Probenecid vs. Allopurinol

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson will compare and contrast medications called allopurinol and probenecid. Other than learning about their uses, you'll learn how they work, and when they shouldn't be used.

One Problem, Two Approaches

Household mold is a well-known problem. You can address this by preventing (anymore) household mold from accumulating and making things worse, or you can collect the moldy material and toss it out of the home.

Well, two medications, called allopurinol and probenecid, use similar approaches to deal with, not mold, but high levels of uric acid in the body (including in the blood). High levels of uric acid in the blood is known as hyperuricemia, and this can contribute to the formation of a form of arthritis known as gout.

Let's compare and contrast these two medications in this lesson and figure out what they have to do with uric acid and the example in this introduction.

Brand Names, Dosage Forms & Administration

Probenecid goes by the trade name of Benemid. This one is easy to recall as it's '-benecid', but with an 'm' instead of a 'c'. Allopurinol is called Zyloprim or Aloprim.

Probenecid comes as an oral tablet while allopurinol comes as an oral tablet as well as a solution for intravenous injection.

Probenecid should be given with food and allopurinol should be given after a meal (when given orally). The person taking either medication should drink plenty of fluids.

Indications & Pharmacology

Probenecid is indicated to treat hyperuricemia that is associated with gout. It is also used to prolong the effects of or elevate the levels of a class of antibiotics known as beta-lactams.

Allopurinol is used to treat gout, hyperuricemia caused by cancer treatment, and recurrent calcium oxalate calculi in individuals excreting large amounts of uric acid in their urine.

How do they work? Well, let's go back to that intro. We can manage mold by preventing any more mold from accumulating in the home, right? Allopurinol is a xanthine oxidase inhibitor. It manages hyperuricemia and its associated consequences like gout by inhibiting the action of an enzyme known as xanthine oxidase. This prevents our body from forming more uric acid.

We can also manage mold by tossing the mold out of the home! Probenecid is a uricosuric agent. This means it increases the excretion of uric acid out of the body via our urine.

The level of uric acid in the urine increases within hours after the administration of probenecid. It takes 2-3 days to notice a significant decrease in a person's uric acid levels when taking allopurinol. It takes at least 1 week for allopurinol to reach its peak effect.

Contraindications and Adverse Effects

Neither medication should be given to people who are hypersensitive (allergic) to it. People shouldn't take probenecid if they are taking aspirin, if they have uric acid kidney stones, if they are less than 2 years of age, or if they have any one of a number of blood disorders. Probenecid shouldn't be started in people who are currently having a sudden and/or severe gout attack.

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