Generic Name: penicillamine, Oral capsule

Cuprimine

All Brands

  • Cuprimine
SECTION 1 of 4

Highlights for penicillamine

Oral capsule
1

Penicillamine is an oral medication used to treat rheumatoid arthritis, Wilson’s disease, and cystinuria.

2

Common side effects include upset stomach, nausea, loss of taste, stomach pain, not feeling hungry, and diarrhea.

3

This medication can cause harm to your baby. Talk to your doctor if you’re pregnant, trying to become pregnant, or breastfeeding.

4

Penicillamine may cause your body to lose vitamin B6 (pyridoxine). Your doctor may advise you to take vitamin B6 supplements every day.

5

If you’re taking this medicine because you develop stones in your kidney and bladder (cystinuria), drink at least 2 pints of water each day to flush the medicine through your system.

IMPORTANT INFORMATION

FDA Warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Monitoring problems and side effects. This drug should only be prescribed by doctors who are trained to use the medicine. Because this drug can cause serious side effects, your doctor will watch you closely for any problems.

May cause fetal damage

Talk to your doctor if you’re pregnant, plan to become pregnant, miss a period, or have unprotected sex. This medication can cause harm to a developing fetus. Avoid becoming pregnant while taking this medication.

May cause you to bleed more easily

This medication may affect the ability of your blood to clot. You may bleed more easily while taking it. 

May increase infection risk

Avoid people who are sick and wash your hands frequently. Talk to your doctor if you have any signs of infection, such as fever, pain, chills, or sore throat.

Drug Features

Penicillamine is a prescription drug. It’s available in these forms: oral tablet and oral capsule. A generic form is available. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand.  Talk to your healthcare provider to see if the generic will work for you.

Why It's Used

Penicillamine is used to decrease pain, swelling, and tenderness associated with joint disease.

It’s used to treat:

  • rheumatoid arthritis
  • an inherited disease that causes the build up of too much copper in your body (Wilson’s disease)
  • an inherited disorder that causes you to develop bladder or kidney stones (cystinuria)

How It Works

It isn’t known how penicillamine works to treat joint disease. It works to treat cystinuria by removing a protein called cystine from your body. It works to treat Wilson disease by removing excess copper from your body.

Penicillamine is a chelating agent. That means it binds to certain compounds, which helps your body to remove them.

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penicillamine Side Effects

Oral capsule

Most Common Side Effects

The most common side effects that occur with penicillamine include:

  • rash

  • loss of taste

  • not feeling hungry

  • vomiting

  • diarrhea

  • reduced white blood cells and platelets. Symptoms may include:

    • bleeding
    • fever
    • infection
  • ulcer or sore in your mouth

  • protein in your urine, which can cause kidney failure. Symptoms and signs may include:

    • swelling of your hands, feet, or face
    • cloudy or foamy urine

Mild side effects may disappear within a few days or a couple of weeks. Talk to your doctor or pharmacist if they’re more severe or don’t go away.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • allergic reaction. Symptoms may include:

    • rash
    • hives
    • itching
    • redness
    • chest tightness
    • fever
  • infection. Symptoms may include:

    • fever
    • chills
    • sore throat
    • cough
  • increased bleeding. Symptoms may include:

    • vomiting blood
    • blood in your stool
    • bleeding from your gums
    • bruising easily
  • liver problems. Symptoms may include:

    • dark-colored urine
    • vomiting
    • stomach pain
    • yellowing of the whites of your eyes or skin
  • kidney problems. Symptoms may include:

    • inability to pass urine
    • increased body weight
    • blood in your urine
  • pancreas problems. Symptoms may include:

    • stomach pain
    • vomiting
    • back pain
  • rash on your cheeks

  • trouble breathing

  • muscle pain

  • feeling weak

  • changes to your skin, such as:

    • excessive skin wrinkling
    • skin that’s easily torn or rubs away
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This medication doesn’t cause drowsiness. 

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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penicillamine May Interact with Other Medications

Oral capsule

Penicillamine can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food Interactions

Food can decrease the effect of this medication. Take penicillamine on an empty stomach. You can take penicillamine 1 hour before or 2 hours after you eat.

Medications That Might Interact with This Drug

Heart drug
  • digoxin

Penicillamine can cause lower levels of digoxin in your body and reduce its effect. Your doctor may need to increase your digoxin dose.

Antacids
  • aluminum hydroxide
  • magnesium hydroxide (milk of magnesia)

Antacids can decrease the effect of penicillamine in your body. You should avoid using antacids. 

Iron pills

Iron pills may decrease the effect of penicillamine in your body. You shouldn’t take iron pills while taking penicillamine.

Malaria drugs

If you’re taking drugs to treat malaria, don’t take penicillamine. Combining them could cause serious side effects.

Cancer drugs

If you’re taking drugs to treat cancer, don’t take penicillamine. Combining them could cause serious side effects.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with blood cell disorder

Don’t take this medication if you have a condition in which your body has stopped making new blood cells or isn’t making enough white blood cells. This may lead to serious side effects, including infection. Your doctor may need to do routine blood tests to monitor your blood cell counts.

People with kidney disease

Don’t take this medication if you have moderate or severe kidney disease. Penicillamine is removed from your body by your kidneys. Kidney disease may lead to an increased amount of penicillamine in your body. This could cause increased side effects.

Pregnant women

Penicillamine is a category D pregnancy drug. That means two things:

  1. Studies show a risk of adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant, plan to become pregnant, miss a period, or have unprotected sex while taking this medication. Penicillamine can cause harm to a developing fetus. Avoid becoming pregnant while taking this drug.

Women who are nursing

Penicillamine may pass through breast milk and cause harm to your baby if you breastfeed. Breastfeeding isn’t recommended while you’re taking penicillamine.

For Children

For rheumatoid arthritis and Wilson’s disease, the safety and effectiveness of penicillamine haven’t been established in people younger than 18 years.

Allergies

Penicillamine can cause a severe allergic reaction. Symptoms may include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

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How to Take penicillamine (Dosage)

Oral capsule

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Wilson’s disease

Brand: Cuprimine

Form: Oral Capsule
Strength: 250 mg


Brand: Depen

Form: Oral Tablet
Strength: 250 mg
Adult Dosage (ages 18 years and older)
  • Doses range from 250 mg per day to a maximum of 2,000 mg per day. Your doctor will prescribe your specific dose.
  • Doses greater than 500 mg per day should be given in divided doses.
Child Dosage (ages 0-17 years)

Dosage for people younger than 18 years hasn’t been established.

Cystinuria

Brand: Cuprimine

Form: Oral Capsule
Strength: 250 mg


Brand: Depen

Form: Oral Tablet
Strength: 250 mg
Adult Dosage (ages 18 years and older)
  • The usual dose is 2,000 mg per day. The dose can range from 1,000 to 4,000 mg per day. Your doctor will prescribe your specific dose.
  • Doses greater than 500 mg per day should be given in divided doses.
Child Dosage (ages 0-17 years)
  • The dose is based on your child’s weight.
  • The usual dose is 30 mg/kg per day divided into 4 evenly spaced doses.

Rheumatoid arthritis

Brand: Cuprimine

Form: Oral Capsule
Strength: 250 mg


Brand: Depen

Form: Oral Tablet
Strength: 250 mg
Adult Dosage (ages 18 years and older)
  • The dose ranges from 125 mg per day to a maximum of 1,500 mg per day. Your doctor will prescribe your specific dose.
  • Doses greater than 500 mg per day should be given in divided doses.
Child Dosage (ages 0-17 years)

Dosage for people younger than 18 years hasn’t been established.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

If You Don’t Take It or Miss Doses

If you don’t take your medication or keep missing doses, your condition may get worse.

If You Stop Taking It

It’s important to continue taking your medication as directed, even if you feel better. Doing so will give you the best chance of helping you feel your best. Stopping this medication may also lead to returning symptoms.

If You Take Too Much

If you take too much, you may have more serious side effects, including nausea and vomiting or even liver or kidney problems.

What To Do If You Miss a Dose

If you miss a dose, take it as soon as you remember. However, if it’s just a few hours until your next dose, wait and take a single dose at the usual time. Never try to catch up by taking two doses at once. This could result in toxic side effects.

How Can I Tell if the Drug is Working?

You may be able to tell the drug is working if you experience a reduction in your symptoms. Talk to your doctor to see if your medication is working for you.

This medication may be taken long term or short term. Talk to your doctor about how long you’ll need to take it.

Important Considerations for Taking Penicillamine

Take penicillamine on an empty stomach

You can take it 1 hour before or 2 hours after you eat. 

Store penicillamine in temperatures from 59–86°F (15–30°C)

Keep it in a tightly closed container away from moisture.

Note: Keep your medications away from areas where they could get wet, such as bathrooms. Store them away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s preprinted label to identify the medication. Keep the original prescription-labeled box with you when traveling.

Clinical Monitoring

Your doctor may do these tests:

  • urine and blood tests for blood and kidney function
  • skin checks. Your doctor may check your skin for changes twice a week for the first month. After that, they may check your skin every 2 weeks for the next 5 months. If you aren’t having skin problems, your doctor may check it only once a month after that.
  • liver tests. These may be done every 6 months while you take this drug.
  • additional lab tests to check if you’re experiencing side effects and that the drug is working

Your Diet

Take dairy products either 2 hours before or 2 hours after taking penicillamine.

You may have to drink a lot of liquids while taking this medication. Talk to your doctor about how much fluid you need to drink. Be sure to follow these instructions so you get the best results from your medicine.

What does the pill look like?

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Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.


Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on May 6, 2015

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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