Benemid (probenecid) is a well-established uricosuric agent specifically formulated for the chronic management of hyperuricemia associated with gout and gouty arthritis. As a potent inhibitor of renal tubular reabsorption of urate, it effectively reduces serum uric acid levels by enhancing urinary excretion, thereby preventing the formation of tophi and reducing the frequency of acute gout attacks. This medication represents a cornerstone in long-term gout prophylaxis, particularly for patients who are unresponsive to lifestyle modifications or who cannot tolerate alternative therapies. Its mechanism of action and clinical efficacy have been validated through decades of therapeutic use, making it a trusted option for rheumatologists and nephrologists managing chronic hyperuricemic conditions.

Features

• Contains probenecid as the active pharmaceutical ingredient (500 mg tablets)
• Classified as a uricosuric agent with specific renal tubular action
• White, round, scored tablets for accurate dosing
• Manufactured under strict pharmaceutical GMP standards
• Stable shelf life of 36 months when stored properly
• Requires prescription and medical supervision for use

Benefits

• Effectively lowers serum uric acid levels by increasing urinary excretion
• Reduces frequency and severity of acute gout attacks with consistent use
• Helps prevent formation of new tophi and promotes resolution of existing deposits
• Enables long-term management of chronic gout and hyperuricemia
• May be combined with colchicine for enhanced prophylactic effect
• Well-tolerated profile when used appropriately in indicated patients

Common use

Benemid is primarily indicated for the treatment of chronic gouty arthritis and tophaceous gout in patients who experience frequent acute attacks despite appropriate management. It is particularly valuable for patients who underexcrete uric acid rather than overproduce it, as determined by 24-hour urinary uric acid measurements. The medication is also used as an adjunct to antibiotic therapy to elevate and prolong antibiotic plasma levels, particularly with penicillin-type drugs, though this application has become less common with modern antibiotic dosing regimens. It is not indicated for the treatment of asymptomatic hyperuricemia unless the patient is at particularly high risk for complications.

Dosage and direction

The initial adult dosage is 250 mg twice daily for one week, followed by 500 mg twice daily. Dosage may be increased by 500 mg every 4 weeks, as needed, to maintain serum uric acid within normal range. The maximum recommended dosage is 2-3 grams per day. Tablets should be taken with food or antacids to minimize gastrointestinal discomfort. Adequate fluid intake (2-3 liters daily) is essential to prevent uric acid stone formation. During initial therapy, concomitant administration of colchicine or an NSAID is recommended to prevent acute gout attacks that may occur during the initial uric acid mobilization phase.

Precautions

Renal function should be assessed prior to initiation and monitored periodically during therapy. Use with caution in patients with history of peptic ulcer disease. Not recommended for patients with blood dyscrasias or uric acid kidney stones. May cause false-positive results for urinary glucose with Benedict’s solution. Patients should maintain adequate hydration throughout treatment. Regular monitoring of serum uric acid levels is recommended to assess therapeutic response. Use during pregnancy only if clearly needed, as safety in pregnancy has not been established.

Contraindications

Hypersensitivity to probenecid or any component of the formulation. Not recommended for children under 2 years of age. Contraindicated in patients with known blood dyscrasias or uric acid kidney stones. Should not be used in patients with creatinine clearance less than 50 mL/min. Not indicated for treatment of acute gout attacks. Contraindicated in patients with known hypersensitivity to sulfonamides (cross-sensitivity may occur).

Possible side effect

Common side effects include gastrointestinal disturbances (nausea, vomiting, loss of appetite), headache, dizziness, and frequent urination. Less frequently, patients may experience flushing, sore gums, skin rash, or hair loss. Serious but rare adverse effects include nephrotic syndrome, hepatic necrosis, aplastic anemia, and anaphylactic reactions. Urinary frequency and gastrointestinal symptoms often diminish with continued therapy. Any signs of blood dyscrasias (unexplained bleeding, bruising, sore throat) require immediate medical attention.

Drug interaction

Significantly increases plasma levels of penicillin and related antibiotics. May increase levels of methotrexate, sulfonylureas, and NSAIDs. Salicylates antagonize uricosuric effect and should be avoided. Diuretics may decrease effectiveness of probenecid. May prolong half-life of rifampin and zidovudine. Concurrent use with pyrazinamide may decrease uricosuric effect. Hepatic metabolism inducers may decrease probenecid levels.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for a missed dose. Maintain regular dosing schedule to ensure consistent uric acid control. Patients should contact their healthcare provider if multiple doses are missed to discuss appropriate management.

Overdose

Symptoms may include nausea, vomiting, dizziness, and possible convulsions. Gastric lavage and supportive measures are recommended. Maintain adequate urinary output to prevent uric acid crystallization. Hemodialysis may be effective in removing probenecid. There is no specific antidote; treatment should be symptomatic and supportive. Contact poison control center immediately for management guidance.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in original container. Protect from moisture and light. Keep tightly closed and out of reach of children. Do not use if tablets show signs of discoloration or deterioration. Properly discard any unused medication after expiration date.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions should be made in consultation with a qualified healthcare professional familiar with the patient’s complete medical history. Individual response to medication may vary, and proper monitoring is essential for safe and effective use. The prescribing information provided here may not include all possible uses, directions, precautions, or interactions.

Reviews

“After struggling with frequent gout attacks for years, Benemid has provided remarkable control. My uric acid levels have remained within normal range, and I’ve experienced only one minor flare in the past two years. The initial adjustment period required careful management, but the long-term results have been excellent.” - Rheumatology patient, 58

“As a practicing rheumatologist for over 30 years, I’ve found Benemid to be exceptionally reliable for appropriate patients. It’s particularly valuable for those who cannot tolerate allopurinol or have renal impairment that contraindicates other agents. The key is proper patient selection and ongoing monitoring.” - Board-certified rheumatologist

“The combination of Benemid with colchicine prophylaxis has transformed my practice. Patients who previously experienced debilitating monthly attacks now enjoy extended periods of remission. The medication requires education about hydration and avoidance of salicylates, but compliant patients achieve excellent outcomes.” - Nephrology specialist