• Basic Info
• Top Questions
• Clinical Info
• Interactions

What is penicillamine?
Penicillamine is a chelating agent. It attaches to other chemicals in the body, which aids in their removal. Penicillamine is used to remove excess copper associated with Wilson's disease. It is also used to reduce cystine in the urine and to treat severe rheumatoid arthritis. Penicillamine may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of penicillamine?

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.

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How should I take penicillamine?
Take penicillamine exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. Take each dose with a full glass of water. Penicillamine must be taken on an empty stomach, at least 1 hour before or 2 hours after a full meal, and at least 1 hour before or after any other drug, food, or milk. Taking penicillamine with anything else in the stomach greatly decreases its effectiveness. Do not stop taking penicillamine without first talking to your doctor. Stopping therapy may cause your body to react abnormally when therapy is restarted. If you do stop taking the medication, do not restart without first talking to your doctor. You may need special monitoring.

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What is the most important information I should know about penicillamine?
Notify your doctor immediately if you develop fever; chills; a sore throat; unusual bruising or bleeding; blood in your urine, unexplained shortness of breath, coughing, or wheezing; muscle weakness; or double vision. These symptoms could be early signs of dangerous side effects.

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What happens if I miss a dose?
Take the missed dose on an empty stomach as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor. If you have missed several doses in a row, do not take any more doses without first talking to your doctor.

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What other drugs will affect penicillamine?
Do not take penicillamine if you are taking any of the following medicines: a gold-therapy product such as auranofin (Ridaura), aurothioglucose (Solganal), or gold sodium thiomalate (Myochrysine, Aurolate); an antimalarial medicine such as quinine (Quinamm), mefloquine (Lariam), chloroquine (Aralen), hydroxychloroquine (Plaquenil), primaquine, or pyrimethamine (Daraprim); a cancer chemotherapy medicine; or phenylbutazone. Like penicillamine, the medications listed above can affect the blood and the kidneys. Combined with penicillamine, any of these medicines can be very dangerous.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Penicillamine has been assigned to pregnancy category D by the FDA. Penicillamine can cause fetal harm when administered to a pregnant woman. Penicillamine has been shown to be embryotoxic and teratogenic in rats. There are no controlled data in human pregnancy. Although normal outcomes have been reported, characteristic congenital cutis laxa and associated birth defects have been reported in infants born of mothers who received therapy with penicillamine during pregnancy. Several conflicting recommendations have appeared in the literature concerning the use of penicillamine during pregnancy. Although evidence is incomplete, maintaining the daily dose at 500 mg or less may reduce the incidence of penicillamine-induced toxicity in the newborn. The manufacturer recommends, however, that the daily dose be limited to 750 mg and, if cesarean section is planned, the dose should be limited to 250 mg/day for 6 weeks before delivery and postoperatively until wound healing is complete.

Penicillamine is excreted into human milk. Breast-feeding is considered contraindicated by the manufacturer.

A 2000 review stated that no adverse effects in nursing infants have been reported by nursing mothers who were taking penicillamine, even though one study found lower amounts of zinc and copper in milk.

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Who should NOT use this medication?

• Known or suspected pregnancy except when used for the treatment of Wilson’s disease or in certain individuals with cystinuria. (See Fetal/Neonatal Morbidity and Mortality and Pregnancy under Cautions.)
• Breast-feeding. (See Lactation under Cautions.)
• History of penicillamine-related aplastic anemia or agranulocytosis.
• Rheumatoid arthritis patients with current or history of renal insufficiency.

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What does my medication look like?
Penicillamine is available with a prescription under the brand names Cuprimine and Depen. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Cuprimine 125 mg-ivory and gray capsules Cuprimine 250 mg-ivory colored capsules Depen 250 mg-white, oval, scored tablets

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What happens if I overdose?
Seek emergency medical attention. Symptoms of a penicillamine overdose are not known.

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What should I discuss with my healthcare provider before taking penicillamine?
You cannot take penicillamine if you have taken it in the past and it has damaged your blood cells. Before taking penicillamine, tell your doctor if you have kidney disease or any other serious illness. You may not be able to take penicillamine, or you may require a lower dose or special monitoring during therapy. Penicillamine may cause birth defects in an unborn baby. However, it has also been used during pregnancy with no evidence of defects. Penicillamine should not be used during pregnancy except to treat Wilson's disease and some cases of cystine in the urine. Do not take this medication without first talking to your doctor if you are pregnant.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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