Cuprimine Side Effects

Generic name: penicillamine

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

Some side effects of Cuprimine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to penicillamine: oral capsule, oral tablet

If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:

• an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);

• fever or chills;

• a sore throat;

• unusual bleeding or bruising;

• blood in the urine;

• unexplained shortness of breath, coughing, or wheezing;

• abdominal pain;

• yellow skin or eyes;

• muscle weakness; or

• double vision.

Other, less serious side effects may be more likely to occur. Continue to take penicillamine (the active ingredient contained in Cuprimine) and notify your doctor if you experience

• itching or a rash;

• nausea, vomiting, diarrhea, or decreased appetite;

• ringing in the ears;

• decreased taste;

• sores in the mouth;

• poor wound healing; or

• increased wrinkling of the skin.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

For Healthcare Professionals

Applies to penicillamine: oral capsule, oral tablet

Nervous system

Nervous system side effects have included tinnitus, myasthenia gravis, polyradiculopathy (rare), peripheral sensory and motor neuropathies (including polyradiculoneuropathy). Muscular weakness may or may not occur with the peripheral neuropathies.

Ocular

Ocular side effects have included reversible optic neuritis with racemic penicillamine (the active ingredient contained in Cuprimine) (may be related to pyridoxine deficiency).

Gastrointestinal

Gastrointestinal side effects have included anorexia, epigastric pain, nausea, vomiting, and occasional diarrhea (17%). Some patients may report a blunting, diminution, or total loss of taste perception (12%); or may develop oral ulcerations. Although rare, cheilosis, glossitis, and gingivostomatitis have been reported.

Hematologic

Hematologic side effects have included thrombocytopenia (4%), leukopenia (2%), and bone marrow depression. Fatalities have been reported as a result of thrombocytopenia, agranulocytosis, aplastic anemia, and sideroblastic anemia.

Renal

Renal side effects have included proteinuria (6%) and/or hematuria which, in some, may progress to the development of the nephrotic syndrome as a result of an immune complex membranous glomerulopathy. Renal failure and a severe and ultimately fatal renal vasculitis have also been reported.

Musculoskeletal

Musculoskeletal side effects have included myasthenia gravis and dystonia.

Dermatologic

Dermatologic side effects have included skin friability, excessive wrinkling of skin, toxic epidermal necrolysis, anetoderma, development of small white papules at venipuncture and surgical sites, lichen planus, and bullous pemphigoid.

Respiratory

Respiratory side effects have included allergic alveolitis, obliterative bronchiolitis, interstitial pneumonitis, pulmonary fibrosis, and bronchial asthma.

Other

Other side effects have included hyperpyrexia, alopecia, and Goodpasture's syndrome.

The chelating action of the drug may cause increased excretion of other heavy metals such as zinc, mercury, and lead.

Local

Local side effects have included thrombophlebitis.

Genitourinary

Genitourinary side effects have included mammary atrophy.

Immunologic

Immunologic side effects have included polymyositis and dermatomyositis.

Oncologic

There have been reports associating penicillamine (the active ingredient contained in Cuprimine) with leukemia. However, circumstances involved in these reports are such that a cause and effect relationship to penicillamine has not been established.

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