penicillamine, Cuprimine, Depen (cont.)

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GENERIC AVAILABLE: Yes, in other countries

PREPARATIONS: Capsules: 125 and 250 mg; Tablets: 250 mg.

STORAGE: Penicillamine should be stored at room temperature, 15 C to 30 C (59 F to 86 F).

PRESCRIBED FOR: Penicillamine is used to treat active rheumatoid arthritis that has not responded to other drugs. Penicillamine also is used to promote copper excretion from the body in patients with Wilson's disease and is useful for preventing cystine kidney stones in individuals with cystinuria. It has been used in the treatment of lead poisoning.


  • Penicillamine should be taken on an empty stomach, at least one hour before meals or two hours after meals 1-4 times daily. It is usually given with 10-25 mg/day pyridoxine (Vitamin B6).
  • The usual adult dose for treating rheumatoid arthritis is 125 to 250 mg daily. It may be increased by 125 to 250 mg a day every 1 to 3 months up to 500 to 750 mg daily or more if tolerated.
  • Wilson's disease is treated with 250 mg 4 times daily. The dose range is 500 to 1500 mg daily.
  • Cystinuria is treated with 1-4 g daily in 4 doses.
  • Lead poisoning is treated with 1 – 1.5 g/day total orally. The total dose can be divided into twice or three times per day dosing; consult with a toxicologist for dosing and length of time to give medication
  • Pediatric dosing: Dosing is age/weight based and a specialist (pediatric) should be consulted before dosing.

DRUG INTERACTIONS: Penicillamine should not be taken by patients who are also taking gold (gold sodium thiomalate; aurothiomalate [Myochrysine], auranofin [Ridaura], aurothioglucose [Solganal]), antimalarial (hydroxychloroquine [Plaquenil]), phenylbutazone (Butazolidine), or cytotoxic drugs (cyclophosphamide [Cytoxan], azathioprine [Imuran, Azasan], methotrexate [Rheumatrex, Trexall]) because these drugs also affect the bone marrow and kidney and when combined with penicillamine can seriously reduce bone marrow and kidney function.

Medically Reviewed by a Doctor on 8/27/2014

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