Sulfinpyrazone

Used in treating gout and gouty arthritis, sulfinpyrazone works by causing a patient to pass out uric acid through urine, much faster than would otherwise happen.

Overview

Sulfinpyrazone is a drug which is administered orally for the treatment of gout and arthritis that is attributable to gout. The gouty condition itself is triggered by elevated levels of uric acid in the bloodstream, which is a condition referred to as hyperuricemia. By increasing the normal rate of excretion of uric acid, sulfinpyrazone works to lower the levels of uric acid in the body, thereby reducing the symptoms associated with gout. It is a prescription drug which has the characteristic of prolonging platelet survival and inhibiting platelet adherence to subendothelial cells. It has also been studied as an antithrombotic agent.

Condition Treated

  • Chronic or intermittent arthritis due to gout

Type of Medicine

  • Uricosuric compound

Side Effects

While on a treatment program that calls for taking sulfinpyrazone, there may appear some side effects in addition to the beneficial effects worked by the drug. If one or more of the following side effects appear while you are on a treatment program which includes sulfinpyrazone, you should check immediately with your doctor about how to proceed. Side effects in this category include the following:

  • unusual bleeding or bruising at various locations around the body
  • glands which are tender or painful, and may appear swollen to an observer
  • persistent sore throat
  • fever which may or may not be accompanied by chills
  • white spots, ulcers, or sores that appear in the mouth or on the lips
  • respiratory issues which are manifested as wheezing, shortness of breath, difficulty breathing, or the sensation of tightness in the chest area.

There are also side effects which generally characterize an overdose of the drug, and if any of these appear, you should immediately contact your doctor, as well as the Poison Control Center, and follow any instructions you are given. Side effects in this category include the following:

  • severe or persistent stomach pains
  • chronic or extreme nausea and vomiting
  • unexplained convulsions or seizures
  • severe bouts of diarrhea
  • extreme difficulty with breathing
  • clumsiness or unsteadiness in the motor movements.

Some side effects which are manifested during treatment with sulfinpyrazone are not considered to be dangerous, but should still be reviewed by your doctor, in case there might be modifications necessary to your sulfinpyrazone dosage. These types of side effects include some or all of the following:

  • pains which are experienced in the sides or in the lower back
  • urination which is sometimes painful and may occasionally include blood
  • skin rashes or inflammation
  • bloody stools, or stools which are black and tarry
  • elevated blood pressure
  • tiny red spots which appear on skin surfaces all over the body
  • unexplained weight gain
  • fatigue or weakness which is not normal for a patient
  • an unusual decrease in the amount of urine being passed by a patient
  • vomiting which includes blood, or in some cases a substance that has the appearance of coffee grounds
  • swelling which is noticeable in the feet, lower legs, fingers, or face.

There are also some side effects which have been reported by patients taking sulfinpyrazone which require no medical attention at all, but for safety’s sake should be mentioned to the family doctor at the next visit. These type of side effects will generally subside all on their own without treatment, simply because the body is growing used to the drug and develops an increased tolerance. If any of the side effects listed below are severe enough that they cause discomfort or pain to a patient, it is advisable to call the family doctor to see if the symptoms can be mitigated in some way. It's also best to consult with the family doctor if any side effects in this category or other categories persist over a long period of time, or cause undue discomfort to the patient. The side effects of lesser concern include the following:

  • mild stomach pain or discomfort
  • occasional nausea or vomiting
  • mild joint pain
  • swelling or inflammation which can easily be observed in the joints of the body.

Dosage

The initial dosage of sulfinpyrazone prescribed by your doctor will probably be between 200 and 400 mg daily, in two evenly divided dosages, which are to be taken with meals, milk, or some type of antacid, to avoid the risk of an upset stomach.

This dosage can be gradually increased over the course of the first week of treatment, and after that initial week, patients enter into a maintenance phase of treatment, where the dosage is increased, or in some cases may be reduced by your doctor when it is observed that the drug is having a highly beneficial impact.

Generally speaking, the maintenance phase of a sulfinpyrazone treatment program calls for 400 mg daily, which are to be taken in two separate dosages, with meals. There is room for modification in this maintenance phase, and your doctor may prescribe as little as 200 mg daily or as much as 800 mg daily, depending on the effectiveness of the drug in managing your symptoms.

The main objective with a treatment program of sulfinpyrazone is to control the blood urate level, and once it is determined that control has been established, that specific level of daily medication will be continued throughout the program of treatment. In some unusual cases, a worsening of symptoms appears, and it may be necessary to add other drugs to the program such as phenylbutazone, or colchicine.

It is also possible for patients who have been using other treatment programs to be switched over to sulfinpyrazone, because they have developed some kind of intolerance to their original treatment, or because side effects with other drugs have mandated a switch to an alternative form of treatment.

Sulfinpyrazone is usually issued in bottles of 100 tablets, and these tablets are imprinted with a 100 mg symbol so that patients can clearly identify dosages and take the right amount at each scheduled time.

If you have missed a regularly scheduled dosage, you can take the missed dose as soon as you remember it, unless you’re getting very close to the time of the next scheduled dosage, in which case you should skip it. It is never advisable to double up on dosages, even if you feel you need more of the drug to manage your symptoms at any given time.

When symptoms of gout begin to clear up during treatment, you should not discontinue use because your body is returning to a more normal state. Instead, you should continue taking your full prescription of sulfinpyrazone, as directed by your doctor, until that prescription actually runs out. At that point, you and your doctor can make a decision about whether further treatment is necessary.

If you suspect you have taken too much sulfinpyrazone and overdosed, call your doctor immediately, and be prepared to tell him/her exactly how many tablets you have ingested, as well as any side effects you are currently experiencing.

Interactions

Altogether, there is a total of 542 drugs which are known to have various levels of interaction with sulfinpyrazone. Of these 442 are moderate reactions and another 67 are considered to be relatively minor interactions, and due to their lesser severity, these will not be listed here. However, there are an additional 33 drug interactions with sulfinpyrazone which are considered to be major interactions, and these are listed below accordingly:

  • tinzaparin
  • tipranavir
  • tositumomab
  • warfarin
  • Xarelto (rivaroxaban)
  • Xigris (drotrecogin alfa)
  • Y-90 Zevalin (ibritumomab)
  • Zevalin (ibritumomab)
  • Arixtra (fondaparinux)
  • Arixtra 10 mg / dose (fondaparinux)
  • Bexxar (iodine i 131 tositumomab)
  • Clexane (enoxaparin)
  • Clexane Forte (enoxaparin)
  • Cometriq (cabozantinib)
  • Coumadin (warfarin)
  • Cyramza (ramucirumab)
  • Dabigatran
  • Defibrotide
  • Defitelio (defibrotide)
  • Enoxaparin
  • Exjade (deferasirox)
  • Imbruvica (ibrutinib)
  • In-111 Zevalin (ibritumomab)
  • Innohep (tinzaparin)
  • iodine i 131 tositumomab
  • Normiflo (ardeparin)
  • Omacetaxine
  • Orgaran (danaparoid)
  • Orlaam (levomethadyl acetate)
  • Iprivask (desirudin)
  • Jadenu (deferasirox)
  • Jadenu Sprinkle (deferasirox)
  • Arixtra 5 mg / dose (fondaparinux)
  • Arixtra 7.5 mg / dose (fondaparinux)
  • Betrixaban
  • Bevyxxa (betrixaban)
  • Jantoven (warfarin)
  • Kengreal (cangrelor)
  • Krystexxa (pegloticase)
  • levomethadyl acetate
  • Sprycel (dasatinib)
  • Stivarga (regorafenib)
  • Synribo (omacetaxine)
  • Anisindione
  • Apixaban
  • Aptivus (tipranavir)
  • Ardeparin
  • Lovenox (enoxaparin)
  • Dalteparin
  • Danaparoid
  • Dasatinib
  • Deferasirox
  • Lovenox HP (enoxaparin)
  • Miradon (anisindione)
  • Pegloticase
  • Desirudin
  • Dicumarol
  • drotrecogin alfa
  • edoxaban
  • Eliquis (apixaban)
  • Ponatinib
  • Pradaxa (dabigatran)
  • Ramucirumab
  • Ranexa (ranolazine)
  • Ranolazine
  • Regorafenib
  • Rivaroxaban
  • Savaysa (edoxaban)
  • Bexxar Dosimetric (tositumomab)
  • BexxarTherapeutic (tositumomab)
  • Cabometyx (cabozantinib)
  • Cabozantinib
  • Cangrelor
  • Fondaparinux
  • Fragmin (dalteparin)
  • Ibritumomab
  • Ibrutinib
  • Iclusig (ponatinib)

Warnings

There are certain warnings and precautions which should be observed by patients on a treatment program which includes sulfinpyrazone. First among these is that anyone who knows they are allergic to the drug or any of its ingredients should discuss this thoroughly with a family doctor before agreeing to take the drug.

In addition, if any kind of side effects should emerge during a treatment program, this should trigger another discussion with the family doctor about the benefits of taking the drug versus the risks or disadvantages. If the disadvantages to a specific user outweigh any benefits to be realized, that could be sufficient grounds for discontinuance of the drug.

Sulfinpyrazone should be taken orally with a meal, with milk, or an antacid, so as to reduce the likelihood of developing an upset stomach. There are certain products which tend to decrease the potency and effectiveness of sulfinpyrazone, and these should either be avoided completely or taken less frequently, per your doctor. Some of these types of products are salsalate, magnesium salicylate, choline and magnesium salicylate, and most other products which are aspirin-like in nature. Although taking one aspirin per day to reduce the risk of heart attack is acceptable in most cases, even this should be discussed with your family doctor.

You should not take sulfinpyrazone under any of the following conditions:

  • you have ever had an allergic reaction to the drug
  • if you have kidney disease or any type of kidney problems
  • if you have stomach ulcers or any kind of blood problems
  • if you are on a high-dose aspirin program or salicylate therapy
  • it is not known whether sulfinpyrazone has any effect on infants, but that does not mean it is safe for pregnant women to take the drug. Since no studies or research have been conducted in this area, even on animals, this is a matter which should be reviewed with the family doctor for any woman who is currently pregnant or planning to become pregnant.
  • along those same lines, it is also not known whether sulfinpyrazone is passed on to an infant through breast milk, so this is another area which should be carefully considered and reviewed with the family doctor.

Storage

Sulfinpyrazone should be stored at room temperature in a tightly sealed container, well out of the reach of any pets or children. It is not advisable to store this drug in a pill reminder container, because very few of these have any safety features which prevent access, and that means curious children might well be able to break into your pill reminder and ingest one or more of the tablets.

Sulfinpyrazone should not be allowed to freeze, nor should it be exposed to direct sunlight, or extreme heat or humidity. All of these conditions can have the effect of decreasing the potency of the drug, so it should be kept in a location which is relatively immune from all such effects.

Any unused medication should be properly disposed of, and if the expiration date has been reached, sulfinpyrazone should not be used. If you are unsure about how to properly dispose of unused drugs, you should contact your doctor or pharmacist for advice on how to proceed.

Summary

Sulfinpyrazone is a drug which can easily be ingested orally but should always be taken with food or drink, because it has the potential to cause an upset stomach if ingested in standalone mode. It is generally very effective in treating patients with gout, or with arthritis caused by gout, because it works on the conditions underlying the presence of gout.

Since gout occurs when there is an excess of uric acid in the body, particularly in the joints, the removal or reduction of much of that uric acid would be highly beneficial in treating the condition, and that’s what sulfinpyrazone does. By causing a patient to eliminate uric acid in the body much faster than a normal rate might call for, a good amount of the excess uric acid can be passed, and the conditions triggering gout will have the opportunity to subside.

There are some side effects associated with taking the drug, although these will not be manifested in all patients, and when they do appear, they are generally not extreme in nature. In most cases, side effects are mild and should be discussed with the family doctor for possible treatment. It is common for sulfinpyrazone to achieve favorable results within a few weeks, and for patients suffering from gout symptoms to experience at least some degree of relief while in the maintenance phase of treatment.

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Last Reviewed:
December 23, 2017
Last Updated:
December 22, 2017
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