Question

Following his third episode of gouty arthritis, a 50-year-old man sees you in the clinic. Each case was successfully treated acutely; however, your patient is interested in trying to prevent future episodes. He is not on regular medications and has a normal physical examination today. Blood work reveals an elevated serum uric acid level and otherwise normal renal function and electrolytes. A 24-hour urine collection for uric acid reveals that he is underexcreting uric acid. Suspecting that this is the cause of his recurrent gout, you place him on probenecid.

Which drugs could have their excretion inhibited by probenecid?

Answer 1

Probenecid elevates the plasma levels of multiple drugs which has weak acids by mechanisms. It affects the reabsorption of weak acids in kidney.It interferes with renal secretion and decreases renal clearance, increases half life of drugs, thereby elevating their plasma concentrations if not titrated the dosage.

Interactions happen with the following drugs:

Peniciilin

Beta-lactum antibiotics

Methotrexate

Aspirin

Captopril

indomethacin

cephalosporins

Zidovudin

lorazepam

Acyclovir