Version July 2025
Note: Urate-lowering therapy may be initiated during a gout flare or after the flare subsides (Ref).
Gouty arthritis, flare prophylaxis: Oral: Colchicine 0.5 mg/probenecid 500 mg: 1 tablet once daily for 1 week, then 1 tablet twice daily thereafter; may increase dose by 1 tablet every 4 weeks as tolerated if symptoms not controlled or the 24-hour uric acid excretion is <700 mg. Note: Current prescribing information includes dosing up to 4 tablets/day; however, this exceeds the maximum dose of colchicine for gout prophylaxis (1.2 mg/day).
Note: Other agents are preferred over probenecid as first-line urate-lowering therapy in patients with moderate to severe chronic kidney disease (stage ≥3) (Ref). Additional therapeutic considerations may apply; refer to individual agents for information.
GFR >30 mL/minute: There are no dosage adjustments provided in the manufacturer's labeling.
GFR ≤30 mL/minute: Avoid use, as probenecid may not be effective, and the colchicine dose would not be able to be dose-adjusted for kidney function properly.
There are no dosage adjustments provided in the manufacturer's labeling; use with caution.
Refer to adult dosing.
See individual agents.
Hypersensitivity to colchicine, probenecid, or any component of the formulation; children <2 years of age; blood dyscrasias; uric acid kidney stones; initiation during an acute gout attack.
See individual agents.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, Oral:
Generic: Colchicine 0.5 mg and probenecid 500 mg
Yes
Tablets (Colchicine-Probenecid Oral)
0.5-500 mg (per each): $0.97 - $1.93
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Oral: Administer with food if GI upset occurs. Maintain adequate fluid intake (at least 64 oz water/day).
Colchicine is a hazardous agent (NIOSH 2024 [table 2]).
Use appropriate precautions for receiving, handling, storage, preparation, dispensing, transporting, administration, and disposal. Follow NIOSH and USP 800 recommendations and institution-specific policies/procedures for appropriate containment strategy (NIOSH 2023; NIOSH 2024; USP-NF 2020).
Note: Facilities may perform risk assessment of some hazardous drugs to determine if appropriate for alternative handling and containment strategies (USP-NF 2020). Refer to institution-specific handling policies/procedures.
Gouty arthritis, flare prophylaxis: Treatment of chronic gouty arthritis when complicated by frequent, recurrent acute attacks of gout.
Refer to individual components.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Acetaminophen: Probenecid may increase serum concentration of Acetaminophen. Probenecid may also limit the formation of at least one major non-toxic metabolite, possibly increasing the potential for formation of the toxic NAPQI metabolite. Management: Consider limiting acetaminophen use in combination with probenecid. Probenecid may reduce clearance of acetaminophen to one of its non-toxic metabolities, increasing the risk for acetaminophen toxicity, even a lower doses. Risk D: Consider Therapy Modification
Anagliptin: Probenecid may increase serum concentration of Anagliptin. Risk C: Monitor
Antihepaciviral Combination Products: May increase serum concentration of Colchicine. Risk X: Avoid
Asciminib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Atazanavir: May increase serum concentration of Colchicine. Management: This combination is often contraindicated, but combined use may be permitted with dose adjustment and monitoring. Recommendations vary based on brand, indication, use of P-gp inhibitors, and hepatic/renal function. See interaction monograph for details. Risk X: Avoid
Avibactam: Probenecid may increase serum concentration of Avibactam. Risk X: Avoid
Baricitinib: Probenecid may increase serum concentration of Baricitinib. Management: When baricitinib is combined with probenecid, reduce baricitinib 4 mg daily to 2 mg daily or reduce baricitinib 2 mg daily to 1 mg daily. Don't use probenecid if recommended baricitinib dose is only 1 mg daily. Risk D: Consider Therapy Modification
Betalactamase Inhibitors: Probenecid may increase serum concentration of Betalactamase Inhibitors. Management: Coadministration of probenecid with amoxicillin/clavulanate is not recommended per official package labeling. Risk D: Consider Therapy Modification
Cabozantinib: MRP2 Inhibitors may increase serum concentration of Cabozantinib. Risk C: Monitor
Cefotaxime: Probenecid may increase serum concentration of Cefotaxime. Management: Avoid cefotaxime doses greater than 6 grams per day with concurrent probenecid. Any patients receiving this combination should be monitored for evidence of cefotaxime toxicity. Risk D: Consider Therapy Modification
Cephalosporins: Probenecid may increase serum concentration of Cephalosporins. Risk C: Monitor
Certoparin: Probenecid may increase anticoagulant effects of Certoparin. Risk C: Monitor
Choline C 11: Colchicine may decrease therapeutic effects of Choline C 11. Risk C: Monitor
Clofarabine: OAT1/3 Inhibitors may increase serum concentration of Clofarabine. Risk C: Monitor
Clofazimine: May increase serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk C: Monitor
CYP3A4 Inducers (Strong): May decrease serum concentration of Colchicine. Risk C: Monitor
CYP3A4 Inhibitors (Moderate): May increase serum concentration of Colchicine. Management: Avoidance, dose reduction, or increased monitoring for colchicine toxicity may be needed and will depend on brand, indication for colchicine use, renal/hepatic function, and use of a P-gp inhibitor. See full monograph for details. Risk D: Consider Therapy Modification
CYP3A4 Inhibitors (Strong): May increase serum concentration of Colchicine. Management: This combination is often contraindicated, but combined use may be permitted with dose adjustment and monitoring. Recommendations vary based on brand, indication, use of P-gp inhibitors, and hepatic/renal function. See interaction monograph for details. Risk D: Consider Therapy Modification
Deferiprone: UGT1A6 Inhibitors may increase serum concentration of Deferiprone. Risk X: Avoid
Dexketoprofen: Probenecid may increase serum concentration of Dexketoprofen. Risk C: Monitor
Dichlorphenamide: OAT1/3 Inhibitors may increase serum concentration of Dichlorphenamide. Risk C: Monitor
Digoxin: May increase adverse/toxic effects of Colchicine. Risk C: Monitor
Doripenem: Probenecid may increase serum concentration of Doripenem. Risk X: Avoid
Dyphylline: Probenecid may increase serum concentration of Dyphylline. Risk C: Monitor
Elacestrant: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Erdafitinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Management: If coadministration with these narrow therapeutic index/sensitive P-gp substrates is unavoidable, separate erdafitinib administration by at least 6 hours before or after administration of these P-gp substrates. Risk D: Consider Therapy Modification
Ertapenem: Probenecid may increase serum concentration of Ertapenem. Risk X: Avoid
Fibric Acid Derivatives: May increase myopathic (rhabdomyolysis) effects of Colchicine. Risk C: Monitor
Fusidic Acid (Systemic): May increase serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Management: Consider avoiding this combination if possible. If required, monitor patients closely for increased adverse effects of the CYP3A4 substrate. Risk D: Consider Therapy Modification
Futibatinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Ganciclovir-Valganciclovir: Probenecid may increase serum concentration of Ganciclovir-Valganciclovir. Risk C: Monitor
Gemifloxacin: Probenecid may increase serum concentration of Gemifloxacin. Risk C: Monitor
Gilteritinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Grapefruit Juice: May increase serum concentration of Colchicine. Risk X: Avoid
HMG-CoA Reductase Inhibitors (Statins): Colchicine may increase myopathic (rhabdomyolysis) effects of HMG-CoA Reductase Inhibitors (Statins). Colchicine may increase serum concentration of HMG-CoA Reductase Inhibitors (Statins). HMG-CoA Reductase Inhibitors (Statins) may increase serum concentration of Colchicine. Risk C: Monitor
Hormonal Contraceptives: Colchicine may increase adverse/toxic effects of Hormonal Contraceptives. Risk C: Monitor
Imipenem: Probenecid may increase serum concentration of Imipenem. Risk C: Monitor
Itraconazole: May increase serum concentration of Colchicine. Management: Colchicine is contraindicated during and for 2 weeks after itraconazole in patients with impaired renal or hepatic function. In those with normal renal and hepatic function, reduce colchicine dose as directed. See interaction monograph for details. Risk D: Consider Therapy Modification
Ketoprofen: Probenecid may increase serum concentration of Ketoprofen. Risk X: Avoid
Ketorolac (Nasal): Probenecid may increase serum concentration of Ketorolac (Nasal). Risk X: Avoid
Ketorolac (Systemic): Probenecid may increase serum concentration of Ketorolac (Systemic). Risk X: Avoid
Lasmiditan: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk X: Avoid
Levacetylleucine: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Loop Diuretics: Probenecid may decrease diuretic effects of Loop Diuretics. Probenecid may increase serum concentration of Loop Diuretics. Risk C: Monitor
LORazepam: Probenecid may increase serum concentration of LORazepam. Management: Reduce lorazepam dose 50% during coadministration with probenecid. Monitor for increased and prolonged lorazepam effects, particularly CNS depressant effects. Patients using lorazepam ER capsules should be switched to lorazepam tablets. Risk D: Consider Therapy Modification
Lumacaftor and Ivacaftor: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (High risk with Inhibitors or Inducers). Lumacaftor and Ivacaftor may decrease serum concentration of P-glycoprotein/ABCB1 Substrates (High risk with Inhibitors or Inducers). Risk C: Monitor
Meropenem: Probenecid may increase serum concentration of Meropenem. Risk X: Avoid
Methotrexate: Probenecid may increase serum concentration of Methotrexate. Management: If possible, the concomitant use of methotrexate and probenecid should be avoided. If used concomitantly, monitor closely for increased methotrexate serum concentrations and toxicities. Methotrexate dose reductions may be needed. Risk D: Consider Therapy Modification
Mitapivat: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Mycophenolate: Probenecid may increase serum concentration of Mycophenolate. Risk C: Monitor
Nirmatrelvir and Ritonavir: May increase serum concentration of Colchicine. Risk X: Avoid
Nitrofurantoin: Probenecid may decrease therapeutic effects of Nitrofurantoin. Probenecid may increase serum concentration of Nitrofurantoin. Risk C: Monitor
Nonsteroidal Anti-Inflammatory Agents: Probenecid may increase serum concentration of Nonsteroidal Anti-Inflammatory Agents. Risk C: Monitor
Oseltamivir: Probenecid may increase active metabolite exposure of Oseltamivir. Risk C: Monitor
P-glycoprotein/ABCB1 Inhibitors: May increase serum concentration of Colchicine. Colchicine distribution into certain tissues (e.g., brain) may also be increased. Management: This combination is often contraindicated, but combined use may be permitted with dose adjustment and monitoring. Recommendations vary based on brand, indication, use of CYP3A4 inhibitors, and hepatic/renal function. See interaction monograph for details. Risk D: Consider Therapy Modification
Pacritinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Pegloticase: Probenecid may increase adverse/toxic effects of Pegloticase. Specifically, Probenecid may blunt increases in serum urate that would signal an elevated risk of anaphylaxis and infusion reactions. Risk X: Avoid
Penicillins: Probenecid may increase serum concentration of Penicillins. Risk C: Monitor
Pexidartinib: UGT1A4 Inhibitors may increase serum concentration of Pexidartinib. Management: If combined use cannot be avoided, pexidartinib dose should be reduced as follows: reduce pexidartinib doses of 500 mg or 375 mg daily to 125 mg twice daily; reduce pexidartinib 250 mg daily to 125 mg once daily. Risk D: Consider Therapy Modification
Phenprocoumon: Probenecid may decrease serum concentration of Phenprocoumon. Risk C: Monitor
PRALAtrexate: Probenecid may increase serum concentration of PRALAtrexate. Management: Avoid coadministration of pralatrexate with probenecid. If coadministration cannot be avoided, closely monitor for increased pralatrexate serum concentrations or possible toxicity with concomitant use of probenecid. Risk D: Consider Therapy Modification
Pretomanid: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Primaquine: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Propacetamol: Probenecid may increase active metabolite exposure of Propacetamol. Specifically, accetaminophen exposure may be increased. Probenecid may also limit the formation of at least one major non-toxic acetaminophen metabolite, possibly increasing the formation of the toxic NAPQI metabolite. Management: Consider limiting the use of propacetamide in patients who are also taking probenecid. Patients may be at an increased risk for toxicity, even if reduced propacetamide doses are used. Risk D: Consider Therapy Modification
Quinolones: Probenecid may increase serum concentration of Quinolones. Probenecid may decrease excretion of Quinolones. Specifically, probenecid may decreased the renal excretion of quinolone antibiotics. Risk C: Monitor
RifAMPin: Probenecid may increase serum concentration of RifAMPin. Risk C: Monitor
Roxadustat: Probenecid may increase serum concentration of Roxadustat. Risk C: Monitor
Salicylates: May decrease therapeutic effects of Probenecid. Salicylates may increase serum concentration of Probenecid. Probenecid may increase serum concentration of Salicylates. Risk X: Avoid
Seladelpar: OAT1/3 Inhibitors may increase serum concentration of Seladelpar. Risk X: Avoid
Sodium Benzoate: Probenecid may decrease therapeutic effects of Sodium Benzoate. Risk C: Monitor
Sotorasib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Management: Consider avoiding use of sotorasib and narrow therapeutic index/sensitive P-gp substrates. If combined use is unavoidable, monitor for increased toxicities of the substrate and consider a decrease in the substrate dosage. Risk D: Consider Therapy Modification
Sparsentan: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk X: Avoid
Sulbactam: Probenecid may increase serum concentration of Sulbactam. Management: Recommendations for management of this interaction vary by specific sulbactam-containing product. Coadministration of probenecid with sulbactam/durlobactam is not recommended, but no specific actions are recommended for ampicillin/sulbactam. Risk D: Consider Therapy Modification
Sulfonylureas: Probenecid may increase serum concentration of Sulfonylureas. Risk C: Monitor
Tacrolimus (Systemic): May increase serum concentration of Colchicine. Risk C: Monitor
Taurursodiol: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk X: Avoid
Thiopental: Probenecid may increase adverse/toxic effects of Thiopental. Specifically, anesthetic potency and duration may be enhanced. Risk C: Monitor
Tipranavir: May increase serum concentration of Colchicine. Management: Colchicine should not be used with tipranavir in patients with impaired renal or hepatic function. In those with normal renal and hepatic function, reduced colchicine doses (as directed) are required if used with tipranavir. Risk D: Consider Therapy Modification
Urea Cycle Disorder Agents: Probenecid may increase active metabolite exposure of Urea Cycle Disorder Agents. Specifically, concentrations of phenylacetate and phenylacetylglutamine may be increased. Risk C: Monitor
Vadadustat: OAT1/3 Inhibitors may increase serum concentration of Vadadustat. Risk C: Monitor
Venetoclax: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Management: Avoid concomitant use of venetoclax and oral p-glycoprotein (P-gp) substrates if possible. If combined use is unavoidable, administer the P-gp substrate at least 6 hours before venetoclax to minimize the potential for an interaction. Risk D: Consider Therapy Modification
Vimseltinib: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (High risk with Inhibitors). Management: Avoid concomitant use of vimseltinib and P-gp substrates when possible. If combined, administer vimseltinib at least 4 hours before the P-gp substrate. Risk D: Consider Therapy Modification
Xanomeline: May increase serum concentration of P-glycoprotein/ABCB1 Substrates (Narrow Therapeutic Index/Sensitive with Inhibitors). Risk C: Monitor
Zidovudine: Probenecid may increase serum concentration of Zidovudine. Risk C: Monitor
See individual agents.
See individual agents.
CBC, renal function, serum uric acid, urinary uric acid.
Uric acid, serum:
Adults:
Normal values: 3 to 7 mg/dL (SI: 178.5 to 416.5 micromole/L). Note: Reference ranges may vary depending on the laboratory.
Goal during therapy: <6 mg/dL (SI: <357 micromole/L); <5 mg/dL (SI: <297.5 micromole/L) in patients with severe gout (eg, tophi, frequent attacks, chronic arthropathy) (EULAR [Richette 2017]). Levels <3 mg/dL (SI: <178.5 micromole/L) are not recommended long-term (EULAR [Richette 2017]).
Note: Serum uric acid values >7 mg/dL (SI: >416.5 micromole/L) do not necessarily represent clinical gout; the American College of Rheumatology clinical practice guidelines recommend against initiating pharmacologic management of asymptomatic hyperuricemia (ACR [FitzGerald 2020]).
See individual agents.
