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Probenecid (Benemid)
Available:
500 mg tablets
Dose:
Initial dose of 250 mg twice daily for the first week, then
500 mg twice daily, adjusted if needed up to 1 gram twice
daily if needed to reduce uric acid levels
Cost:
Generic 500 mg, 60 pills = $34.99
Side
effects: This medication is usually well-tolerated, but
can cause nausea, decreased appetite, and rash. Because
probenecid works by increasing uric acid excretion in the
urine, fluid intake must be adequate, and individuals with a
history of uric acid stones or impaired kidney function are
not good candidates to take this medication.
Monitoring:
Uric acid levels should be checked every 2-4 weeks while
adjusting the dose of probenecid and can be monitored less
frequently thereafter.
Important
points to know: Take this medication with food to
decrease upset stomach. Drink enough fluid to produce about 2
quarts of urine daily. The dose of probenecid should not be
adjusted during an attack of gout, as it may worsen the
symptoms. Like allopurinol, it is used to prevent attacks,
not to treat them while they are occurring.
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