$Unique_ID{BRK03271}
$Pretitle{}
$Title{penicillamine}
$Subject{Cuprimine Merck Sharp Dohme Depen Titratable Tablets Wallace Chelator
antirheumatic penicillamine Wilson disease high blood copper levels severe
rheumatoid arthritis cystinuria high urine levels cystine}
$Volume{}
$Log{}

Copyright (C) 1993 Publications International, Ltd.


penicillamine
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BRAND NAMES (Manufacturers)

     Cuprimine (Merck Sharp & Dohme)
     Depen Titratable Tablets (Wallace)

TYPE OF DRUG

     Chelator and antirheumatic

INGREDIENT

     penicillamine

DOSAGE FORMS

     Tablets (250 mg)
     Capsules (125 mg and 250 mg)

STORAGE

     Store at room temperature in a tightly closed container.

USES

     This drug is used to treat Wilson's disease (high blood copper levels),
severe rheumatoid arthritis, and cystinuria (high urine levels of cystine).
Penicillamine binds to copper and cystine, which prevents their harmful
effects on the body.  It is not clearly understood how penicillamine relieves
rheumatoid arthritis.

TREATMENT

     In order to obtain the maximum benefit from penicillamine, you should
take it on an empty stomach one hour before or two hours after a meal.  To
ensure maximal absorption of this drug, each dose should be separated from
doses of other medications and from food and milk by at least an hour.
     If you miss a dose of this drug, take the dose as soon as possible,
unless it is almost time for the next dose.  In that case, do not take the
dose at all; return to your regular dosing schedule.  Do not double the dose.
     The full benefits of this drug may not become apparent for as long as
three months after therapy.

SIDE EFFECTS

     Minor.

     Altered taste sensations, diarrhea, loss of appetite, nausea, stomach
upset, or vomiting.  These side effects should disappear as your body adjusts
to the medication.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
breast enlargement (in both sexes), difficult or painful urination, difficulty
in breathing, joint pain, loss of hair, mouth sores, ringing in the ears, skin
rash, sore throat, tingling sensations in the fingers or toes, unusual
bleeding or bruising, or wheezing.

INTERACTIONS

     Penicillamine interacts with several other types of medications:
     1. The absorption of penicillamine from the gastrointestinal tract can be
decreased by iron or antacids.
     2. Penicillamine can decrease the blood levels and beneficial effects of
digoxin.
     3. Concurrent use of penicillamine and gold salts, hydroxychloroquine,
phenylbutazone, oxyphenbutazone, or anticancer drugs can lead to increased
side effects to the blood and kidneys.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any of those listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to penicillamine or penicillin or cephalosporin
antibiotics.
     * Before starting to take this medication, be sure to tell your doctor if
you now have or if you have ever had blood disorders or kidney disease.
     * Do not stop taking this drug unless you first check with your doctor.
     * Penicillamine can decrease the body's ability to repair wounds, so try
to avoid injuring yourself while you are taking this medication.  This warning
is especially important for diabetic patients.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this drug.
     * Your doctor may want you to take pyridoxine (vitamin B) to prevent some
of the side effects (for example, tingling sensations) of penicillamine.
     * Be sure to tell your doctor if you are pregnant.  Penicillamine has
been reported to cause birth defects in both animals and humans.  Also, tell
your doctor if you are breast-feeding an infant.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.