What should be done if probenecid is not achieving target urate levels?

When probenecid is not achieving target urate levels, the appropriate course of action is to increase the dose by small increments weekly. Probenecid is a uricosuric agent that works by increasing the excretion of uric acid in the kidneys, and adjusting the dose is a recommended strategy when the current dosage does not effectively lower urate levels.

In many cases, individual patients may respond differently to medications, so dose adjustments can be necessary to reach therapeutic goals without causing adverse effects. Gradually increasing the dose allows healthcare providers to monitor the patient's response and side effects, ensuring that the management of uric acid levels is both effective and safe.

Other options, such as switching to colchicine or dropping the medication altogether, may not directly address the specific issue of inadequate urate control while on probenecid. Combining with ibuprofen, though it may provide anti-inflammatory benefits, does not target the underlying problem of urate level management. Therefore, increasing the dose of probenecid methodically is the most appropriate strategy when initial treatment is insufficient.