Penicillamine
Rheumatoid Arthritis, Lead Poisoning ... show more
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
Definite
Pharmaceutical Class
Antirheumatic Agent
Controlled Drug Substance
NO
Penicillamine
Summary
Penicillamine is used for treating Wilson's disease, which is a condition of excess copper buildup in the body. It's also used for rheumatoid arthritis, a type of joint inflammation, and cystinuria, a condition that causes kidney stones.
Penicillamine works by removing excess copper in Wilson's disease. It also reduces inflammation in rheumatoid arthritis. For cystinuria, it helps manage kidney stones by binding to a substance called cystine. It also affects the immune system to reduce joint damage in autoimmune conditions.
For rheumatoid arthritis, the typical starting dose for adults is 125 mg once or twice daily, gradually increasing to 1-2 grams daily. For Wilson's disease, the usual dose is 1-2 grams daily divided into multiple doses. Always follow your doctor's instructions for your exact needs.
Common side effects of Penicillamine include nausea, vomiting, rash, and low white blood cell count. Serious side effects may include liver damage, bone marrow suppression, and neurological issues.
Penicillamine should not be used in individuals with severe kidney disease, bone marrow disorders, or hypersensitivity to the drug. It should also be avoided during pregnancy unless absolutely necessary. Always inform your doctor of any allergic reactions or liver problems.
Indications and Purpose
How does Penicillamine work?
Penicillamine works by binding to copper in the body and promoting its excretion, particularly in Wilson’s disease. It also interferes with the immune system in conditions like rheumatoid arthritis, reducing inflammation and joint damage. Additionally, it binds to cystine, preventing kidney stones in cystinuria.
Is Penicillamine effective?
Penicillamine is highly effective in treating Wilson’s disease and rheumatoid arthritis. Studies have shown that it effectively removes copper in Wilson’s disease and helps reduce joint damage in rheumatoid arthritis. However, it requires careful monitoring due to potential side effects, and effectiveness can vary from person to person.
What is Penicillamine?
Penicillamine is a chelating agent used to treat conditions like rheumatoid arthritis, Wilson’s disease, and cystinuria. It works by removing excess copper in the body, reducing inflammation, and helping to break down cystine stones in the kidneys. Penicillamine also affects the immune system to reduce joint damage in autoimmune conditions.
Directions for Use
For how long do I take Penicillamine?
Penicillamine is usually taken long-term for conditions like Wilson’s disease and rheumatoid arthritis. The duration depends on the response to treatment and your doctor’s recommendations. For rheumatoid arthritis, it can take several months to see improvement, while treatment for Wilson’s disease is typically lifelong. Your doctor will adjust your dosage based on progress.
How do I take Penicillamine?
Penicillamine should be taken on an empty stomach, at least 1 hour before or 2 hours after meals, to improve absorption. Swallow the tablets whole with a glass of water. It’s important to follow the prescribed schedule, and if you miss a dose, take it as soon as you remember, but skip it if it’s almost time for the next one.
How long does it take for Penicillamine to start working?
Penicillamine may take several weeks to months to show significant improvement, especially in rheumatoid arthritis where it reduces joint damage over time. For Wilson’s disease, improvements in copper levels may be seen within weeks, but it can take months for complete stabilization of symptoms. Regular monitoring by your doctor will track progress.
How should I store Penicillamine?
Penicillamine should be stored at room temperature, away from moisture and heat. Keep it in its original container and tightly closed. Store it out of reach of children. Do not store it in the bathroom or near the kitchen sink, and dispose of expired or unused medication properly.
What is the usual dose of Penicillamine?
For rheumatoid arthritis, the typical starting dose for adults is 125 mg once or twice daily, gradually increasing to 1–2 grams daily. For Wilson’s disease, the usual dose is 1–2 grams daily, divided into multiple doses. Dosage for children and specific conditions varies, so always follow your doctor’s instructions for your exact needs.
Warnings and Precautions
Can I take Penicillamine with other prescription drugs?
Penicillamine interacts with several medications, including antacids, iron supplements, and immunosuppressive drugs. It can also interact with penicillin and copper-containing supplements, reducing the effectiveness of penicillamine. Always inform your doctor about all medications you're taking to avoid harmful interactions and ensure safe usage.
Can Penicillamine be taken safely while breastfeeding?
Penicillamine is excreted in breast milk, so it is generally not recommended for breastfeeding mothers. If you need to take penicillamine, discuss alternatives with your healthcare provider to avoid risks to your infant. In some cases, temporary cessation of breastfeeding may be advised.
Can Penicillamine be taken safely while pregnant?
Penicillamine is classified as Category D for pregnancy, meaning it can cause harm to the fetus. It should only be used during pregnancy if no alternatives are available and the benefits outweigh the risks. If you’re pregnant or planning to become pregnant, consult your doctor to discuss safer options or alternatives.
Is it safe to drink alcohol while taking Penicillamine?
It is generally advisable to avoid alcohol while taking penicillamine. Alcohol can increase the risk of liver damage and may worsen side effects like nausea and fatigue. If you plan to drink alcohol occasionally, consult your doctor to understand the risks and make informed decisions about your health.
Is it safe to exercise while taking Penicillamine?
Exercise is generally safe while on penicillamine, but it’s important to listen to your body. If you experience side effects like fatigue or dizziness, consider adjusting your exercise routine or opting for lower-intensity activities. Always consult your doctor to ensure your exercise plan aligns with your treatment and overall health.
Is Penicillamine safe for the elderly?
Penicillamine should be used cautiously in elderly patients, especially those with kidney or liver issues. Older adults are more susceptible to side effects like bone marrow suppression and kidney damage. Regular monitoring and dose adjustments are important to minimize risks. Discuss with your doctor before starting treatment.
Who should avoid taking Penicillamine?
Penicillamine should not be used in individuals with severe kidney disease, bone marrow disorders, or hypersensitivity to the drug. It should be avoided during pregnancy unless absolutely necessary. Inform your doctor of any allergic reactions or liver problems, as these can worsen with penicillamine.
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