Correspondence

Probenecid with Oseltamivir for Human Influenza A (H5N1) Virus Infection?

N Engl J Med 2006; 354:879-880February 23, 2006

Article

To the Editor:

Probenecid is an inexpensive medication that was widely used when penicillin was in short supply. Owing to the current easy access to abundant supplies of penicillin, this approach is primarily of historical interest. In light of the limited supply of oseltamivir, however, it may be time to revisit the use of probenecid as adjunctive therapy for human influenza A (H5N1) virus infection. Coadministration of oseltamivir and probenecid has resulted in a reduction in the clearance of oseltamivir by approximately 50 percent and a corresponding doubling of the plasma levels of oseltamivir.1 Therefore, part of the planning for an H5N1 pandemic might well include consideration of ready access to probenecid. Existing supplies of oseltamivir might, arguably, be effectively doubled with the use of this approach. Further investigation might clarify any possible benefits and the optimal use of probenecid in this setting.

Joseph C. Howton, M.D.
Portland Adventist Medical Center, Portland, OR 97201
joehowton@wepmg.com

1 References

1. 1

   Hill G, Cihlar T, Oo C, et al. The anti-influenza drug oseltamivir exhibits low potential to induce pharmacokinetic drug interactions via renal secretion-correlation of in vivo and in vitro studies. Drug Metab Dispos 2002;30:13-19
   CrossRef | Web of Science | Medline

Citing Articles (1)

Citing Articles

1. 1

   B. E. Davies. (2010) Pharmacokinetics of oseltamivir: an oral antiviral for the treatment and prophylaxis of influenza in diverse populations. Journal of Antimicrobial Chemotherapy 65:Supplement 2, ii5-ii10
   CrossRef