A patient with severe gout and chronic kidney disease (eGFR 20 mL/min) requires urate-lowering therapy. The preferred drug is:

• A Probenecid at full dose
• B Allopurinol with dose reduction ✓
• C Benzbromarone
• D High-dose colchicine for long-term suppression

Explanation

Allopurinol, a xanthine oxidase inhibitor, reduces uric acid synthesis and is effective even with reduced GFR (dose-adjusted: e.g., starting at 50–100 mg/day when GFR < 30). Probenecid and benzbromarone are uricosurics requiring adequate renal tubular function and GFR > 30 mL/min to be effective. Colchicine at high doses is dangerous in CKD due to accumulation and neuromuscular toxicity.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.