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Cuprimine

Last reviewed on RxList: 5/26/2016
Cuprimine Side Effects Center

Last reviewed on RxList 2/15/2016

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.

Cuprimine Consumer Information

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)

Cuprimine Professional 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).

Allergic

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).

Urticaria and exfoliative dermatitis have occurred.

Thyroiditis has been reported; hypoglycemia in association with anti-insulin antibodies has been reported. These reactions are extremely rare.

Some patients may develop a migratory polyarthralgia, often with objective synovitis (see DOSAGE AND ADMINISTRATION).

Gastrointestinal

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.

Hematological

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.

Thrombotic thrombocytopenic purpura, hemolytic anemia, red cell aplasia, monocytosis, leukocytosis, eosinophilia, and thrombocytosis have also been reported.

Renal

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-Barr´┐Ż 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.

Neuromuscular

Myasthenia gravis (see WARNINGS); dystonia.

Other

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.

Increased skin friability, excessive wrinkling of skin, and development of small white papules at venipuncture and surgical sites have been reported (see PRECAUTIONS); yellow nail syndrome.

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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© Cuprimine Patient Information is supplied by Cerner Multum, Inc. and Cuprimine Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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