Uricosuric Drugs, with Special Reference to Probenecid and Sulfinpyrazone

Abstract

This chapter discusses the uricosuric drugs, with special reference to probenecid and sulfinpyrazone. Uricosuric drugs increase urinary uric acid excretion by inhibiting renal tubular reabsorption of uric acid, and thereby reduce the plasma urate concentration and enhance the renal clearance of uric acid. The compounds possessing authentic uricosuric properties are of diverse structure, with no apparent coninion coniponent, but virtually all are organic acids; a striking and inexplicable exception is zoxazolamine, a weak base yet one of the most potent of the uricosuric drugs. The uricosuria produced by these various agents really represents a net renal response, since the acidic uricosuric drugs are all secreted by the same “organic acid system” of renal tubular transport, in common with uric acid, and in the process may also competitively inhibit, to greater or lesser degree, the tubular secretion of uric acid. When there is a dual action on tubular reabsorption and secretion of uric acid, the net effect, whether it is to augment or to diminish urinary elimination of uric acid, varies with the nature of the drug, the dosage employed, and the species treated.