Penicillamine Side Effects
Some side effects of penicillamine 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
Along with its needed effects, penicillamine 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
- 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
- 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
- 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
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
- 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 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 side effects have included reversible optic neuritis with racemic penicillamine (may be related to pyridoxine deficiency).
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 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 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 side effects have included myasthenia gravis and dystonia.
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 side effects have included allergic alveolitis, obliterative bronchiolitis, interstitial pneumonitis, pulmonary fibrosis, and bronchial asthma.
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 side effects have included thrombophlebitis.
Genitourinary side effects have included mammary atrophy.
Immunologic side effects have included polymyositis and dermatomyositis.
There have been reports associating penicillamine 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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