Yes

Uricosuric Agent

Treatment of chronic gouty arthritis and intermittent gouty arthritis

C; D (near term, per expert analysis)

Active peptic ulcers, hypersensitivity to sulfinpyrazone, phenylbutazone, or other pyrazoles, GI inflammation, blood dyscrasias

Safety and efficacy not established in children <18 years of age, use with caution in patients with impaired renal function and urolithiasis

1% to 10%: Gastrointestinal: Nausea, vomiting, stomach pain

<1%:

Cardiovascular: Flushing

Central nervous system: Dizziness, headache

Dermatologic: Dermatitis, rash

Hematologic: Anemia, leukopenia, increased bleeding time (decreased platelet aggregation)

Hepatic: Hepatic necrosis

Genitourinary: Polyuria

Renal: Nephrotic syndrome, uric acid stones

Symptoms of overdose include nausea, vomiting, ataxia, respiratory depression, seizures

Following GI decontamination, treatment is supportive only

CYP2C and 3A3/4 enzyme inducer; CYP2C9 enzyme inhibitor

Increased effect of oral anticoagulants

Risk of acetaminophen hepatotoxicity is increased, but therapeutic effects may be reduced

Acts by increasing the urinary excretion of uric acid, thereby decreasing blood urate levels; this effect is therapeutically useful in treating patients with acute intermittent gout, chronic tophaceous gout, and acts to promote resorption of tophi; also has antithrombic and platelet inhibitory effects

Absorption: Complete and rapid

Metabolism: Hepatic to two active metabolites

Half-life, elimination: 2.7-6 hours

Time to peak serum concentration: 1.6 hours

Elimination: Renal excretion with 22% to 50% as unchanged drug

Adults: Oral: 100-200 mg twice daily; maximum daily dose: 800 mg

Should be administered with food or milk

Serum and urinary uric acid, CBC

uric acid (S)

May cause dizziness

May cause leukopenia; use caution with clozapine and carbamazepine

No information available to require special precautions

No effects or complications reported

Take as directed, with meals or antacids and a full glass of water. Avoid aspirin or acetaminophen products and avoid large quantities of vitamin C. It is very important to maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake) to prevent kidney damage. You may experience nausea or vomiting (small frequent meals, frequent mouth care, chewing gum, or sucking lozenges may help). Report skin rash, persistent stomach pain, painful urination or bloody urine, unusual bruising or bleeding, fatigue, or yellowing of eyes or skin. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Consult prescriber if breast-feeding.

Monitor serum and urinary uric acid

Capsule: 200 mg

Tablet: 100 mg

Emmerson BT, "The Management of Gout," N Engl J Med, 1996, 334(7):445-51.