sulfinpyrazone

Action and Spectrum

Actions and Spectrum: 

Actions: 

Uric Acid Reduction: Sulfinpyrazone works by preventing the kidneys from reabsorbing uric acid, which raises the amount of uric acid excreted in urine. Lowering the amount of uric acid in the blood helps to stop urate crystals from forming, which is what causes gout. 

Spectrum: 

Sulfinpyrazone is prescribed for the management of chronic gout and specific blood clotting disorders. It seems to reduce blood clotting by diminishing the stickiness of platelets, the cells responsible for forming blood clots. Additionally, it hinders the formation of gout crystals by enhancing the movement of uric acid and water through the kidneys. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Agranulocytosis 

Leukopenia 

Anemia 

Stomach upset 

Nausea 

Heartburn 

Black Box Warning

Black Box Warning: 

Initiating sulfinpyrazone is not recommended during a sudden or severe gout attack. It is advisable to wait until the current attack subsides before starting this medication.

It’s common to experience an uptick in the frequency of gout attacks for several months after commencing this medicine as the body works to eliminate excess uric acid. In the event of a gout attack while on sulfinpyrazone, continue taking the medication along with your prescribed gout pain medications. 

Contraindication / Caution

Contraindication/Caution: 

Contraindications 

• Hypersensitivity 

Cautions 

• Renal impairment 
• Blood disorders 
• Geriatrics 
• GI disorders 
• Active peptic ulcer disease 
• Cardiovascular diseases 
• Hepatic impairment 
• Drug interactions 
• Pregnancy  
• Breastfeeding 

Pregnancy / Lactation

Pregnancy consideration:  

No data is available regarding the administration of the drug during pregnancy. 

Breastfeeding warnings:  

No data is available regarding the excretion of drug in breast milk. 

Pregnancy category: 

Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology: 

Sulfinpyrazone aids in reducing the blood’s uric acid level, leading to a decrease in the occurrence and intensity of gout attacks. This is accomplished by enhancing uric acid excretion through the kidneys and diminishing its production in the body. As a sustained treatment, it can effectively address chronic gout by preventing the accumulation of uric acid crystals in the joints, ultimately alleviating pain, inflammation, and potential damage. 

Pharmacodynamics: 

Sulfinpyrazone elevates the elimination of uric acid in urine by competitively inhibiting the tubular reabsorption of uric acid. Consequently, this lowers the concentration of uric acid in the serum, ultimately diminishing urate deposits in the tissues. 

Pharmacokinetics: 

Absorption 

The time to achieve peak effect is 1-2 hours 

Distribution 

Protein-bound is 98 

Metabolism 

Experiences partial hepatic metabolism through reduction to the sulfide, oxidation to the sulfone, and conversion to hydroxy-compounds. 

Elimination and Excretion 

The half-life is 2-4 hours 

The drug is excreted 5% in feces and as unchanged with metabolites in urine. 

Adminstartion

Administration: 

Take it with food or following meals to minimize stomach upset. 

Ingest the tablets whole, accompanied by a full glass of water. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: sulfinpyrazone 

Pronounced: suhl-fin-PEYE-ra-zone 

Why do we use sulfinpyrazone? 

Sulfinpyrazone, categorized as a uricosuric medication, is primarily prescribed for treating gout and specific types of kidney stones. Gout, a form of arthritis, results from the uric acid crystal accumulation in the joints. Sulfinpyrazone operates by enhancing the excretion of uric acid through the kidneys, effectively reducing its levels in the bloodstream. This mechanism aids in preventing gout attacks and mitigating associated symptoms like joint pain and inflammation. 

In addition to its role in managing gout, sulfinpyrazone is utilized to prevent certain types of kidney stones. Through its ability to increase the excretion of uric acid, the medication reduces the likelihood of crystal formation in the kidneys. By addressing both gout and the prevention of kidney stones, sulfinpyrazone proves to be a valuable therapeutic agent for managing conditions associated with uric acid metabolism.