Probenecid / Colchicine	(pro-BEN-uh-sid/KOHL-chih-seen)
Trade Name(s):	Probenecid and Colchicine   ·Tablets 500 mg probenecid and 0.5 mg colchicine Indicates Canadian Trade Name.
Class:	Agents for gout
Action:
	Probenecid Inhibits tubular reabsorption of urate, thus increasing urinary excretion of uric acid.
	Colchicine Inhibits inflammation and reduces pain and swelling associated with gouty arthritis.
Indications:	Treatment of chronic gouty arthritis when complicated by frequent, recurrent, acute attacks of gout.
Contraindications:	Hypersensitivity to any component of product; children younger than 2 yr of age; known blood dyscrasias; uric acid kidney stones; current acute gouty attack.
Interactions:
	Acetaminophen, indomethacin, ketoprofen, lorazepam, meclofenamate, naproxen, rifampin Plasma levels of these agents may be increased.
	Beta-lactam antibiotics, penicillins Psychic disturbances may occur.
	Induction anesthesia (eg, thiopental) Less anesthetic may be required.
	Methotrexate Probenecid increases plasma levels; methotrexate dose may need to be reduced.
	Pyrazinamide, salicylates Uricosuric action of probenecid may be antagonized.
	Sulfonamides Total sulfonamide (drug plus metabolite) levels may be increased.
	Sulfonylureas Risk of hypoglycemia may be increased.
Lab Test Interferences:	Falsely high reading for theophylline may occur when measured by the Schack and Waxler technique.
Adverse Reactions:
	cns:
	Probenecid Headache; dizziness.
	Colchicine Peripheral neuritis.
	dermatologic:
	Probenecid Urticaria; pruritus; dermatitis; alopecia; flushing.
	Colchicine Urticaria; purpura; alopecia; dermatitis.
	gi:
	Probenecid Vomiting; nausea; anorexia; sore gums.
	Colchicine Nausea; vomiting; abdominal pain; diarrhea.
	gu:
	Probenecid Nephrotic syndrome; uric acid stones with or without hematuria; renal colic; costovertebral pain; urinary frequency.
	hematologic:
	Probenecid Aplastic anemia; leukopenia; hemolytic anemia.
	Colchicine Aplastic anemia; agranulocytosis.
	hepatic:
	Probenecid Hepatic necrosis.
	metabolic:
	Probenecid Precipitation of acute gouty arthritis.
	miscellaneous:
	Probenecid Anaphylaxis; fever.
	Colchicine Muscular weakness.
Precautions:
	Pregnancy: Category C .
	Lactation: Undetermined.
	Children: Safety and efficacy not established; contraindicated in children younger than 2 yr of age.
	Renal function impairment: May not be effective in patients with chronic renal function impairment (30 mL/min or less); dose may need to be increased.
	Alkalinization of urine May be needed to prevent hematuria, renal colic, costovertebral pain, formation of uric acid stones.
	Exacerbation of gout May occur.
	Peptic ulcer Use with caution in patients with history of peptic ulcer disease.
Overdosage:	Signs & symptoms Diarrhea, generalized vascular damage, renal damage, hematuria, oliguria.
Patient/Family Education:	Advise patient to take tablets as prescribed by health care provider. Advise patient to take without regard to meals but to take with food if GI upset occurs. Inform patient that dose will be slowly increased until max benefit is obtained. Advise patient to maintain adequate fluid intake (at least eight 8 oz glasses of water/day) and to carefully follow any instructions regarding alkalinizing the urine that were provided by health care provider. Caution patient to not increase the dose of this medication if gout symptoms should recur. Instruct patient to discuss other treatments for acute gout while continuing this medication. Caution patient to avoid concurrent use of aspirin or aspirin-containing products. Advise patient to use acetaminophen for management of mild to moderate pain. Advise patient to stop taking the drug and notify health care provider if persistent diarrhea or other GI symptoms occur, or if a rash or other signs of an allergic reaction develop.