Penicillamine use while Breastfeeding
Drugs containing Penicillamine: Cuprimine, Depen, Depen Titratabs
Penicillamine Levels and Effects while Breastfeeding
Summary of Use during Lactation
Penicillamine has been used with apparent safety during nursing of 3 infants. Some authors state that use of penicillamine is unacceptable during lactation.[1][2][3] Other authors have pointed out that breastmilk transfer to the infant is likely to be low because of high protein binding (80%) and short half-life (about 2 hours).[1][4] In infants who breastfeed infrequently, taking the drug right after nursing and waiting 4 to 6 hours before nursing again should minimize the amount in breastmilk. Copper and zinc levels in breastmilk are reduced in patients taking penicillamine. The implications for infants of this effect are not known.
Drug Levels
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
One woman taking penicillamine 1500 mg daily for cysteinuria breastfed her infant for 3 months with no apparent adverse effects in her infant.[5]
Another woman breastfed 2 infants after 2 pregnancies while being treated for Wilson's disease with penicilliamine 750 mg daily. One infant had prolonged icterus that was unlikely to have been related to the penicillamine.[6]
Possible Effects on Lactation
Milk concentrations of zinc and copper are reduced during therapy of Wilson's disease with penicillamine.[3][7][8][9]
Alternate Drugs to Consider
(Rheumatoid Arthritis) Auranofin, Etanercept, Gold Sodium Thiomalate, Hydroxychloroquine, Infliximab, Methotrexate, Sulfasalazine, (Wilson's disease) Trientine
References
1. Byron MA. Treatment of rheumatic diseases. Br Med J. 1987;294:236-8. PMID: 3101825
2. Ramsey-Goldman R, Schilling E. Optimum use of disease-modifying and immunosuppressive antirheumatic agents during pregnancy and lactation. Clin Immunother. 1996;5:40-58.
3. Shiga K, Kaga H, Kodama H et al. Copper and zinc concentrations in the breast milk of mothers with Wilson disease and effects on infants. J Inherit Metab Dis. 2006;29 Suppl. 1:139. Abstract.
4. Needs CJ, Brooks PM. Antirheumatic medication during lactation. Br J Rheumatol. 1985;24:291-7. PMID: 3893608
5. Gregory MC, Mansell MA. Pregnancy and cystinuria. Lancet. 1983;2:1158-60. PMID: 6139526
6. Messner U, Gunter HH, Niesert S. [Wilson disease and pregnancy. Review of the literature and case report]. Z Geburtshilfe Neonatol . 1998;202:77-9. PMID: 9654718
7. Bunke H, Cario WR, Schneider M. [Variations in the composition of breast milk in Wilson's disease]. Kinderarztl Prax. 1989; 57:89-92. PMID: 2724779
8. Sternlieb I. Wilson's disease and pregnancy. Hepatology. 2000;31:531-2. Editorial. PMID: 10655282
9. Kaga F, Kodama H, Siga K et al. Copper and zinc status in the breast milk of mothers with Wilson disease. J Inherit Metab Dis 2008;31 (Suppl. 1):157. Abstract.
Penicillamine Identification
Substance Name
CAS Registry Number
52-67-5
Drug Class
- Antirheumatic Agents
Administrative Information
LactMed Record Number
208
Information from the National Library of Medicine's LactMed Database.
Last Revision Date
2010-07-09
Disclaimer
Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
See Also...
- Penicillamine use during Pregnancy
- Penicillamine Consumer Information
- Breastfeeding Support Group
- Safe Medications during Breastfeeding
- Medicine use while Breastfeeding
- Medicine use during Pregnancy
Disclaimer: This information is not intended as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Use of this website signifies your agreement to the Terms of Use and Online Privacy Policy.
