![]() ![]() ![]() The biphasic action of salicylates in the renal tubules accounts for the so-called “paradoxical effect” of uricosuric agents. In patients on probenecid the use of salicylates in either small or large doses is contraindicated because it antagonizes the uricosuric action of probenecid. ![]() If probenecid is given with methotrexate, the dosage of methotrexate should be reduced and serum levels may need to be monitored. In animal studies, increased methotrexate toxicity has been reported. Probenecid increases plasma concentrations of methotrexate in both animals and humans. Probenecid does not influence plasma concentrations of salicylates, nor the excretion of streptomycin, chloramphenicol, chlortetracycline, oxytetracycline, or neomycin.Įxacerbation of gout following therapy with probenecid may occur in such cases colchicine or other appropriate therapy is advisable. The tubular reabsorption of phosphorus is inhibited in hypoparathyroid but not in euparathyroid individuals. Probenecid decreases both hepatic and renal excretion of sulfobromophtalein (BSP). Probenecid also has been reported to inhibit the renal transport of many other compounds including aminohippuric acid (PAH), aminosalicylic acid (PAS), indomethacin, sodium iodomethamate and related iodinated organic acids, 17 –ketosteroids, pantothenic acid, phenolsulfonphthalein (PSP), sulfonamides, and sulfonylureas. A 2-fold to 4-fold elevation has been demonstrated for various penicillins. Probenecid inhibits the tubular secretion of penicillin and usually increases penicillin plasma levels by any route the antibiotic is given. ![]() Effective uricosuria reduces the miscible urate pool, retards urate deposition, and promotes resorption of urate deposits. It inhibits the tubular reabsorption of urate, thus increasing the urinary excretion of uric acid and decreasing serum urate levels. Probenecid is a uricosuric and renal tubular blocking agent. ![]()
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