conditions such as gout, hyperuricemia, and kidney stones by helping the body eliminate excess uric acid. It can also be combined with certain antibiotics to enhance their effectiveness. It is essential to follow your healthcare provider’s instructions carefully when taking Probenecid. If you have any questions or concerns, you can consult one of our providers through telemedicine for personalized advice.

Names of Medication

US Brand Name: Probalan

Generic Name: Probenecid

The generic name refers to the active ingredient in the medication and is listed in parentheses after the brand name.

Pharmacologic Category

Uricosuric Agent

Probenecid Dosage

Probenecid is prescribed for a variety of conditions. Below are the recommended doses for adults. Always consult your healthcare provider before making any changes to your medication. If you need to speak with a provider, you can schedule a telemedicine appointment with us.

1. Gout: The typical starting dose is 250 mg twice daily for 1 week, then increased to 500 mg twice daily. Your doctor may adjust the dose based on your response.
2. Hyperuricemia (high uric acid levels): The usual dose is 500 mg twice daily. The dose may be increased by 500 mg every 4 weeks, up to a maximum of 2 grams per day.
3. Kidney Stones: Start with 250 mg twice daily, increasing to 500 mg twice daily after 1 week. The duration of treatment will depend on your condition.
4. Chronic Gouty Arthritis: Begin with 250 mg twice daily for 1 week, then increase to 500 mg twice daily. Your doctor may adjust the dose based on your response.
5. Uric Acid Nephropathy: 500 mg twice daily, with the dose adjusted according to your doctor’s recommendations.
6. Psoriasis: 500 mg twice daily. Your doctor will determine the appropriate length of treatment.
7. Hemolytic Anemia: 500 mg twice daily. The dose may be adjusted based on your response and condition.
8. Tuberculosis (in combination with antibiotics): 500 mg twice daily. The duration of treatment will depend on the antibiotic regimen.
9. Syphilis (in combination with antibiotics): 500 mg twice daily. Your doctor will determine the length of treatment.
10. Osteoarthritis: 500 mg twice daily. The dose may be adjusted based on your condition and response to treatment.

Dosage Forms and Strengths

Tablet: 500 mg

How to Take Probenecid Safely

Probenecid is taken orally, usually twice daily, with or without food. It is important to drink plenty of water while taking this medication to help prevent kidney stones. Take Probenecid exactly as prescribed by your healthcare provider. Do not stop taking the medication without consulting your doctor, even if you start feeling better. If you miss a dose, take it as soon as you remember, but avoid doubling up on doses.

Probenecid Side Effects

Like all medications, Probenecid can cause side effects. Some are more common, while others are rare but potentially serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers for further guidance.

Common Side Effects of Probenecid

1. Headache: Mild to moderate headaches may occur.
2. Nausea: Some patients may experience an upset stomach or nausea.
3. Loss of appetite: A reduced desire to eat may occur.

Less Common but Serious Side Effects

1. Severe allergic reactions: Symptoms may include rash, itching, swelling, or difficulty breathing. Seek medical attention immediately if these occur.
2. Kidney problems: Watch for symptoms such as pain in your lower back or side, painful urination, or blood in your urine.
3. Liver issues: Be alert for signs like yellowing of the skin or eyes, dark urine, or extreme fatigue.

Contraindications for Probenecid

A contraindication is a specific situation where a medication should not be used because it may be harmful. If you have any of the following conditions, Probenecid may not be safe for you. Always consult with your healthcare provider before starting any new medication. If you have concerns, you can schedule a telemedicine appointment with one of our providers.

1. Severe kidney disease: Probenecid is primarily processed by the kidneys. If your kidneys are not functioning properly, Probenecid may not be effective and could worsen your condition.
2. History of kidney stones: Probenecid increases uric acid excretion, which can raise the risk of developing kidney stones in individuals prone to them.
3. Blood disorders (e.g., aplastic anemia, hemolytic anemia): Probenecid can affect blood cell production and may worsen these conditions.
4. Severe dehydration: Dehydration can increase the risk of kidney problems while taking Probenecid, as it may lead to higher concentrations of uric acid in the kidneys.
5. Hypersensitivity or allergic reactions: If you have had an allergic reaction to Probenecid or similar medications in the past, you should not take it.

Probenecid Drug Interactions

Probenecid can interact with other medications, potentially affecting their effectiveness or increasing the risk of side effects. It’s important to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with Probenecid:

1. Aspirin (Bayer, Ecotrin): Aspirin can reduce Probenecid’s ability to lower uric acid levels, making it less effective.
2. Penicillin (Pen-VK): Probenecid can increase the levels of penicillin in your body, which may be beneficial but could also raise the risk of side effects.
3. Cephalosporins (Keflex, Ceclor): Probenecid can elevate the concentration of these antibiotics, potentially leading to side effects.
4. NSAIDs (Ibuprofen, Naproxen): Nonsteroidal anti-inflammatory drugs may increase the risk of kidney problems when taken with Probenecid.
5. Methotrexate (Trexall): Probenecid can raise methotrexate levels, which could lead to toxicity.

Probenecid and Pregnancy

Is it safe to take Probenecid during pregnancy?

There is limited information on the safety of Probenecid during pregnancy. While animal studies have not shown significant harm, there is a lack of comprehensive human studies. Probenecid should only be used during pregnancy if the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, it’s essential to discuss the risks and benefits with your healthcare provider. You can also schedule a telemedicine consultation with one of our providers to discuss your specific situation.

Probenecid while Breastfeeding

Is it safe to take Probenecid while breastfeeding?

There is limited data on whether Probenecid passes into breast milk. Due to this uncertainty, caution is advised when taking Probenecid while breastfeeding. If you are breastfeeding or planning to breastfeed, it’s important to talk to your healthcare provider to weigh the potential risks and benefits. Our telemedicine providers are available to help you make an informed decision.

Estimated Cost of Probenecid Medication

The estimated cost of a 30-day supply of Probenecid without insurance, using a GoodRX coupon, typically ranges from $20 to $40. Prices may vary depending on the pharmacy and location. Be sure to check GoodRX or other discount programs for the most current pricing.

Possible Alternatives to Probenecid

If Probenecid is not the right option for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss these alternatives with your healthcare provider before making any changes to your treatment plan. You can also consult one of our telemedicine providers to explore these options further.

1. Gout: Alternatives include allopurinol (Zyloprim), febuxostat (Uloric), and lifestyle changes such as reducing alcohol intake, avoiding purine-rich foods (e.g., red meat, shellfish), and staying well-hydrated.
2. Hyperuricemia: Allopurinol or febuxostat may be used as alternatives. Dietary changes, such as reducing sugar and fructose intake, can also help lower uric acid levels.
3. Kidney stones: Increasing water intake, reducing sodium, and avoiding foods high in oxalates (e.g., spinach, nuts) can help prevent kidney stones. Medications like potassium citrate may also be used.
4. Chronic gouty arthritis: Allopurinol, febuxostat, or pegloticase (Krystexxa) may be considered. Physical therapy and anti-inflammatory medications can help manage symptoms.
5. Uric acid nephropathy: Allopurinol or febuxostat may be used to lower uric acid levels. Staying hydrated and avoiding dehydration are important lifestyle changes.
6. Psoriasis: Topical treatments, phototherapy, or systemic medications like methotrexate or biologics (e.g., adalimumab) may be used as alternatives.
7. Hemolytic anemia: Treatment depends on the underlying cause. Alternatives may include corticosteroids, immunosuppressants, or blood transfusions.
8. Tuberculosis: Probenecid is sometimes used to enhance the effectiveness of certain antibiotics. Alternative treatments include standard anti-tuberculosis medications such as isoniazid, rifampin, and ethambutol.
9. Syphilis: Penicillin remains the treatment of choice. Probenecid may be used to boost penicillin levels, but other antibiotics like doxycycline can be considered if penicillin is not an option.
10. Osteoarthritis: Non-drug treatments like physical therapy, weight management, and exercise can help manage symptoms. Medications like NSAIDs or corticosteroid injections may also be used.

Recent Updates on Probenecid Research

Recent research has explored the potential use of Probenecid beyond its traditional role in managing gout and hyperuricemia. Some studies are investigating its ability to enhance the effectiveness of antiviral medications, particularly in the treatment of COVID-19. Early findings suggest that Probenecid may inhibit viral replication, but more research is needed to confirm these results. Additionally, Probenecid is being studied for its potential to improve the efficacy of certain antibiotics by slowing their excretion from the body. These developments are still in the research phase, and Probenecid is not yet approved for these uses. If you are interested in learning more about ongoing studies or how this might impact your treatment, consult with one of our telemedicine providers.

James Kingsley

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