Probenecid side effects are rare.
But you must take some precautions to avoid common problems.
How does Probenecid Work?
Before you look at side effects of probenecid, you should understand how probenecid works. Because it was developed to improve the effects of penicillin by restricting its excretion through the kidneys. So it has significant effects on many compounds by either restricting or encouraging excretion rates in urine.
Importantly, if you are taking any other medications or supplements, including herbal medicine, you must tell your doctor. Then this will help your doctor determine if the side-effects are down to probenecid. Or if the other compounds are involved. Because if they are, you can often overcome side-effects by adjusting the dose of the other medicine.
On the main probenecid page, I described how the dose might be accompanied by alkalizing agents or alkalizing diet. But be sure to advise your doctor if you are taking precautions against acid urine. Then your acid-base balance can be monitored. Because failure to alkalize might lead to the following side-effects:
- Hematuria – red blood cells in the urine. These are not usually visible. But you should confirm that your doctor will include this in your urine tests.
- Costovertebral pain – pain in the joints between spine and ribs.
- Renal colic – sudden, sharp kidney pains, which could be associated with kidney stones.
- Formation of uric acid stones.
Other Health Conditions
Use probenecid with caution if you have a history of peptic ulcer.
Because if you have kidney problems, you may need a higher dosage. Also if you suffer chronic kidney disease(glomerular filtration rate is 30 mL/minute or less), then probenecid is unlikely to be effective. Finally, do not take penicillin with probenecid if you have kidney problems.
Probenecid might affect tests for other health problems. Because it causes reducing substances in the urine. So this might cause a suspicion of diabetes. But that can be ruled out with a specific test for glucose.
Probenecid Side Effects
Your probenecid packaging should list common side effects. But gout patients in our forum discussions have raised other points:
Side Effects of Probenecid noticed by Gout Patients
- In these notes about probenecid, I explain that the drug can cause gout flares as old crystals dissolve. Because this is similar to the reaction to new crystals forming. But it can be more widespread.
- Normally, we only notice pain and inflammation in one or two joints. Also, new crystal attacks are usually accompanied by feverish, flu-like symptoms, and itchy skin. But the pain often masks these.
- Our reaction to old crystals is often less intense and more widespread. So, we might not recognize it as gout. Then you must not stop uric acid lowering. Because it gets easier with each passing week.
- Starting new medications can make us worry about how they will work. Also, other aspects of treating your gout can cause anxiety. So, you need to learn the difference between side effects of probenecid and anxiety. Because common symptoms of anxiety are:
- Racing heartbeat (palpitations)
- Breathing fast, feeling short of breath, or finding it hard to ‘get breath’
- Chest tightness
- Dry mouth, butterflies in the stomach, feeling sick
- An urge to pass urine
Try to stay calm and trust the process. Then you will soon be enjoying your gout freedom.
Probenecid Adverse Events
Side effects, or adverse reactions to probenecid, starting with the most severe, include:
- Central Nervous System:
- Headache, dizziness.
- Precipitation of acute gouty arthritis.
- Hepatic necrosis (localized liver damage), vomiting, nausea, anorexia, sore gums.
- Nephrotic syndrome (non-specific kidney damage), uric acid stones with or without hematuria, renal colic, costovertebral pain, urinary frequency.
- Anaphylaxis (severe allergic reaction), fever, urticaria (rash/hives), pruritus (itch).
- Aplastic anemia (shortage of red blood cells from bone marrow), leukopenia (shortage of white blood cells), hemolytic anemia (premature death of red blood cells) which can sometimes be related to genetic deficiency of glucose -6- phosphate dehydrogenase in red blood cells, anemia (shortage of red blood cells with unknown cause).
- Dermatitis, alopecia, flushing.
Like many medicines, probenecid is often misspelled. Though spelling is often overrated, it pays to take extra care with medicines, as a misunderstanding might cause treatment problems in the unlikely event of a similar sounding drug being taken mistakenly.
In the list below, I have included brand names, where the active ingredient is probenecid alone (it is frequently mixed with colchicine). When buying medicine, it is usually best to use the generic name rather than a brand name, unless additional active ingredients make the gout medicine more useful to you.
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This is the correct spelling of the uricosuric drug probenecid, which encourages uric acid excretion in those gout patients who are under-excreters.
- Probenecid Brands
Common brand names include: Benemid; Probecid; Benecid; Benuryl; Pro-Cid
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If you are aware of other alternative spellings or common brand names, please share them on the gout resources forum. Though I am happy to discuss all aspects of probenecid side effects, I cannot give you specific personal advice. If you experience adverse reactions, you must consult your doctor or pharmacist immediately.
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