Sulfinpyrazone

Indications

Sulfinpyrazone is used for: Hyperuricaemia with gout

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.

Child Dose

Renal Dose

Renal impairment: Mild to moderate: Reduce dose. Severe: Contraindicated.

Administration

Should be taken with food.

Contra Indications

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.

Precautions

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.

Pregnancy-Lactation

Interactions

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.

Adverse Effects

Side effects of Sulfinpyrazone : 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.

Mechanism of Action

Sulfinpyrazone increases urinary excretion of uric acid by inhibiting tubular reabsorption of uric acid. It also decreases platelet aggregation.