PROBENECID & COLCHICINE

Brand & Generic Names

Col Benemid
Col-Probencid
Proben-C

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antigout

Uses

• Increases blood levels of penicillins and cephalosporins.
• Relieves joint pain, inflammation, swelling from gout.
• Also used for familial Mediterranean fever, dermatitis herpetiformis.

Dosage & Usage Information

How to take:
Tablet--Swallow with liquid or food to lessen stomach irritation. If you can't swallow whole, crumble tablet and take with liquid or food.

When to take:
At the same time each day.

If you forget a dose:
Take as soon as you remember up to 12 hours late. If more than 12 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Forces kidneys to excrete uric acid.
Reduces amount of penicillin excreted in urine.
Decreases acidity of joint tissues and prevents deposits of uric-acid crystals.

Time lapse before drug works:
12 to 48 hours.

Don't take with:
Non-prescription drugs containing aspirin or caffeine.
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Breathing difficulty, severe nervous agitation, convulsions, bloody urine, diarrhea, vomiting, muscle weakness, fever, stupor, seizures, delirium, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Blood in urine; Discontinue. Seek convulsions; severe emergency treatment. muscle weakness; difficult breathing; burning feeling of stomach, throat or skin; worsening gout.

Common:

Diarrhea, headache, abdominal pain.

Infrequent:

• Back pain; painful, difficult urination.
• Dizziness, red or flushed face, urgent urination, sore gums, hair loss.

Rare:

Sudden decrease in urine output; nausea; vomiting; mood change; fever; chills; diarrhea; jaundice; numbness or tingling in hands or feet; rash; sore throat, fever, mouth sores; swollen face, feet and ankles; unexplained bleeding or bruising; weight gain or loss; low white or red blood cells.

Warnings & Precautions

Don't take if:
You are allergic to any uricosuric* or colchicine.

Before you start, consult your doctor:

• If you have had kidney stones, kidney disease, heart or liver disease, peptic ulcers or ulcerative colitis.
• If you have bone marrow or blood cell disease.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.
• If you are undergoing chemotherapy for cancer.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons. Colchicine has a narrow margin of safety for people in this age group.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
No problems expected, but consult doctor.

Infants & children:
Not recommended.

Prolonged use:

• Possible kidney damage.
• Permanent hair loss.
• Anemia. Request blood counts.
• Numbness or tingling in hands and feet.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check serum uric acid, urine uric acid.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:

• May be unnecessary to finish medicine. Follow doctor's instructions.
• Stop taking if severe digestive upsets occur before symptoms are relieved.

Others:

• If signs of gout attack develop while taking medicine, consult doctor.
• Limit each course of treatment to 8 mg. Don't exceed 3 mg. per 24 hours.
• Decreased sperm count in males.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Acetohexamide	Increased acetohexamide effect.
Allopurinol	Increased effect of each drug.
Anticoagulants*	Irregular effect on anticoagulation,
	sometimes increased, sometimes
	sometimes decreased. Follow
	prothrombin times.
Antidepressants*	Oversedation.
Antihistamines*	Oversedation.
Antihypertensives*	Decreased antihypertensive effect.
Appetite	Increased appetite suppressant
suppressants*	effect.
Bismuth	Decreased effect of probenecid.
Cefixime	Increased cefixime effect.
Cephalosporins*	Increased cephalosporin effect.
Dapsone	Increased dapsone effect. Increased
	toxicity.
Diclofenac	Increased diclofenac effect.
Diuretics, thiazide*	Decreased probenecid effect.
Indomethacin	Increased adverse effects of
	indomethacin.
Ketoprofen	Increased effect of ketoprofen
	toxicity.
Methotrexate	Increased methotrexate effect.
Mind-altering drugs*	Oversedation.
Narcotics*	Oversedation.
Nitrofurantoin	Increased nitrofurantoin effect.
Non-steroidal	Increased toxic risk.
drugs* (NSAIDs)
Para-aminosalicylic	Increased effect of para-
acid (PAS)	aminosalicylic acid.
Penicillins*	Enhanced penicillin effect.
Phenylbutazone	Decreased antigout effect of
	colchicine.
Pyrazinamide	Decreased probenecid effect.
Salicylates*	Decreased probenecid effect.
Sedatives*	Oversedation.
Sleep inducers*	Oversedation.
Sulfa drugs*	Slows elimination. May cause
	harmful accumulation of sulfa.
Thioguanine	More likelihood of toxicity of both
	drugs.
Tranquilizers*	Oversedation.
Vitamin B-12	Decreased absorption of vitamin
	B-12.
Zidovudine	Increased risk of zidovudine
	toxicity.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Decreased probenecid effect.
Caffeine drinks.	Loss of probenecid effectiveness.
Herbal teas.	Increased colchicine effect. Avoid.
Cocaine:	Overstimulation. Avoid.
Foods:	No proven problems.
Marijuana:	Decreased colchicine and probenecid
	effect.
Tobacco:	No proven problems.