
GENERIC NAME: penicillamine
BRAND NAMES: Cuprimine, Depen
DRUG CLASS AND MECHANISM: Penicillamine is an
antirheumatic drug
used to treat patients with active rheumatoid arthritis. It is
also
classified as a metal binding (or "chelating"), agent
used in
the treatment of Wilson's disease, a genetic disease that
results in
excessive copper deposits in the body tissues.
PRESCRIPTION: yes
GENERIC AVAILABLE: no
PREPARATIONS: (Cuprimine) Capsules: 125mg, 250mg; (Depen)
Tablets: 250mg.
STORAGE: Store at room temperature, sealed container,
avoid
moisture.
PRESCRIBED FOR: Penicillamine is used to treat active
rheumatoid
arthritis that has not responded to other measures.
Penicillamine is also
used in the treatment of scleroderma. Penicillamine is also
used to treat
the genetic disease, Wilson's disease, to promote copper
excretion from
the body where it has deposited in the tissues. It is also
helpful to
treat another rare inherited disease, cystinuria, where it is
used to bind
cystine and prevent cystine kidney stones.
DOSING: Should be taken on an empty stomach, at least
one hour
before meals or two hours after meals.
DRUG INTERACTIONS: Patients who are allergic to
penicillin may
theoretically have a sensitivity to penicillamine, but this is
not common.
Penicillamine can increase the requirement for vitamin B6
(pyridoxine) and
supplementation is advised. Penicillamine should not be taken
by patients
who are also taking gold (Myochrysine, Ridaura, Solganal),
antimalarial (Plaquenil), phenylbutazone (Butazolidine), or cytotoxic drugs (Cytoxan,
Imuran, Rheumatrex) because of similar bone marrow and kidney
risks.
Penicillamine can weaken the protein (collagen) that is used to
form body
tissues. Therefore, it is advised to reduce the dose when
surgery is
considered and resume full dose after the wound has healed.
The effectiveness of penicillamine for treating arthritis in
children
has not been established.
PREGNANCY: Penicillamine should not be taken by
pregnant women
with rheumatoid arthritis. Women with rheumatoid arthritis in
whom
pregnancy is suspected should discontinue penicillamine.
SIDE EFFECTS: Penicillamine
can cause rashes early in treatment which usually resolve within days of
discontinuing the drug. A late rash,
seen after 6 months of treatment, may take weeks to disappear.
Rashes can
be associated with itching, which can often be controlled by
simply adding
antihistamine medication. Rashes associated with fever and
joint pain
usually require discontinuing penicillamine. It can also cause
loss of
appetite, nausea, abdominal pain, and loss of the sense of
taste.
Penicillamine can cause bone marrow suppression and serious
kidney
disease. All patients who take penicillamine require regular
blood and
urine testing for monitoring.
Penicillamine has an unusual risk of inducing immune-related
diseases,
such as systemic lupus erythematosus, polymyositis,
Goodpasture's syndrome
and myasthenia gravis.
Last Editorial Review: 12/31/1997
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission).
- Lupus - Get information on lupus (SLE) disease treatment, signs, diagnosis, types of symptoms (butterfly, discoid rash), causes, pregnancy flares, prevention and statistics.
- Scleroderma - Read about scleroderma (an autoimmune disease) symptoms, causes, diagnosis, treatment, facts and prognosis. Scleroderma may be diffuse or limited (CREST variant, in which Raynaud's phenomenon and calcinosis are skin complications).
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