Pharm
Uricosuric
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Uricosuric
, Probenecid, Sulfapyrazine, Lesinurad, Zurampic, Duzallo
Indication
Rarely used now due to toxicity
Allopurinol
used most often for gout prophylaxis
Gout
for
Uric Acid
under-excreter
Indicated for
Urine Uric Acid
< 700 mg/24h
Mechanism
Increases
Uric Acid
excretion in
Gout
Indications
Requirements for use
Age <60 years
Normal
Renal Function
No history of renal stone
No overproduction of
Uric Acid
Preparations
Use concurrent
NSAID
or
Colchicine
when starting
Probenecid (Consider
Allopurinol
instead)
Dose: 250 mg PO bid
Maximum: 1500 mg PO bid
Sulfapyrazine (Rarely used)
Dose: 50 mg PO bid
Maximum: 100 mg PO bid
Lesinurad (Zurampic)
Dose: 200 mg orally each morning
Risk of
Acute Renal Failure
(should not be used as
Uric Acid
monotherapy)
Must be taken with
Xanthine Oxidase Inhibitor
(
Allopurinol
or Febuxostat)
Allopurinol
dose must be at least 300 mg/day (at least 200 if
CrCl
<60 ml/min)
Available as Duzallo (
Allopurinol
with Lesinurad)
As of 2017, costs $12/day (compared with $3/day for
Allopurinol
and probenacid)
(2017) Presc Lett 24(11): 64
Adverse effects
Dermatitis
Cytopenias
Reduces excretion of other drugs (e.g.
Penicillin
)
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