Names and pronunciation
(proe-ben′e-sid)
PDF page 1085
Loading InternPractice…
Drug reference
(proe-ben′e-sid)
PDF page 1085
Func. class.: Uricosuric, antigout agent
PDF page 1085
Chem. class.: Sulfonamide derivative
PDF page 1085
ACTION: Inhibits tubular reabsorption of urates, with increased excretion of uric acids
PDF page 1085
USES: Hyperuricemia in gout, gouty arthritis, adjunct to penicillin treatment
PDF page 1085
CONTRAINDICATIONS: Hyper sensitivity, severe renal/hepatic disease, CCr <50 mg/min, history of uric acid calculus Precautions: Pregnancy, children <2 yr, sulfonamide hypersensitivity, peptic ulcer
PDF page 1085
SIDE EFFECTS CNS: Drowsiness, headache, flushing CV: Bradycardia GI: Gastric irritation, nausea, vomit ing, anorexia, hepatic necrosis GU: Glycosuria, thirst, frequency, nephrotic syndrome INTEG: Rash, dermatitis, pruritus, fever META: Acidosis, hypokalemia, hyper chloremia, hyperglycemia RESP: Apnea, irregular respirations
PDF page 1085
INTERACTIONS Increase: effect of acyclovir, barbiturates, allopurinol, benzodiazepines, dyphylline, zidovudine, cephalosporins, penicillins, sulfonamides Increase: toxicity—sulfa products, dap- sone, clofibrate, indomethacin, rifAMPin, naproxen, methotrexate Decrease: action of probenecid— salicylates Drug/Lab Test Increase: theophylline levels
PDF pages 1085, 1086
DOSAGE AND ROUTES Adjunct to penicillin • Adult/adolescent >15 yr, >50 kg (110 lb): PO 500 mg qid Gout/gouty arthritis • Adult: PO 250 mg bid for 1 wk, then 500 mg bid, max 2 g/day; maintenance 500 mg/day × 6 mo Adjunct in penicillin treatment • Adult and adolescent >50 kg: PO 500 mg qid • Child <50 kg: PO 25 mg/kg, then 40 mg/kg in divided doses qid Renal dose • Avoid use if CCr <50 mL/min
PDF page 1085
Available forms: Tabs 500 mg
PDF page 1085
Administer: • After meals or with milk if GI symp- P toms occur • Increase fluid intake to 2-3 L/day to prevent urinary calculi
PDF page 1085
Assess: • Uric acid levels (3-7 mg/dL); mobility, joint pain, swelling, maintain fluid intake at 2-3 L/day • Respiratory rate, rhythm, depth; notify prescriber of abnormalities • Electrolytes; CO2 before, during treat- ment • Urine pH, output, glucose during be- ginning treatment, poor effect in GFR <30 mL/min • For CNS symptoms: confusion, twitch- ing, hyperreflexia, stimulation, headache; may indicate overdose • Beers: avoid in older adults with cre- atinine clearance <30 mL/min
PDF page 1086
Evaluate: • Therapeutic response: absence of pain, stiffness in joints
PDF page 1086
CLINICAL CONSIDERATIONS
PDF page 1086
Patient and caregiver information: • To avoid OTC preparations (aspirin) unless directed by prescriber; to increase water intake, avoid alcohol, caffeine
PDF page 1086
PHARMACOKINETICS Peak 2-4 hr, duration 8 hr, half-life 5-8 hr; metabolized by liver; excreted in urine
PDF page 1085
• Adult/adolescent >15 yr, >50 kg (110 lb): PO 500 mg qid Gout/gouty arthritis
PDF page 1085
• Adult: PO 250 mg bid for 1 wk, then 500 mg bid, max 2 g/day; maintenance 500 mg/day × 6 mo Adjunct in penicillin treatment
PDF page 1085
• Adult and adolescent >50 kg: PO 500 mg qid
PDF page 1085
• Child <50 kg: PO 25 mg/kg, then 40 mg/kg in divided doses qid Renal dose
PDF page 1085
• Avoid use if CCr <50 mL/min
PDF page 1085