sulfinpyrazone

CLINICAL USE

Gout prophylaxis Hyperuricaemia

DOSE IN NORMAL RENAL FUNCTION

100–200 mg daily with food (or milk); maximum dose 600–800 mg

PHARMACOKINETICS

Molecular weight :404.5

%Protein binding :98

%Excreted unchanged in urine : 22–42

Volume of distribution (L/kg) :0.06

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

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function Use lower dose range

<10 : Avoid

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Avoid.

HD :Not dialysed. Avoid.

HDF/high flux :Unknown dialysability. Avoid. See ‘Other Information’

CAV/VVHD :Not dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anticoagulants: enhances anticoagulant effect of coumarinsAntidiabetics: enhances effect of sulphonylureas

Anti-epileptics: increases plasma concentration of phenytoin

Ciclosporin: may reduce ciclosporin levels

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

An adequate fluid intake of 2–3 litres daily should be taken to reduce risk of uric acid renal calculiUricosuric effects are lost when GFR <10 mL/minReversible acute renal failure may occur especially with high initial dosesCan cause salt and water retention In combination with aspirin, has been shown to improve vascular access thrombosis in haemodialysis patients, but there was an increased occurrence of gastrointestinal bleeding

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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