Probenecid for use with Cefazolin
General Information
This monograph is only related to use of probenecid with cefazolin.
Pharmacokinetic Booster Agent
Probenecid must be given at the same time as the cefazolin
Restricted formulary antimicrobial: For details see OUH netFormulary
Standard dose
For use with cefazolin iv 2g once daily: Give probenecid 1g od at the same time as the cefazolin dose is given.
Obesity
No dose modification of probenecid required
Renal and hepatic impairment
Renal impairment
|
Creatinine clearance (mL/min) |
Dose of probenecid oral |
|
30 and over |
Dose as in normal renal function |
|
Less than 30 |
Do not use |
Hepatic impairment
No dose modification required
Interactions
Probenecid increases the plasma levels of many drugs.
Significant interactions occur with the following medications and probenecid: Discuss with pharmacy.
- ACE inhibitors
- Aciclovir (encephalitis dosing)
- Salicylates, including treatment dose aspirin (Low dose aspirin (75mg po od) can continue)
- Baricitinib
- Benzodiazepines
- Dapsone
- Fexofenadine
- Loop diuretics
- Methotrexate
- Mycophenolate
- NSAIDs
- Oseltamivir
- Paracetamol (dosing of paracetamol may need to be reduced)
- Other antibiotics as probenecid may reduce excretion of other antibiotics (for patients on TB meds - discuss with Micro/ID)
- Sulphonylureas (e.g. gliclazide)
- Theophylline/aminophylline
This is not a complete list. Please see the Summary of Product Characteristics or speak to a pharmacist.
Additional information
- Advise daily U+E, FBC, CRP and LFTs whilst taking probenecid
- Probenecid is unlicensed in the UK - patient should be given an unlicensed medication information sheet
- Do NOT use probenecid (contraindications):
- Uric acid kidney stones
- Acute gout episode
- Acute peptic ulcer disease or severe GORD
- Use probenecid with caution in (discuss with pharmacy):
- G6PD deficiency
- Peptic ulcer disease (non-acute)
Pregnancy and breastfeeding
Pregnancy
Not recommended due to lack of data. Discuss with pharmacy.
Breastfeeding
Not recommended due to lack of data. Discuss with pharmacy.
References
1. Pharmaceuticals A. PROBENECID-AFT, Probenecid 500 mg film coated tablets [Internet]. Last revision of the text: 21/6/24 Medsafe.co.nz; Available from: https://www.medsafe.govt.nz/profs/Datasheet/a/aft-Probenecidtab.pdf Accessed 13/3/25
2. Drugs.com [Internet]. Probenecid: Package Insert / Prescribing Information. Available from: https://www.drugs.com/pro/probenecid.html Accessed 13/3/25
3. Kingston M, Apea V, Evans C, Fifer H, Foster K, Patrick P, et al. BASHH UK guidelines for the management of syphilis 2024. Int J STD AIDS. 2024 Dec;35(14):1142–60.
4. Preferred Medicines List - the Pink Book [Internet]. Available from: https://www.pinkbook.org.nz/ Accessed 13/3/25