Indication
Hyperuricaemia with gout
Administration
Should be taken with food.
Adult Dose
Oral
Hyperuricaemia with gout
Adult: Initially, 100-200 mg bid, increase gradually over 2-3 wk to 600 mg daily. Maintenance dose (after plasma-urate concentration is controlled): 200 mg daily in divided doses. Max: 800 mg daily.
Hepatic impairment: Severe: Avoid.
Renal Dose
Renal impairment: Mild to moderate: Reduce dose. Severe: Contraindicated.
Contraindication
Hypersensitivity to sulfinpyrazone and other pyrazolone derivatives. Patient in whom attacks of asthma, urticaria or acute rhinitis are precipitated by aspirin or other drugs w/ prostaglandin-synthetase inhibiting activity. Acute gout attack, blood coagulation disorders, uric acid renal calculi, porphyria, peptic ulceration, severe parenchymal lesions of liver or kidneys, blood dyscrasias. Severe hepatic and renal impairment. Concomitant use w/ salicylates.
Mode of Action
Sulfinpyrazone increases urinary excretion of uric acid by inhibiting tubular reabsorption of uric acid. It also decreases platelet aggregation.
Precaution
Patient w/ heart failure. Mild to moderate renal impairment. Pregnancy and lactation. Patient Counselling Ensure adequate fluid intake (approx 2-3 L/day) and urine alkalinisation. Monitoring Parameters Monitor renal function, blood count.
Side Effect
Nausea, vomitting, diarrhoea, skin rashes, renal impairment or failure, salt and water retention, blood dyscrasia, jaundice, hepatitis, acute gout attacks, uric acid renal calculi development if inadequate fluid intake.
Interaction
Decreased therapeutic effect when given w/ drugs that increase uric acid concentration (e.g. diuretics, pyrazinamide). May potentiate the action of coumarin anticoagulants (e.g. warfarin, acenocoumarol), hypoglycaemic agents and sulfonamides. May decrease plasma levels of theophylline. May increase plasma levels of penicillins and phenytoin. Increased risk of haemorrhage w/ substances affecting homeostasis (e.g. non-steroidal antirheumatic drugs). Probenecid may inhibit renal tubular secretion of sulfinpyrazone.
Potentially Fatal: Salicylates may antagonise the effect of sulfinpyrazone.