Colchicine and probenecid

Name: Colchicine and probenecid

What is the most important information I should know about colchicine and probenecid?

This medication will not stop a gout attack that has already started. Your doctor may prescribe other medications to treat your gout. Take all of your gout medications as directed.

What should I discuss with my healthcare provider before taking colchicine and probenecid?

This medication will not stop a gout attack that has already started. Your doctor may prescribe other medications to treat your gout. Take all of your gout medications as directed.

To make sure colchicine and probenecid is safe for you, tell your doctor if you have:

  • heart disease;

  • kidney disease or a history of kidney stones;

  • liver disease;

  • a blood disease;

  • stomach problems such as an ulcer or severe intestinal disorder;

  • if you drink large amounts of alcohol; or

  • if you are receiving chemotherapy or radiation.

It is not known whether colchicine and probenecid will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether colchicine and probenecid passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the side effects of this medication.

Uses of Colchicine and Probenecid

  • It is used to prevent gouty arthritis.

Consumer Information Use and Disclaimer

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else's drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this medicine, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

This information should not be used to decide whether or not to take colchicine and probenecid or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to colchicine and probenecid. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Review Date: October 4, 2017

Dosing Adult

Gout: Oral: One tablet/day for 1 week, then 1 tablet twice daily thereafter

Note: Current prescribing information states a maximum dose of 4 tablets per day; however this exceeds the usual maximum dose of colchicine for gout prophylaxis (1.2 mg per day).

Dosing Geriatric

Refer to adult dosing.

Dosing Hepatic Impairment

No dosage adjustment provided in manufacturer's labeling; use with caution.

Liver Dose Adjustments

Patients with hepatic impairment should not take colchicine in conjunction with drugs that inhibit both P-glycoprotein (P-gp) and CYP450 3A4.

Use caution; the possibility of increased colchicine toxicity in the presence of hepatic dysfunction should be considered.

Dose Adjustments

Patients with renal impairment should not take colchicine in conjunction with drugs that inhibit both P-glycoprotein (P-gp) and CYP450 3A4.

CrCl less than 30 mL/min: Not recommended as it may not be effective

Mild to moderate renal impairment: Use caution; dosage requirements may be increased; monitor closely for colchicine toxicity.

Colchicine / probenecid Pregnancy Warnings

Teratogenicity has been shown in mice given 1.25 to 1.5 mg/kg and hamsters given colchicine 10 mg/kg. A study of 231 pregnancies in 116 women treated with colchicine before or during pregnancy did not show an increased frequency of fetal defects. Another study of eleven pregnancies in women treated with colchicine throughout the pregnancy resulted in 9 healthy babies and 2 miscarriages. Occasional cases of trisomy or aneuploidy have been reported in patients being treated with colchicine for gout. A causal relationship is uncertain. Some early studies suggested an increase in Down's syndrome, but that association appears to be coincidental. In a study of 28 women with familial Mediterranean fever (FMF) who were taking colchicine, 25% had miscarriages and 36% had periods of infertility. These rates were high but similar to rates reported for women with FMF without colchicine. All 16 babies born to the FMF women on colchicine were healthy. There are no well-controlled studies in pregnant patients. A summary of 3 studies showed 4 of 14 men taking colchicine developed reversible azoospermia. Probenecid crosses the placenta barrier and appears in cord blood. Case reports of probenecid use throughout pregnancy for the treatment of hyperuricemia associated with gout and renal dysfunction have not documented probenecid-induced adverse fetal outcome. In addition, one study evaluating the efficacy of single-dose ampicillin plus probenecid for the treatment of urinary tract infection during pregnancy failed to reveal evidence of adverse fetal effects. There are no adequate and well controlled studies in pregnant women taking either agent individually or the combination of both drugs together. US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. US FDA pregnancy category B: Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

Contraindicated US FDA pregnancy category: Not formally assigned -Colchicine: C -Probenecid: B

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