Benemid: Effective Uric Acid Control for Gout Management
| Product dosage: 500mg | |||
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Synonyms | |||
Benemid (probenecid) is a well-established uricosuric agent specifically formulated for the long-term management of chronic gout and gouty arthritis. It functions by increasing the urinary excretion of uric acid, thereby lowering serum urate levels and preventing the formation of tophi and acute gouty attacks. This medication is a cornerstone in prophylactic therapy, particularly for patients who exhibit underexcretion of uric acid and have not responded adequately to conservative measures like diet modification or colchicine alone. Proper patient selection and adherence to dosing protocols are critical for achieving optimal therapeutic outcomes and minimizing the risk of renal complications.
Features
- Active ingredient: Probenecid 500 mg
- Pharmacological class: Uricosuric agent
- Mechanism of action: Inhibits renal tubular reabsorption of uric acid
- Form: Oral tablets
- Standard packaging: 100 tablets per bottle
- Prescription-only medication
Benefits
- Effectively reduces serum urate levels to below 6 mg/dL, the saturation point for uric acid
- Prevents formation of new tophi and promotes resorption of existing deposits
- Decreases frequency and severity of acute gout attacks when used prophylactically
- May be combined with colchicine to enhance prophylaxis during initial therapy
- Provides long-term management solution for chronic gout patients
- Reduces risk of joint damage and deformity associated with advanced gout
Common use
Benemid is primarily indicated for the treatment of hyperuricemia associated with gout and gouty arthritis. It is particularly effective in patients who are underexcretors of uric acid, as determined by 24-hour urinary uric acid measurement. The medication is not intended for use during acute gout attacks but rather as maintenance therapy to prevent recurrent episodes. It may also be used as an adjunct to antibiotic therapy to elevate and prolong antibiotic plasma levels, particularly with penicillin derivatives.
Dosage and direction
Initial therapy: 250 mg twice daily for one week, followed by 500 mg twice daily. Dosage may be increased by 500 mg every 4 weeks until satisfactory control is achieved, not to exceed 2-3 grams daily.
Maintenance therapy: Typically 1-2 grams daily in divided doses. Many patients respond to 1 gram daily, while some may require up to 2 grams.
Administration: Should be taken with food or antacids to minimize gastrointestinal upset. Adequate fluid intake (2-3 liters daily) is essential to prevent uric acid stone formation. Tablets should be swallowed whole and not crushed or chewed.
Precautions
Regular monitoring of serum uric acid levels is recommended, especially during dosage adjustment periods. Renal function should be assessed periodically, as impaired renal function may reduce efficacy. Patients should be advised to maintain adequate hydration to minimize risk of uric acid nephrolithiasis. Caution is advised in patients with history of peptic ulcer disease. Blood counts may be warranted during prolonged therapy.
Contraindications
Hypersensitivity to probenecid or any component of the formulation. Not recommended for children under 2 years of age. Contraindicated in patients with blood dyscrasias or uric acid kidney stones. Should not be used during acute gout attacks until inflammation has subsided. Contraindicated in patients with known glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Possible side effect
Common reactions include gastrointestinal disturbances (nausea, vomiting, loss of appetite), headache, and dizziness. Less frequently, patients may experience flushing, sore gums, urinary frequency, or hair loss. Hypersensitivity reactions including dermatitis, pruritus, and fever may occur. Rare cases of nephrotic syndrome, hepatic necrosis, and aplastic anemia have been reported.
Drug interaction
Significant interactions occur with salicylates (aspirin), which antagonize uricosuric effect. May increase plasma levels of penicillins, cephalosporins, and other beta-lactam antibiotics. Enhances effects of oral hypoglycemic agents, NSAIDs, and methotrexate. Concurrent use with sulfonylureas may prolong their hypoglycemic effect. May interfere with laboratory tests for theophylline.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed one. Maintain regular dosing schedule to ensure consistent uric acid control.
Overdose
Symptoms may include nausea, vomiting, dizziness, and convulsions. No specific antidote exists. Treatment should be supportive and symptomatic. Gastric lavage may be considered if ingestion was recent. Maintain adequate hydration and renal function. Hemodialysis may be effective in removing probenecid.
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Protect from light and moisture. Keep container tightly closed. Do not store in bathroom or other humid areas. Keep out of reach of children and pets.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual patient responses may vary, and proper medical supervision is essential for safe and effective use. Not all possible interactions, uses, or effects are listed here.
Reviews
Clinical studies demonstrate that Benemid effectively maintains serum urate levels below 6 mg/dL in approximately 70-80% of compliant patients. Long-term follow-up studies show significant reduction in acute gout attacks and tophus size over 12-24 months of continuous therapy. Patient satisfaction surveys indicate improved quality of life measures when adequate uric acid control is achieved. Most adverse effects are reported as mild to moderate and often diminish with continued therapy.