Anturane

Anturane is part of the drug class:

• Preparations increasing uric acid excretion

Anturane is indicated for the treatment of:

1. Chronic gouty arthritis
   
2. Intermittent gouty arthritis

Studies on the teratogenicity of pyrazole compounds in animals have yielded inconclusive results. Up to the present time, however, there have been no reported cases of human congenital malformation proved to be due to the use of the drug.

      It is suggested that Anturane be used with caution in pregnant women, weighing the potential risks against the possible benefits.

As with all pyrazole compounds, patients receiving Anturane should be kept under close medical supervision and periodic blood counts are recommended. It may be administered with care to patients with a history of healed peptic ulcer.

      Recent reports have indicated that Anturane potentiates the action of certain sulfonamides, such as sulfadiazine and sulfisoxazole. In addition, other pyrazole compounds (phenylbutazone) have been observed to potentiate the hypoglycemic sulfonylurea agents, as well as insulin. In view of these observations, it is suggested that Anturane be used with caution in conjunction with sulfa drugs, the sulfonylurea hypoglycemic agents and insulin.

      Because Anturane is a potent uricosuric agent, it may precipitate urolithiasis and renal colic, especially in the initial stages of therapy. For this reason, an adequate fluid intake and alkalinization of the urine are recommended. In cases with significant renal impairment, periodic assessment of renal function is indicated. Occasional cases of renal failure have been reported; but a cause-and-effect relationship has not always been clearly established.

      Salicylates antagonize the uricosuric action of Anturane and for this reason their concomitant use is contraindicated in gouty arthritis.

      Anturane may accentuate the action of coumarin-type anticoagulants and further depress prothrombin activity when these medications are employed simultaneously.

Safety and effectiveness in pediatric patients have not been established.

NOTE

Anturane has minimal anti-inflammatory effect and is not intended for the relief of an acute attack of gout.

      In the initial stages of therapy, because of the marked ability of Anturane to mobilize urates, acute attacks of gouty arthritis may be precipitated.

Symptoms

Nausea, vomiting, diarrhea, epigastric pain, ataxia, labored respiration, convulsions, coma. Possible symptoms, seen after overdosage with other pyrazolone derivatives: anemia, jaundice, ulceration.

Treatment

No specific antidote. Induce emesis; gastric lavage, supportive treatment (intravenous glucose infusions, analeptics).

Initial

200-400 mg daily in two divided doses, with meals or milk, gradually increasing when necessary to full maintenance dosage in one week.

Maintenance

400 mg daily, given in two divided doses, as above. This dosage may be increased to 800 mg daily, if necessary, and may sometimes be reduced to as low as 200 mg daily after the blood urate level has been controlled. Treatment should be continued without interruptian even in the presence of acute exacerbations, which can be concomitantly treated with phenylbutazone or colchicine. Patients previously controlled with other uricosuric therapy may be transferred to Anturane at full maintenance dosage.

Applies to sulfinpyrazone: oral capsule, oral tablet

Gastrointestinal

Gastrointestinal symptoms have been the most frequently reported side effects. Peptic ulcer disease may be exacerbated or reactivated.[Ref]

Hematologic

Hematologic side effects including anemia, leukopenia, agranulocytosis, thrombocytopenia, and aplastic anemia have occurred. Two cases of leukemia following chronic sulfinpyrazone (the active ingredient contained in Anturane) therapy have been reported. Concomitant drug therapy was also reported and a causal relationship with sulfinpyrazone has not been established.[Ref]

Dermatologic

Dermatologic side effects have been limited to rash.[Ref]

Renal

Renal failure has been reported. Suggested mechanisms have included hypersensitivity induced interstitial nephritis, tubular-interstitial damage due to precipitation of urinary uric acid crystals, and inhibition of renal prostaglandin synthesis. Urolithiasis and renal colic may occur following initiation of therapy. Adequate fluid intake and urinary alkalinization are recommended.[Ref]

Musculoskeletal

Mobilization of urates during initiation of therapy has resulted in musculoskeletal symptoms of acute gouty arthritis.[Ref]

Some side effects of Anturane may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Sulfinpyrazone has not been assigned to an FDA pregnancy category. Animal teratogenicity studies of pyrazole compounds have resulted in inconclusive data. There are no data from controlled human pregnancy studies. Sulfinpyrazone should be given during pregnancy only when benefit outweighs risk.