Probalan (Probenecid) – Oral

What Is Probalan?

Probalan (probenecid) is an oral prescription drug used to treat hyperuricemia (high levels of uric acid in the blood) associated with gout, also known as gouty arthritis. It can also be used along with certain antibiotics, such as penicillin, to make them more effective.

Probenecid is in a drug class called uricosurics. It treats gout by acting on the kidneys to help the body get rid of uric acid. When probenecid is used to make certain antibiotics work better, it prevents the body from eliminating the antibiotics in the urine.

Probalan is available as a tablet that is taken by mouth.

Drug Facts

Generic Name: Probenecid

Brand Name(s): Probalan, Benemid (discontinued)

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Uricosuric

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Probenecid

Dosage Form(s): Tablet

What Is Probalan Used For?

The Food and Drug Administration (FDA) approved probenecid to treat high uric acid levels associated with gout.

Gout is a type of arthritis that causes severe pain, redness, tenderness, and swelling in joints, often in the big toe. The pain and inflammation of gout happen when there is too much uric acid in the body, which forms crystals in the joints.

Probenecid can also be used along with certain antibiotics (e.g., penicillin, ampicillin, oxacillin, or nafcillin) to help the antibiotic stay in the body longer. For example, it can be used:

How to Take Probalan

If you are prescribed Probalan, read the prescription label and the information leaflet that comes with it. Consult your healthcare provider if you have any questions.

Use probenecid exactly as directed by your healthcare provider, and do not skip doses. While taking it, drink lots of water. This helps prevent kidney stones (hard deposits made of salts and minerals that form in the kidneys). You may also be prescribed other medications to prevent kidney stones, so make sure to take those as directed.

Probenecid can affect how your body reacts to anesthesia (medication used during surgical procedures). Therefore, let your surgeon know that you are taking it before undergoing any surgery.

Call your healthcare provider if your gout symptoms worsen or do not improve. In some cases, they may also prescribe a medication called colchicine.

Storage

Store Probalan tablets at room temperature (between 68 and 77 degrees F), away from heat, light, and moisture. Keep the bottle tightly closed when not in use. Keep out of the reach of children and pets to prevent accidental consumption.

Off-Label Uses

Healthcare providers may prescribe probenecid for off-label uses, meaning for conditions not specifically indicated by the FDA.

Probenecid is sometimes given off-label to prevent kidney toxicity in people taking a drug called cidofovir. Cidofovir is used to treat eye infections caused by cytomegalovirus (CMV) in people with AIDS.

How Long Does Probalan Take To Work?

When you first start taking Probalan, you may notice an increase in the frequency of gout attacks. You may be prescribed colchicine during this time to control them. However, after six to 12 months, probenecid should start working to prevent them.

What Are the Side Effects of Probalan?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or a pharmacist. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Like other medications, probenecid can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

Common side effects of probenecid are:

  • Anemia (low levels of red blood cells)
  • Appetite loss
  • Fever
  • Flushing
  • Frequent urination
  • Headache
  • Dizziness
  • Nausea and vomiting
  • Nephrotic syndrome (a kidney disorder that causes the body to eliminate too much protein in the urine)
  • Renal colic (sharp pain that occurs when a stone gets stuck in the urinary tract)
  • Skin irritation and itching
  • Sore gums
  • Worsening of gout

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Dial 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Aplastic anemia: This is when the body stops producing enough new blood cells due to bone marrow damage. Symptoms may include tiredness, dizziness, rapid heart rate, and bleeding.
  • Hemolytic anemia: This occurs when red blood cells are destroyed faster than they can be replaced. Symptoms include pale skin, fever, weakness, dizziness, and jaundice (yellowing of the skin or whites of the eyes).
  • Hepatic necrosis: This is an acute, toxic injury that can cause liver problems or liver failure. Symptoms may include nausea, weakness, tiredness, and stomach pain.
  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, difficulty breathing, and swelling around the lips, tongue, and face.

Long-Term Side Effects

While many people tolerate probenecid well, long-term or delayed side effects are possible. Some long-term side effects can be mild, such as:

  • Appetite loss
  • Hair loss

Moderate long-term side effects can include:

  • Blood in the urine
  • Kidney stones
  • Low red blood cells
  • Low white blood cells, which can interfere with the body's ability to fight infection
  • Pain near the rib cage (which indicates kidney problems)
  • Worsening of gout

Severe long-term side effects may include:

  • Aplastic anemia
  • Hemolytic anemia
  • Hepatic necrosis
  • Nephrotic syndrome
  • Severe allergic reactions

Report Side Effects

Probalan may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Probalan Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For treating gout or removing uric acid from the body:
    • Adults: 250 mg (one-half of a 500-mg tablet) two times a day for about one week, then 500 mg (one tablet) two times a day for a few weeks. After this, the dose will depend on the amount of uric acid in your blood or urine. Most people need 2, 3, or 4 tablets a day, but some people may need higher doses.
    • Children: It is not likely that probenecid will be needed to treat gout or to remove uric acid from the body in children. If a child needs this medicine, however, the dose would have to be determined by the doctor.
  • For helping antibiotics work better:
    • Adults: The amount of probenecid will depend on the condition being treated. Sometimes, only one dose of 2 tablets is needed. Other times, the dose will be 1 tablet four times a day.
    • Children: The dose will have to be determined by the doctor. It depends on the child's weight, as well as on the condition being treated. Older children and teenagers may need the same amount as adults.

Modifications

You may need to use caution when taking Probalan if you are 65 years or older, especially if you have kidney problems.

You should not take Probalan if you are 65 years or older and have a creatinine clearance (CrCl) of less than 30 milliliters per minute. CrCl is a measure of kidney function. Your healthcare provider will test this for you. People with kidney problems should also not take Probalan to increase antibiotic effectiveness. This is because probenecid depends on kidney function to work properly.

The following may also affect your treatment with Probalan:

  • People with gout who have kidney failure or a glomerular filtration rate (GFR) of less than 30 milliliters per minute should not take probenecid. Some providers will avoid prescribing if the CrCl is less than 50 milliliters per minute.
  • The drug is less effective when the CrCl is less than 80 milliliters per minute and does not work at all when the GFR is less than 30 milliliters per minute.
  • Probenecid should not be used in people who are on dialysis.
  • People with liver problems can generally take probenecid safely but should consult their healthcare provider before using Probalan.
  • Probalan can be used in children 2 years and older and adolescents since the dose is based on weight.

Women who are pregnant, planning to become pregnant, or are breastfeeding, should consult their healthcare provider regarding the use of Probalan.

Missed Dose

If you miss a dose of probenecid, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose. Do not take an extra dose to make up for a missed dose.

Overdose: What Happens If I Take Too Much Probalan?

Taking too much Probalan may cause stomach discomfort, nausea, and/or vomiting.

What Happens If I Overdose On Probalan?

If you think you or someone else may have overdosed on Probalan, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Probalan, call 911 immediately.

Precautions

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If you will be taking probenecid for more than a few weeks, your doctor should check your progress at regular visits.

Before you have any medical tests, tell the person in charge that you are taking this medicine. The results of some tests may be affected by probenecid.

For diabetic patients:

  • Probenecid may cause false test results with copper sulfate urine sugar tests (Clinitest®), but not with glucose enzymatic urine sugar tests (Clinistix®). If you have any questions about this, check with your health care professional.

For patients taking probenecid for gout or to help remove uric acid from the body:

  • Taking aspirin or other salicylates may lessen the effects of probenecid. This will depend on the dose of aspirin or other salicylate that you take, and on how often you take it. Also, drinking too much alcohol may increase the amount of uric acid in the blood and lessen the effects of this medicine. Therefore, do not take aspirin or other salicylates or drink alcoholic beverages while taking this medicine, unless you have first checked with your doctor.

What Are Reasons I Shouldn't Take Probalan?

Probalan is not appropriate for everyone. You should not take this medication if you are allergic to probenecid or any of the inactive ingredients in Probalan.

Additionally, you should not take Probalan if you:

  • Have a CrCl of less than 30 milliliters per minute
  • Have uric acid nephrolithiasis (uric acid kidney stones)
  • Have blood dyscrasia (a blood disorder such as anemia or leukemia)
  • Are having a gout attack

Probalan may be prescribed with caution in some people and will be dispensed only if the healthcare provider determines it is safe. This includes people with:

What Other Medications Interact With Probalan?

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter (OTC) drugs, vitamins, herbal supplements, and plant-based medicines.

When used to bolster the effectiveness of antibiotics, Probalan increases levels of the antibiotic in the body. This may enhance some of the side effects associated with the antibiotic.

Probenecid can also interact with the following medications:

  • Aspirin or salicylates (e.g., Pepto Bismol, Kaopectate): Do not use probenecid with these medications.
  • Certain oral diabetes drugs, such Amaryl (glimepiride), Glucotrol XL (glipizide), or Diabeta (glyburide): Probenecid may increase the risk of hypoglycemia (low blood sugar).
  • Anesthesia: People on probenecid may require less anesthesia. Let your surgeon know if you are on probenecid before surgery.

Probenecid can also increase the levels of certain drugs, which may require a dosage adjustment. Examples include:

Other drug interactions may occur with probenecid. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Besides Probalan, other medications indicated for gout include:

  • Colcrys, Gloperba, Mitigare (colchicine): This oral medication prevents gout flares. It is not used to treat a gout flare.
  • Krystexxa (pegloticase): This drug is given as an intravenous infusion (infusion delivered by IV into a vein) and treats chronic gout in adults who have not responded to other medications.
  • Probenecid and colchicine: This oral medication is a combination of two ingredients and is used to treat gout in people who have frequent attacks.
  • Zyloprim (allopurinol): Allopurinol is classified as a xanthine oxidase inhibitor. It lowers uric acid levels. It can be used in adults with gout symptoms (or complications from gout), including acute attacks (flares), uric acid crystals or stones, joint destruction, or kidney problems.
  • Uloric (febuxostat): This oral medicine is in a drug class called xanthine oxidase inhibitors. It treats high uric acid levels in adults with gout who have not responded to or cannot take allopurinol.

Other types of medications are sometimes prescribed to treat gout, such as nonsteroidal anti-inflammatory drugs (NSAIDs), particularly indomethacin, or steroids.

Frequently Asked Questions

  • What is Probalan used for?

    Probalan is used to treat high uric acid levels from gout. It can also be used with certain antibiotics, such as penicillin, to make them more effective.

  • How does Probalan work?

    Probalan works for gout by helping the kidneys get rid of uric acid. When probenecid is used to make certain antibiotics more effective, it prevents the body from eliminating the antibiotics in the urine.

  • What drugs should not be taken with Probalan?

    Probalan can interact with certain drugs, including aspirin, Glucotrol XL (glipizide), Diabeta (glyburide), and anesthesia. (See the list of interactions above for other examples.) Before taking probenecid, tell your healthcare provider about all your medications, including prescription and OTC drugs, and vitamins or supplements.

  • How long does it take for Probalan to work?

    Gout attacks may increase for the first six to 12 months of treatment with Probalan. However, after that, it should start working to prevent them.

    If Probalan takes a while to work for you, your healthcare provider may also prescribe colchicine to help manage these gout flare-ups.

  • What are the side effects of Probalan?

    Common side effects include appetite loss, fever, flushing, frequent urination, headache, dizziness, nausea, vomiting, kidney problems/kidney stones, sore gums, worsening of gout, and skin itching and irritation.

  • How do I stop taking Probalan?

    Your healthcare provider will advise you on how long to take probenecid.

How Can I Stay Healthy While Taking Probalan?

Eating a healthy diet, low in uric acid, can help prevent gout attacks (in combination with your prescription medication). Modifying your diet for gout focuses on lowering uric acid in the body and getting to (and maintaining) a healthy weight.

Purines can raise uric acid levels, so a low-purine diet is often recommended. People who want to try this diet should avoid foods that contain a high or moderate amount of purine.

Foods that are high in purine include:

  • All types of alcohol
  • Certain fish, seafood, and shellfish (anchovies, sardines, herring, mussels, codfish, scallops, trout, and haddock) 
  • Certain meats, like bacon, turkey, veal, venison, and liver 

Foods that have a moderate amount of purine include:

  • Meats like beef, chicken, duck, pork, and ham 
  • Shellfish like crab, lobster, oysters, and shrimp 

It may be helpful to consult with a registered dietitian who can help you with dietary modifications.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  5. Wolf DL, Rodríguez CA, Mucci M, Ingrosso A, Duncan BA, Nickens DJ. Pharmacokinetics and renal effects of cidofovir with a reduced dose of probenecid in HIV-infected patients with cytomegalovirus retinitis. J Clin Pharmacol. 2003;43(1):43-51. doi:10.1177/0091270002239705

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By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.