jackspratt wrote:polehawk wrote: I've been on Probenecid 500 mg for maintenance of the gout condition for a number of years. If you have ever had a gout attack then you might consider it a chronic condition.
ph what do you pay for the Probenecid?
I am going to the BD hospital this morning for my 3 monthly script of Allopurinol (100mg @ 1/day), which cost me 1 baht each - hospital pharmacy only.
Allopurinol does a very similar job to Probenecid in the treatment of gout (by controlling the uric acid), although it is a completely different drug.
Hello everyone. I am quite new to Udonmap, so please forgive my unsolicited opinion.
I was reading this thread while looking for a suitable pharmacy, and although the thread is old, I thought I might clarify the difference between allopurinol and probenecid.
Gout, as you all know, is caused by an excess of uric acid in the blood, and acute attacks are caused by crystals forming in the joints. While acute gout attacks are painful, and may require emergent treatment, the chronic condition of gout needs management over time. As part of the so-called "metabolic syndrome", it is genetically linked, but can be managed by weight loss, exercise and diet, and by drugs. Eating meat, which is high in purines (a type of amino acid), often causes sharp increases in uric acid, and can lead to an acute attack. Gout was once known as a 'rich man's disease', since few peasants could afford to eat meat every day, and fewer could attain the level of obesity which contributes to the disease...
The excess buildup of uric acid can be for one of two reasons: excess production, or insufficient excretion. Allopurinol works by reducing uric acid
production, while probenicid inhibits renal tubular re-absorption of uric acid, thereby increasing
excretion in the urine.
Generally, when your doctor first diagnoses gout, he/she should do a 24 hr. urine collection, as well as a serum uric acid test. This will guide them to the correct drug. In practice, however, since Probenicid is a very old and reliable drug, it is often prescribed as a panacea. Colchicine is often added to Probenicid, and has been in use since ancient Greek times.
Using the correct drug is important for people with diabetes, because they need to avoid adverse effects to their kidneys. If uric acid production is excessive, allopurinol is the preferred treatment, because high concentrations of uric acid can form kidney stones, and probenicid may have other kidney side effects. If production is within the normal range, then probenicid should be used to increase excretion.
I hope this hasn't been too pedantic; I urge anyone with gout, or other of the metabolic diseases, to seek medical advice, and NEVER self-treat.
Good health.
