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Sulfinpyrazone
Sulfinpyrazone (Anturane)
Sulfinpyrazone
(sul-fin-PEER-ah-zohn) Antazone Anturane Apo-Sulfinpyrazone Novo-Pyrazone Nu-Sulfinpyrazone (Rx)

Classification: Antigout agent, uricosuric

Action/Kinetics: Inhibits tubular reabsorption of uric acid, thereby increasing its excretion. Also exhibits antithrombotic and platelet inhibitory actions. Peak plasma levels: 1-2 hr. Therapeutic plasma levels: Up to 160 mcg/mL following 800 mg/day for uricosuria. Duration: 4-6 hr (up to 10 hr in some). t1/2: 3-8 hr. Metabolized by the liver. Approximately 45% of the drug is excreted unchanged by the kidney, and a small amount is excreted in the feces.

Uses: Chronic and intermittent gouty arthritis. Not effective during acute attacks of gout and may even increase the frequency of acute episodes during the initiation of therapy. However, do not discontinue during acute attacks. Concomitant administration of colchicine during initiation of therapy is recommended. Investigational: To decrease sudden death during first year after MI.

Contraindications: Active peptic ulcer or symptoms of GI inflammation or ulceration. Blood dyscrasias. Sensitivity to phenylbutazone or other pyrazoles. Use to control hyperuricemia secondary to treatment of malignancies.

Special Concerns: Use with caution in pregnant women. Dosage has not been established in children. Use with extreme caution in clients with impaired renal function and in those with a history of peptic ulcers.

Side Effects: GI: N&V;, abdominal discomfort. May reactivate peptic ulcer. Hematologic: Leukopenia, agranulocytosis anemia, thrombocytopenia, aplastic anemia. Miscellaneous: Skin rash (which usually disappears with usage), bronchoconstriction in aspirin-induced asthma. Acute attacks of gout may become more frequent during initial therapy. Give concomitantly with colchicine at this time.

Overdose Mangement: Symptoms: N&V;, diarrhea, epigastric pain, labored respiration, ataxia, seizures, coma. Treatment: Supportive measures.

Drug Interactions: Acetaminophen / Risk of acetaminophen hepatotoxicity; effect of acetaminophen Anticoagulants / Effect of anticoagulants due to plasma protein binding Niacin / Uricosuric effect of sulfinpyrazone Salicylates / Inhibit uricosuric effect of sulfinpyrazone Theophylline / Effect of theophylline due to plasma clearance Tolbutamide / Risk of hypoglycemia Verapamil / Effect of verapamil due to plasma clearance

How Supplied: Capsule: 200 mg; Tablet: 100 mg

Dosage
•Capsules, Tablets Gout.
Adults, initial: 200-400 mg/day in two divided doses with meals or milk. Clients who are transferred from other uricosuric agents can receive full dose at once. Maintenance: 100-400 mg b.i.d. Maintain full dosage without interruption even during acute attacks of gout.
Following MI.
Adults: 300 mg q.i.d. or 400 mg b.i.d.