Penicillamine Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Wilson's Disease

Initial dose: 0.75 to 1.5 grams/day that results in an initial 24-hour cupriuresis of over 2 mg should be continued for about three months.

Maintenance dose: The optimal maintenance dosage can be determined by measurement of urinary copper excretion and determination of free copper in the serum. It is seldom necessary to exceed a dosage of 2 g/day.

Total daily dose should be divided into four equal doses. If four equal doses are not feasible, give the larger portion at bedtime.

Usual Adult Dose for Cystinuria

Usual adult dose: 2 grams/day with a range of 1 to 4 grams/day. The total daily dose should be divided into four doses. If four equal doses are not feasible, give the larger portion at bedtime.

Usual Adult Dose for Rheumatoid Arthritis

Initial dose: Begin with a single daily dose of 125 mg or 250 mg, which is thereafter increased at one to three month intervals, by 125 mg or 250 mg/day, as patient response and tolerance indicate.

Maintenance dose: The maintenance dosage must be individualized, and may require adjustment during the course of treatment. Many patients respond satisfactorily to a dosage within the 500 to 750 mg/day range.

If there is no improvement and there are no signs of potentially serious toxicity after two to three months of treatment with doses 500 to 750 mg/day, increases of 250 mg/day at two to three month intervals may be continued until remission, toxicity develops, and/or there is no discernible improvement after three to four months of treatment with 1000 to 1500 mg of penicillamine per day.

Usual Pediatric Dose for Wilson's Disease

Initial dose: 0.75 to 1.5 grams/day that results in an initial 24-hour cupriuresis of over 2 mg should be continued for about three months.

Maintenance dose: The optimal maintenance dosage can be determined by measurement of urinary copper excretion and determination of free copper in the serum. It is seldom necessary to exceed a dosage of 2 g/day.

Total daily dose should be divided into four equal doses. If four equal doses are not feasible, give the larger portion at bedtime.

Usual Pediatric Dose for Cystinuria

Usual pediatric dose: 30 mg/kg/day. The total daily dose should be divided into four doses. If four equal doses are not feasible, give the larger portion at bedtime.

Usual Pediatric Dose for Rheumatoid Arthritis

Initial dose: Begin with a single daily dose of 125 mg or 250 mg, which is thereafter increased at one to three month intervals, by 125 mg or 250 mg/day, as patient response and tolerance indicate.

Maintenance dose: The maintenance dosage must be individualized, and may require adjustment during the course of treatment. Many patients respond satisfactorily to a dosage within the 500 to 750 mg/day range.

If there is no improvement and there are no signs of potentially serious toxicity after two to three months of treatment with doses 500 to 750 mg/day, increases of 250 mg/day at two to three month intervals may be continued until remission, toxicity develops, and/or there is no discernible improvement after three to four months of treatment with 1000 to 1500 mg of penicillamine per day.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dialysis

Data not available

Other Comments

Initiating dosage with 250 mg/day and increasing gradually to the requisite amount will give closer control of the effects of the drug and may help to reduce the incidence of adverse reactions.

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