Cuprimine Side Effects

Generic name: penicillamine

Medically reviewed by Drugs.com. Last updated on Jun 1, 2023.

Note: This document contains side effect information about penicillamine. Some dosage forms listed on this page may not apply to the brand name Cuprimine.

Applies to penicillamine: oral capsule, oral tablet.

Warning

Oral route (Capsule)

Physicians planning to use penicillamine should thoroughly familiarize themselves with its toxicity, special dosage considerations, and therapeutic benefits. Penicillamine should never be used casually. Each patient should remain constantly under the close supervision of the physician. Patients should be warned to report promptly any symptoms suggesting toxicity.

Serious side effects of Cuprimine

Along with its needed effects, penicillamine (the active ingredient contained in Cuprimine) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur while taking penicillamine:

More common

Fever
joint pain
lesions on the face, neck, scalp, and/or trunk
skin rash, hives, or itching
swollen and/or painful glands
ulcers, sores, or white spots on lips or in mouth

Less common

Bloody or cloudy urine
shortness of breath, troubled breathing, tightness in chest, or wheezing
sore throat and fever with or without chills
swelling of face, feet, or lower legs
unusual bleeding or bruising
unusual tiredness or weakness
weight gain

Rare

Abdominal or stomach pain (severe)
blisters on skin
bloody or black, tarry stools
chest pain
coughing or hoarseness
dark urine
difficulty in breathing, chewing, talking, or swallowing
eye pain, blurred or double vision, or any change in vision
general feeling of discomfort or illness or weakness
lower back or side pain
muscle weakness
painful or difficult urination
pale stools
pinpoint red spots on skin
redness, tenderness, itching, burning, or peeling of skin
red or irritated eyes
red, thick, or scaly skin
ringing or buzzing in the ears
spitting blood
yellow eyes or skin

Other side effects of Cuprimine

Some side effects of penicillamine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea
lessening or loss of sense of taste
loss of appetite
nausea or vomiting
stomach pain (mild)

For Healthcare Professionals

Applies to penicillamine: oral capsule, oral tablet.

Nervous system

Very common (10% or more): Blunting, diminution, or total loss of taste (12%)

Frequency not reported: Headache, dizziness, deterioration of neurological symptoms of Wilson's disease (dystonia, rigidity, tremor, dysarthria) following introduction of therapy in patients treated for this condition (this may be a consequence of mobilization and redistribution of copper from the liver to the brain), arthralgia, tinnitus, peripheral sensory and motor neuropathies (including polyradiculoneuropathy, i.e., Guillain-Barre Syndrome)^[Ref]

Gastrointestinal

Very common (10% or more): Epigastric pain (17%), nausea (17%), vomiting (17%), diarrhea (17%)

Rare (0.01% to 0.1%): Mouth ulceration, stomatitis, glossitis

Frequency not reported: Pancreatitis, reactivated peptic ulcer^[Ref]

Hematologic

Common (1% to 10%): Thrombocytopenia, leukopenia

Frequency not reported: Neutropenia (usually reversible), agranulocytosis (sometimes fatal), aplastic anemia (sometimes fatal), hemolytic anemia, lymphadenopathy, thrombotic thrombocytopenic purpura, red cell aplasia, monocytosis, leukocytosis, eosinophilia, thrombocytosis^[Ref]

Renal

Common (1% to 10%): Proteinuria

Rare (less than 0.1%): Hematuria, renal vasculitis

Frequency not reported: Nephrotic syndrome, glomerulonephritis, Goodpasture's syndrome^[Ref]

Musculoskeletal

Rare (less than 0.1%): Polymyositis, dermatomyositis

Frequency not reported: Lupus erythematosus, myasthenia gravis, rheumatoid arthritis, septic arthritis (in patients with rheumatoid arthritis), muscular weakness^[Ref]

Dermatologic

Common (1% to 10%): Rash (early and/or later in therapy), pruritus

Rare (less than 0.1%): Alopecia, pseudoxanthoma elasticum, elastosis perforans, skin laxity, lichen planus

Frequency not reported: Urticaria, epidermolysis bullosa, exfoliative dermatitis, dermopathy, dermatomyositis, pemphigus, Stevens-Johnson syndrome^[Ref]

Respiratory

Rare (less than 0.1%): Bronchial asthma

Frequency not reported: Pulmonary hemorrhage, dyspnea, pleural effusion, alveolitis, pulmonary fibrosis, bronchiolitis, pneumonitis^[Ref]

Other

Frequency not reported: Deafness, fever, the chelating action of the drug may cause increased excretion of other heavy metals (in addition to copper) such as zinc, mercury, and lead^[Ref]

Genitourinary

Rare (less than 0.1%): Breast enlargement^[Ref]

Hepatic

Rare (less than 0.1%): Intrahepatic cholestasis, toxic hepatitis

Frequency not reported: Cholestatic jaundice, hepatic dysfunction, pancreatitis, increased serum alkaline phosphatase, increased lactic dehydrogenase, positive cephalin flocculation test, positive thymol turbidity test^[Ref]

Ocular

Frequency not reported: Abnormal vision, optic neuritis^[Ref]

Cardiovascular

Rare (less than 0.1%): Thrombophlebitis^[Ref]

Endocrine

Very rare (less than 0.01%): Thyroiditis^[Ref]

General

Both the frequency and severity of many side effects are dose related and vary according to the disease being treated. Initiating therapy at lower doses and titrating up helps to attenuate some side effects.^[Ref]