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Uricosuric Agents for Gout

Examples

Generic NameBrand Name
probenecidProbalan
sulfinpyrazone 

How It Works

Uricosuric agents lower uric acid levels in the body by increasing the elimination of uric acid by the kidneys.

Why It Is Used

Uricosuric agents are used to lower the uric acid level in the blood and to prevent the formation of uric acid crystals in your joints and kidneys. They are also used to reduce the frequency of recurrences of acute gout.

Uricosuric agents are never started during a gout attack. But they should be continued if you are already taking them.

Uricosuric agents are not recommended for people who:

  • Have urinary tract stones or a urinary tract obstruction.
  • Have hyperuricemia and are receiving chemotherapy or radiation treatment for cancer.
  • Are taking moderate doses of aspirin.
  • Have kidney failure or kidney disease.

How Well It Works

Uricosuric agents can lower uric acid levels in people who have hyperuricemia and gout. Continuous use of uricosuric agents lowers uric acid levels and reduces both the chance of forming and the size of gritty, chalky clumps of uric acid crystals (tophi). But up to 25 out of 100 people using uricosuric agents to lower uric acid levels do not have adequate results.1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Blood in the urine or pain with urination.
  • Lower back or side pain.

Common side effects of this medicine include:

  • Headache.
  • Joint pain.
  • Nausea.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Uricosuric agents should not be started until the symptoms of a gout attack are gone. But if you are already taking these medicines, you should continue to take them, even during an attack.

Gout attacks may increase at first for some people taking probenecid. To avoid this, doctors may also prescribe colchicine or low-dose nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce the inflammation caused by uric acid crystals. After uric acid levels have been normal for 6 to 12 months and no further attacks occur, colchicine or NSAIDs usually do not need to be taken.

Salicylates, such as aspirin, can make uricosuric agents less effective. Talk to your doctor if you take daily aspirin to help reduce your chances of having a stroke or a heart attack. Low-dose aspirin may be important for the prevention of stroke or heart attack, so your doctor may want you to continue to take it.

You can take these medicines with milk or food to reduce the chance of stomach irritation.

To help prevent kidney stones, drink more fluids while taking these medicines.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

  1. Wise C (2007). Crystal-induced joint disease. In DC Dale, DD Federman, eds., ACP Medicine, section 15, chap. 9. New York: WebMD.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
Last Revised June 12, 2012

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