Sulfinpyrazone: Risk for Renal Insufficiency-Reply

Joseph L. Blackshear, MD; M. Thomas Stillman, MD; Morris Davidman, MD
Arch Intern Med. 1984;144(3):648-649. doi:10.1001/archinte.1984.00350150262055.
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In Reply.  —Boelaert et al have reported a renal antiprostaglandin action of sulfinpyrazone and demonstrated clinically significant adverse effects on renal function from the agent.1,2 These observations supplement data indicating that the antiplatelet activity of sulfinpyrazone is due to its inhibitory effect on platelet cyclo-oxygenase.3,4 Clearly, sulfinpyrazone belongs in the same category as nonsteroidal anti-inflammatory drugs in its ability to precipitate renal insufficiency, but it deserves special mention for two reasons: (1) because sulfinpyrazone is not classified as an anti-inflammatory agent, its ability to produce renal insufficiency is likely to be overlooked, and (2) because sulfinpyrazone's two principle uses are as an antiplatelet agent in atherosclerotic disease or as a uricosuric agent in gout, it is likely to be prescribed in precisely those patients with the underlying risk factors we identified.5The frequency with which renal deterioration occurred from sulfinpyrazone in patients with identifiable risk is illustrated


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