Benzbromarone

CLINICAL USE

Treatment of hyperuricaemia, chronic gout and tophaceous gout

DOSE IN NORMAL RENAL FUNCTION

50–200 mg daily(Usual dose 50–100 mg daily)

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :424.1

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :>99

%Excreted unchanged in urine &nbsp &nbsp : 6–18 (as metabolites)

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :19 litres

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :2–4

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

40–60 50–200 mg daily120–40 50–100 mg daily1<20 Avoid. Ineffective

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Avoid. Ineffective

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Avoid. Ineffective

HDF/high flux &nbsp :Avoid. Ineffective

CAV/VVHD &nbsp &nbsp &nbsp:Use with caution. Dose as in GFR=20–40 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsA

spirin and salicylates: antagonise uricosuric effects of benzbromarone

Anticoagulants: may enhance effect of warfarinPyrazinamide: antagonise uricosuric effects of benzbromarone

Hepatotoxic agents: enhanced hepatotoxicity

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Monitor LFTs while on benzbromarone as can cause fulminant liver failure

As with other uricosurics, treatment with benzbromarone should not be started during an acute attack of gout

Maintain an adequate fluid intake to reduce the risk of uric acid renal calculi

Biological effect of 100 mg benzbromarone is equivalent to 1.5 g probenecid or greater than 300 mg of allopurinol.

Benzbromarone is considered unsafe in patients with acute porphyria

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