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Physicians planning to use penicillamine should thoroughly familiarize themselves with its toxicity, special dosage considerations, and therapeutic benefits. Penicillamine should never be used casually. Each patient should remain constantly under the close supervision of the physician. Patients should be warned to report promptly any symptoms suggesting toxicity.
Penicillamine is a chelating agent used in the treatment of Wilson's disease. It is also used to reduce cystine excretion in cystinuria and to treat patients with severe, active rheumatoid arthritis unresponsive to conventional therapy (see INDICATIONS). It is 3-mercapto-D-valine. It is a white or practically white, crystalline powder, freely soluble in water, slightly soluble in alcohol, and insoluble in ether, acetone, benzene, and carbon tetrachloride. Although its configuration is D, it is levorotatory as usually measured:
[α] 25°= -62.5° ± 2° (c = 1, 1N NaOH), D
calculated on a dried basis.
The empirical formula is C5H11NO2S, giving it a molecular weight of 149.21. The structural formula is:
It reacts readily with formaldehyde or acetone to form a thiazolidine-carboxylic acid. Capsules CUPRIMINE* (Penicillamine) for oral administration contain either 125 mg or 250 mg of penicillamine. Each capsule contains the following inactive ingredients: D & C Yellow 10, gelatin, lactose, magnesium stearate, and titanium dioxide. The 125 mg capsule also contains iron oxide.
What are the possible side effects of penicillamine (Cuprimine, Depen)?
If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:
- an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);
- fever or chills;
- a sore throat;
- unusual bleeding or bruising;
- blood in the urine;
- unexplained shortness of breath, coughing, or wheezing;
- abdominal pain;
- yellow skin or eyes;
- muscle weakness; or
- double vision.
What are the precautions when taking penicillamine (Cuprimine)?
Before taking penicillamine, tell your doctor or pharmacist if you are allergic to it; or to penicillins; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: a previous severe reaction to penicillamine (such as aplastic anemia, agranulocytosis), kidney disease, blood/bone marrow disorders (such as thrombocytopenia).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Penicillamine is not recommended for use during pregnancy. It may harm an...
Last reviewed on RxList: 12/17/2008
This monograph has been modified to include the generic and brand name in many instances.
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