- 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.
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