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Penicillamine

Generic Name: penicillamine (PEN-ih-SILL-ah-meen)
Brand Name: Examples include Cuprimine and Depen

Penicillamine may cause serious side effects. Patients using penicillamine should remain under the close supervision of their doctor. Tell your doctor immediately if you develop a rash, difficulty breathing or wheezing, chills, fever, sore throat, bruising, or bleeding.


Penicillamine is used for:

Treating Wilson disease (excess copper in the body), severe rheumatoid arthritis that has not responded to other treatments, and cystinuria (excess amino acids in the urine, which causes kidney stones). It may also be used for other conditions as determined by your doctor.

Penicillamine is a chelating agent. It works by removing excess copper in patients with Wilson disease, reducing excess cystine in patients with cystinuria, and reducing disease activity in patients with rheumatoid arthritis.

Do NOT use penicillamine if:

  • you are allergic to any ingredient in penicillamine or to penicillin
  • you are pregnant or are breast-feeding
  • you have a history of aplastic anemia or agranulocytosis (decreased number of white blood cells) due to penicillamine use
  • you have a history of kidney problems (rheumatoid arthritis patients only), blood in the urine, or pemphigus (blistering skin disease)
  • you are taking gold therapy (eg, gold salts), antimalarial or cytotoxic medicines (eg, quinine, carboplatin), oxyphenbutazone, or phenylbutazone

Contact your doctor or health care provider right away if any of these apply to you.

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Before using penicillamine:

Some medical conditions may interact with penicillamine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are planning to become pregnant
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you are scheduled for surgery
  • if you have Goodpasture syndrome, myasthenia gravis, aplastic anemia, or decreased blood platelets or white blood cells

Some MEDICINES MAY INTERACT with penicillamine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Antimalarial medicines (eg, atovaquone), cytotoxic medicines (eg, carboplatin, quinine), gold salts, oxyphenbutazone, or phenylbutazone because the risk of side effects, such as kidney problems and blood disorders, may be increased
  • Digoxin because its effectiveness may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if penicillamine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use penicillamine:

Use penicillamine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take penicillamine on an empty stomach (1 hour before meals or 2 hours after meals).
  • Take penicillamine at least 2 hours before or after other medicines containing aluminum or magnesium (antacids), iron, or vitamins that contain iron.
  • If you are taking penicillamine for cystinuria, drink plenty of water while taking penicillamine. Drink a pint (16 ounces [480 mL]) at bedtime and another pint during the night, unless directed otherwise by your doctor.
  • It may take 1 to 3 months for penicillamine to work.
  • If you miss a dose of penicillamine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use penicillamine.

Important safety information:

  • Your doctor may prescribe a vitamin B supplement called pyridoxine while you are taking penicillamine. Follow your doctor's instructions for taking this supplement.
  • Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using penicillamine.
  • LAB TESTS, including complete blood cell counts, platelet counts, liver and kidney function tests, urinalysis, and body temperature, may be required to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.
  • Use penicillamine with caution in the ELDERLY because they may be more sensitive to its effects.
  • Penicillamine is not recommended for use in CHILDREN with juvenile rheumatoid arthritis. Safety and effectiveness have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Penicillamine has been shown to cause harm to the fetus. If you become, discuss with your doctor the benefits and risks of using penicillamine during pregnancy. It is unknown if penicillamine is excreted in breast milk. Do not breast-feed while taking penicillamine.

Possible side effects of penicillamine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; loss of appetite; mild stomach pain; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; bleeding or bruising; blood in the urine; burning, itching, peeling, or redness of skin; changes in taste; chills; cough; dark urine; difficult urination; fever; general feeling of discomfort; joint pain; muscle weakness; severe stomach pain; shortness of breath; skin lesions; sore throat; swelling of the feet or legs; vision problems; weight gain; wheezing.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of penicillamine:

Store penicillamine at room temperature, 77 degrees F (25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep penicillamine out of the reach of children and away from pets.

General information:

  • If you have any questions about penicillamine, please talk with your doctor, pharmacist, or other health care provider.
  • Penicillamine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take penicillamine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about penicillamine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to penicillamine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using penicillamine.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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