penicillamine, Cuprimine, Depen (cont.)

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DOSING:

  • 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.

The absorption of penicillamine is reduced by iron (ferrous sulphate), magnesium and aluminum salts (for example, antacids) because they form unabsorbable complexes with penicillamine in the intestine. Administration of penicillamine and iron containing products or antacids should be separated by 2 hours.

PREGNANCY: Penicillamine should not be taken by pregnant women unless it is for a life-threatening condition, because of potential harm to the fetus.

Medically Reviewed by a Doctor on 8/27/2014


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