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Generic Name: penicillamine (pen ih SILL ah meen)
Brand Name: Cuprimine, Depen

Medically reviewed by on May 23, 2019 – Written by Cerner Multum

What is Cuprimine?

See also: Orencia

Cuprimine is a chelating (KEE-late-ing) agent that binds to excess copper and removes it from the blood stream. In certain conditions, excess copper can build up in the blood stream, leading to tissue damage throughout the body.

Cuprimine is used to remove excess copper in people with an inherited condition called Wilson's disease.

Cuprimine is also used to reduce urine levels of an amino acid called cystine, which can cause stones to form in the kidneys and bladder in people with an inherited condition called cystinuria.

Cuprimine is also used to treat severe rheumatoid arthritis after other medicines have been tried without success. This medicine is not approved to treat juvenile rheumatoid arthritis.

Cuprimine may also be used for purposes not listed in this medication guide.

Important Information

You should not use Cuprimine if you are breast-feeding, if you have ever had an infection or damaged blood cells caused by this medicine, or if you have kidney disease and you need this medicine to treat rheumatoid arthritis.

Every person taking Cuprimine should remain under the close supervision of a doctor.

Before taking this medicine

You should not use Cuprimine if you are allergic to it, or:

  • if you are breast-feeding;

  • if you have kidney disease (if using Cuprimine to treat rheumatoid arthritis); or

  • if you have developed an infection or damaged blood cells after taking Cuprimine in the past.

Some medicines can interact with Cuprimine and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • gold injections;

  • medicine to treat or prevent malaria; or

  • drugs that weaken the immune system such as cancer medicine, steroids, and medicines to prevent organ transplant rejection.

To make sure Cuprimine is safe for you, tell your doctor if you have:

  • kidney disease;

  • liver disease;

  • an allergy to penicillin;

  • a history of stomach ulcers;

  • a weak immune system; or

  • if you are malnourished.

Follow your doctor's instructions about taking Cuprimine if you are pregnant. Do not start or stop taking Cuprimine without your doctor's advice, and tell your doctor right away if you become pregnant.

  • Cuprimine may cause harm to an unborn baby and should not be used to treat cystinuria or rheumatoid arthritis if you are pregnant.

  • Cuprimine may be used during pregnancy to prevent a relapse of Wilson's disease. Not treating this condition during pregnancy can cause harmful or fatal effects on the mother. The benefit of preventing a relapse of Wilson's disease may outweigh any risks to the baby.

It is not known whether penicillamine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I take Cuprimine?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Take Cuprimine on an empty stomach, at least 1 hour before or 2 hours after a meal.

Do not drink milk within 1 hour before or 1 hour after you take Cuprimine.

While using Cuprimine, you may need frequent blood and urine tests.

It may take up to 3 months before your rheumatoid arthritis symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Drink plenty of liquids while you are taking Cuprimine.

Your doctor may want you to take a multivitamin or take extra iron or vitamin B6 while you are taking Cuprimine. Take only the amount of supplements that your doctor has prescribed.

Cuprimine may be only part of a complete program of treatment that also includes a special diet. Follow the diet plan created for you by your doctor or nutrition counselor. Get familiar with the list of foods you must avoid to help control your condition.

Your condition may seem to get worse for a short time when you first start taking this medicine. Do not change your doses or medication schedule without your doctor's advice. Every person taking Cuprimine should remain under the care of a doctor.

If you do stop taking Cuprimine for any reason, do not start taking it again until you talk to your doctor.

Your condition may need to be treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Cuprimine?

Follow any special diet restrictions recommended by your doctor. Avoid eating nuts, chocolate, molasses, liver, shellfish, mushrooms, broccoli, and cereals that are fortified with copper. Also avoid taking mineral supplements that contain copper. If your drinking water supply contains more than 0.1 mg of copper per liter, you may need to drink distilled or demineralized water.

Avoid taking mineral supplements, unless your doctor tells you to.

Avoid taking other medicines at the same time you take Cuprimine. If you take an iron supplement, take it at least 2 hours before or 2 hours after you take this medicine. Iron can make it harder for your body to absorb this medicine.

Cuprimine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • sudden fever, skin rash, joint pain, or swollen glands;

  • sudden weakness or ill feeling, chills, sore throat, mouth sores, skin sores, red or swollen gums;

  • easy bruising or bleeding;

  • pale skin, feeling light-headed or short of breath, rapid heart rate;

  • muscle weakness in your arms and legs;

  • muscle weakness in your face, drooping eyelids, double vision, trouble chewing or swallowing;

  • new or worsening cough, fever, trouble breathing;

  • swelling in your hands, legs, and feet; or

  • pain or burning when you urinate, foamy or bloody urine, lower back pain.

Common side effects may include:

  • decreased sense of taste;

  • skin rash or peeling, watery blisters;

  • skin changes such as wrinkling or pimples;

  • stomach pain, nausea, vomiting, diarrhea, loss of appetite;

  • numbness or tingly feeling;

  • ringing in your ears; or

  • a wound that will not heal.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Cuprimine?

Other drugs may interact with penicillamine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.