Col-Benemid (Probenecid / Colchicine)

Description

Col-Benemid is a combination drug used to manage gouty arthritis, a condition that causes painful swelling in the joints. Probenecid helps the body get rid of extra uric acid through the kidneys, which lowers the amount of uric acid in the blood. Colchicine helps reduce swelling and pain during gout attacks. This medicine is usually to prevent recurring gout flares, rather than treat acute episodes.

Directions

Col-Benemid should be taken by mouth. The standard dosage typically starts with 1 tablet per day for the initial week. After this period, the dosage generally increases to 1 tablet taken twice daily. It's important for individuals to follow their doctor's specific instructions about how to manage sudden or severe gout attacks before starting Col-Benemid, as this medication is not suitable for immediate relief of gout symptoms. Patients with renal impairment should be aware that dosage adjustments may be necessary. It is meant for adult use and should not be given to children.

Ingredients

The active ingredient in Col-Benemid is probenecid and colchicine.

Contraindications

Avoid taking Col-Benemid if any of the following apply:

• Acute gouty attack
• Blood dyscrasias, such as bone marrow suppression
• History of uric acid kidney stones
• Children under 2 years of age
• Current pregnancy
• Concomitant use with salicylates, as it may weaken the effect of Col-Benemid

Cautions

• Before taking Col-Benemid, you may want to consult a healthcare provider about the following:
• Any existing health conditions
• Any allergies
• A list of all medications you are currently taking
• Whether you are pregnant or breastfeeding

• Starting Col-Benemid can sometimes cause a short-term flare-up of gout. If this happens, your doctor may recommend additional colchicine or another medicine to help manage the symptoms.
• Aspirin (and other drugs in the salicylate family) can reduce the effectiveness of Col-Benemid and should not be used while you're taking it. If you need a mild pain reliever, acetaminophen is generally a safer option.
• Although uncommon, serious allergic reactions—including rash, hives, or even anaphylaxis—have been reported. These reactions can happen especially if the drug is taken again after a break. Stop the medication and contact your doctor right away if you notice any signs of an allergic reaction.
• Colchicine has been shown to affect sperm production in animals, and rare cases of reversible infertility have been reported in men.
• This medication may increase your risk of uric acid kidney stones. Drinking plenty of fluids and sometimes taking medications to alkalize the urine can help prevent this. A false sugar reading may also appear in urine tests while taking this drug.
• Talk to your doctor if you have kidney disease, peptic ulcers, or liver problems, as you may need a different dose or closer monitoring. Col-Benemid may not work well if you have advanced kidney problems.
• Col-Benemid can affect how other drugs work or stay in your system. It may:
• Raise the levels of methotrexate, penicillin, acetaminophen, NSAIDs, sulfonamides, and more—sometimes to unsafe levels.
• Increase the effects of certain diabetes medications (sulfonylureas), which may raise your risk of low blood sugar.
• Change how you respond to anesthesia, including drugs like thiopental and ketamine.
• Slightly reduce the effects of sulindac, a common arthritis medication.
• Animal studies haven’t fully established whether long-term use of this drug increases the risk of cancer, though colchicine is known to affect cell DNA in lab settings. Your doctor will weigh the risks and benefits for long-term use.
• You may need occasional blood or urine tests while on Col-Benemid to check for side effects or interactions—especially if you're taking it with other medications.

Side Effects

The most common side effects of Col-Benemid include nausea, headache, dizziness, and skin rash. Other problems such as vomiting, anorexia, or sore gums may also occur, especially at higher doses. Colchicine-related side effects tend to be dose-dependent and may require dosage adjustment if symptoms like abdominal pain or diarrhea become severe. Some patients may also experience flushing, dermatitis, or alopecia.

Serious side effects are rare but may include aplastic anemia, leukopenia, or kidney problems such as nephrotic syndrome or uric acid stones. Probenecid may occasionally trigger acute gout attacks during the early stages of treatment. In cases of overdose or toxicity, colchicine can lead to dangerous complications including vascular damage, kidney impairment, or severe gastrointestinal distress. Patients with liver problems may be at increased risk for colchicine toxicity and should be monitored closely.

References

1. Probenecid and Colchicine Tablet Drug Label Information. Parsippany, NJ: Actavis Pharma, Inc.; 2016.
2. Probenecid and Colchicine Tablet Drug Label Information. Orlando, FL: Ingenus Pharmaceuticals, LLC; 2023.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....