Probenecid NSAIDs

Drugs that may affect aspirin include activated charcoal, ammonium chloride, ascorbic acid or methionine, antacids and urinary alkalinizers, carbonic anhydrase inhibitors, corticosteroids, and nizatidine. Drugs that may be affected by aspirin include alcohol, ACE inhibitors, anticoagulants (oral), beta-adrenergic blockers, heparin, loop diuretics, methotrexate, nitroglycerin, NSAIDs, probenecid and sulfinpyrazone, spironolactone, sulfonylureas and exogenous insulin, and valproic acid. 

Er hromycin Sulfisoxazole (Eryzole, Pediazole) [Anti-infective, Macrolide/Sulfonamide] Uses Upper lower resp tract bacterial Infxns H. influenzae otitis media in children Infxns in PCN-allergic pts Action Macrolide antibiotic w/ sulfonamide Dose Adults. Based on erythromycin content 400 mg erythromycin/1200 mg sulfisoxazole PO q6h Feds > 2 mo. 40-50 mg/kg/d erythromycin 150 mg/kg/d sulfisoxazole PO -s- q6h max 2 g/d erythromycin or 6 g/d sulfisoxazole x 10 d in renal impair Caution [C (D if near term), +] w/ PO anticoagulants, hypoglycemics, phenytoin, cyclosporine Contra Infants <2 mo Disp Susp SE GI upset Additional Interactions T Effects of sulfonamides W/ ASA, diuretics, NSAIDs, probenecid EMS See Erythromycin OD See Erythromycin... 

Uses w/ cisplatin in nonresectable mesothelioma NSCLC Action Antifolate antineoplastic Dose 500 mg/m IV over 10 min q3wk hold if CrCl <45 mLAnin give w/ vit Bi2 (1000 meg IM q9wk) folic acid (350-1000 meg PO daily) start 1 wk before dexamethasone 4 mg PO bid x 3 start 1 d before each Rx Caution [D, -] w/ renal/hepatic/ BM impair Contra Component sensitivity Disp IV SE Neutropenia, thrombocytopenia, N/V/D, anorexia, stomatitis, renal failure, neuropathy, fevCT, fatigue, mood changes, dyspnea, anaphylactic Rxns Interactions t Effects W/ NSAIDs, probenecid d/t decreased pemetrexed EMS Monitor for S/Sxs of Infxn OD May cause profound BM suppression, mucous membrane irritation, D, and rash symptomatic and supportive... 

PROBENECID ANALGESICS - NSAIDS Probenecid t levels of indometacin and ketorolac and possibly dexketoprofen, ketoprofen, naproxen, tenoxicam and tiaprofenic acid Probenecid competitively inhibits renal metabolism of these NSAIDs Watch for signs of toxicity of these NSAIDs. Consider using an alternative NSAID. The manufacturers of ketorolac advise avoiding co-administration of ketorolac and probenecid... 

Cephalosporins Cimetidine Furosemide NSAIDs Probenecid Ranitidine Tetracycline Various anticancer ... 

P-Lactam antibiotics Cephalosporins Cidofovir Furosemide Ganciclovir Methotrexate NSAIDs Probenecid Tetracycline Zidovudine KW-3902 ... 

Clinically important, potentially hazardous interactions with nephrotoxic drugs, NSAIDs, probenecid... 

OAT Penicillin Methotrexate Cidofovir Furosemide Various Probenecid NSAIDS Probenecid Probenecid Uremic Toxins f duration of action of penicillin f plasma exposure of methotrexate leading to toxicity J, kidney accumulation and lower incidence of cidofovir nephrotoxicity J, diuretic activity of furosemide J, excretion of OAT substrates... 

Severe drug-drug interactions are known to occur between methotrexate and NSAIDs, probenecid, and penicillin G partially due to inhibition of renal... 

OAT-mediated secretion of methotrexate. By using mouse proximal tubule cells stably expressing human transporters, methotrexate has been demonstrated to be taken up via hOAT3 and hOATl at the basolateral side of the proximal tubule and effluxed or taken up at the apical side via hOAT4, where drug interactions occur between methotrexate and NSAIDs, probenecid, and penicillin G (Takeda et al., 2002). 

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