A uricosuric agent that inhibits renal tubular reabsorption of organic acids. Selected Indications
Hyperuricemia associated with refractory or recurrent gouty arthritis. Metabolism
Rapidly and completely absorbed, with peak plasma levels in about 1 hour. Sulfinpyrazone is 98% protein-bound. The kidney excretes about 40% unchanged. Adverse Reactions
Gastrointestinal irritation is common. Because sulfinpyrazone is similar in structure to phenylbutazone, it should be avoided in patients with known sensitivity to phenylbutazone.
A large alkaline urine output should be maintained, especially during the first week of therapy, to decrease the risk for urate calculi formation. Sulfinpyrazone inhibits platelet aggregation and potentiates the action of protein-bound drugs such as oral hypoglycemics and oral anticoagulants. The action of sulfinpyrazone is antagonized by low-dose salicylates, and the drug is ineffective in the presence of renal failure.
Tablets, 100 mg; capsules, 200 mg. Dosage
Start with 50 to 100 mg twice daily with meals, and increase gradually during several weeks to a maintenance dosage usually of 300 to 400 mg/d in three to four divided doses. Maximum recommended daily dose is 800 mg. Maintenance colchicine should be given for the first 3 months of therapy to prevent precipitation of an acute attack of gouty arthritis.
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