Sulfinpyrazone

A to Z Drug Facts

(sull-fin-PEER-uh-zone)

Anturane, Sulfinpyrazone,  Novo-Pyrazone

Class: Uricosuric/gout

 Action Potent uricosuric agent that inhibits renal tubular reabsorption of uric acid and reduces renal tubular secretion of other organic anions; possesses antithrombotic and platelet-inhibiting effects.

 Indications Treatment of chronic and intermittent gouty arthritis. Not intended for relief of acute attack of gout. unlabeled use(s): Post MI treatment (within 1 to 6 mo of acute MI) to decrease incidence of sudden cardiac death. May also be used to reduce frequency of systemic embolism in rheumatic mitral stenosis.

 Contraindications Active peptic ulcer or symptoms of GI inflammation or ulceration; hypersensitivity to phenylbutazone or other pyrazoles; blood dyscrasias.

 Route/Dosage

ADULTS: PO Initial: 200 to 400 mg daily in 2 divided doses with meals or milk, gradually increasing to full maintenance dosage in 1 wk. Maintenance: 200 to 800 mg daily, given in 2 divided doses; may increase or decrease after serum urate level is controlled. In case of acute exacerbations, administer concomitant treatment with indomethacin (or another NSAID) or colchicine.

 Interactions

Acetaminophen: Increased hepatotoxicity and reduced efficacy of acetaminophen may occur. Anticoagulants, sulfonylureas (eg, tolbutamide): Blood levels and toxicity of these agents may increase. Salicylates: Uricosuric action of sulfinpyrazone may be reduced. Verapamil: Reduced efficacy of verapamil may occur.

 Lab Test Interferences None well documented.

 Adverse Reactions

DERM: Rash. GI: Nausea; vomiting; epigastric distress. HEMA: Blood dyscrasias, including anemia; leukopenia; agranulocytosis; thrombocytopenia; aplastic anemia. RESP: Bronchoconstriction (in aspirin-sensitive patients).

 Precautions

Pregnancy: Use only when clearly needed. Lactation: Undetermined. Children: Safety and efficacy not established. Alkalinization of urine: Sulfinpyrazone use may precipitate acute gouty arthritis, urolithiasis and renal colic. Adequate fluid intake (10 to 12 8 oz glasses of fluid) and alkalinization of urine are recommended to reduce potential for renal complications. Healed peptic ulcer: Administer with care to these patients. Renal function impairment: Periodically assess renal function.

 Administration/Storage

• Administer with food or milk; add antacid if needed.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Maintain adequate fluid intake and alkalinization of urine. Monitor I&O.
• Monitor blood uric acid levels to evaluate efficacy of treatment.
• Monitor complete blood cell counts for evidence of blood dyscrasias.
• In patients with impaired renal function, monitor renal function test values.
• Observe for upper GI disturbances, rash, or bronchoconstriction and report to physician.

 Patient/Family Education

• Tell patient that medication is taken on daily basis to provide long-term protection from attacks of gout.
• Point out that gout attacks may worsen during initial treatment but continue the drug.
• Explain that other medications may be needed to control attacks of gout.
• Explain that drug may cause GI distress and to take with food or milk and antacid if needed.
• Instruct patient to report these symptoms to physician: rash, difficulty breathing, unusual bleeding or bruising, sore throat, fatigue or fever.
• Explain importance of adequate hydration and instruct patient to drink 10 to 12 full glasses of fluid each day.
• Advise patient to consult physician before using aspirin or other salicylates, acetaminophen or drinking alcohol.
• Tell patient to notify physician if GI distress continues.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts