"Nov. 6, 2012 -- The FDA has approved Pfizer's Xeljanz (tofacitinib), a first-of-its-kind treatment for rheumatoid arthritis.
Xeljanz is approved for use by patients not helped by methotrexate, the usual first treatment for RA. It's a "...
Cuprimine Side Effects Center
Medical Editor: John P. Cunha, DO, FACOEP
Cuprimine (penicillamine) is a chelating agent that helps remove copper from the body used to remove excess copper associated with Wilson's disease. Cuprimine is also used to reduce cystine in the urine and to treat severe rheumatoid arthritis. Common side effects of Cuprimine include stomach/abdominal pain, nausea, vomiting, loss of appetite, diarrhea, decreased sense of taste, itching or rash, ringing in the ears, sores in the mouth, poor wound healing, or increased wrinkling of the skin.
Dosing of Cuprimine depends on the condition being treated. Cuprimine may interact with gold-therapy products, antimalarial medicines, cancer chemotherapy medicines, phenylbutazone, digoxin, antacids, or vitamin and mineral supplements. Do not take any medicines or over-the-counter drugs or supplements within 1 hour of a Cuprimine dose. Tell your doctor all medications and supplements you use. Cuprimine is not recommended for use during pregnancy. It may harm a fetus. However, it may sometimes be used during pregnancy in certain situations (such as treating Wilson's disease); consult your doctor. It is unknown if this medication passes into breast milk. Because of the possible risk to the infant, breastfeeding while using this drug is not recommended.
Our Cuprimine (penicillamine) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What is Patient Information in Detail?
Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.
Cuprimine in Detail - Patient Information: Side Effects
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.
Other, less serious side effects may be more likely to occur. Continue to take penicillamine and notify your doctor if you experience
- itching or a rash;
- nausea, vomiting, diarrhea, or decreased appetite;
- ringing in the ears;
- decreased taste;
- sores in the mouth;
- poor wound healing; or
- increased wrinkling of the skin.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.
Read the entire detailed patient monograph for Cuprimine (Penicillamine)
What is Patient Information Overview?
A concise overview of the drug for the patient or caregiver from First DataBank.
Cuprimine Overview - Patient Information: Side Effects
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor immediately if any of these unlikely but serious side effects occur: signs of infection (such as fever, persistent sore throat, swollen lymph nodes), easy bruising/bleeding, unusual tiredness, rapid breathing, skin blisters, mouth sores, new or worsening joint pain, thinning/wrinkling skin.
Tell your doctor immediately if any of these rare but serious side effects occur: change in the amount of urine, bloody urine, coughing up blood, shortness of breath, muscle weakness, eye problems (such as drooping eyelids, blurred vision), persistent nausea/vomiting, severe stomach/abdominal pain, dark urine, yellowing eyes/skin.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Read the entire patient information overview for Cuprimine (Penicillamine)
What is Prescribing information?
The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.
Cuprimine FDA Prescribing Information: Side Effects
Penicillamine is a drug with a high incidence of untoward reactions, some of which are potentially fatal. Therefore, it is mandatory that patients receiving penicillamine therapy remain under close medical supervision throughout the period of drug administration (see WARNINGS and PRECAUTIONS).
Reported incidences (%) for the most commonly occurring adverse reactions in rheumatoid arthritis patients are noted, based on 17 representative clinical trials reported in the literature (1270 patients).
Generalized pruritus, early and late rashes (5%), pemphigus (see WARNINGS), and drug eruptions which may be accompanied by fever, arthralgia, or lymphadenopathy have occurred (see WARNINGS and PRECAUTIONS). Some patients may show a lupus erythematosus-like syndrome similar to drug-induced lupus produced by other pharmacological agents (see PRECAUTIONS).
Anorexia, epigastric pain, nausea, vomiting, or occasional diarrhea may occur (17%).
Isolated cases of reactivated peptic ulcer have occurred, as have hepatic dysfunction including hepatic failure, and pancreatitis. Intrahepatic cholestasis and toxic hepatitis have been reported rarely. There have been a few reports of increased serum alkaline phosphatase, lactic dehydrogenase, and positive cephalin flocculation and thymol turbidity tests.
Some patients may report a blunting, diminution, or total loss of taste perception (12%); or may develop oral ulcerations. Although rare, cheilosis, glossitis, and gingivostomatitis have been reported (see PRECAUTIONS).
Gastrointestinal side effects are usually reversible following cessation of therapy.
Penicillamine can cause bone marrow depression (see WARNINGS). Leukopenia (2%) and thrombocytopenia (4%) have occurred. Fatalities have been reported as a result of thrombocytopenia, agranulocytosis, aplastic anemia, and sideroblastic anemia.
Patients on penicillamine therapy may develop proteinuria (6%) and/or hematuria which, in some, may progress to the development of the nephrotic syndrome as a result of an immune complex membranous glomerulopathy (see WARNINGS). Renal failure has been reported.
Central Nervous System
Tinnitus, optic neuritis and peripheral sensory and motor neuropathies (including polyradiculoneuropathy, i.e., Guillain-Barré syndrome) have been reported. Muscular weakness may or may not occur with the peripheral neuropathies. Visual and psychic disturbances; mental disorders; and agitation and anxiety have been reported.
Adverse reactions that have been reported rarely include thrombophlebitis; hyperpyrexia (see PRECAUTIONS); falling hair or alopecia; lichen planus; polymyositis; dermatomyositis; mammary hyperplasia; elastosis perforans serpiginosa; toxic epidermal necrolysis; anetoderma (cutaneous macular atrophy); and Goodpasture's syndrome, a severe and ultimately fatal glomerulonephritis associated with intra-alveolar hemorrhage (see WARNINGS). Vasculitis, including fatal renal vasculitis, has also been reported. Allergic alveolitis, obliterative bronchiolitis, interstitial pneumonitis and pulmonary fibrosis have been reported in patients with severe rheumatoid arthritis, some of whom were receiving penicillamine. Bronchial asthma also has been reported.
The chelating action of the drug may cause increased excretion of other heavy metals such as zinc, mercury and lead.
There have been reports associating penicillamine with leukemia. However, circumstances involved in these reports are such that a cause and effect relationship to the drug has not been established.
Read the entire FDA prescribing information for Cuprimine (Penicillamine)
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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