hydroxychloroquine-sulfate and Cuprimine Interactions

Interactions between hydroxychloroquine-sulfate(hydroxychloroquine) and Cuprimine (penicillamine)

penicillamine and hydroxychloroquine (Moderate Drug-Drug)

GENERALLY AVOID: The concomitant use of penicillamine and chloroquine or hydroxychloroquine may potentiate the risk of hematologic and dermatologic adverse reactions due to overlapping toxicity profiles of these drugs. In addition, coadministration with chloroquine has been shown to increase the plasma concentrations of penicillamine. In six patients with rheumatoid arthritis receiving penicillamine 250 mg daily for at least three months, a single 250 mg dose of chloroquine phosphate increased the mean area under the plasma concentration-time curve of penicillamine by 52%. The mechanism of interaction has not been established.

MANAGEMENT: In general, penicillamine and chloroquine or hydroxychloroquine therapy should not be administered concurrently. Caution is advised if these drugs must be used together. Pharmacologic response to penicillamine should be monitored more closely whenever chloroquine is added to or withdrawn from therapy, and the penicillamine dosage adjusted as necessary. Patients should be advised to notify their physician if they experience signs and symptoms of toxicity such as fever, chills, sore throat, unusual bruising or bleeding, hematuria, coughing, wheezing, unexplained shortness of breath, muscle weakness, or visual disturbances.