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D-Penamine Side Effects

Generic name: penicillamine

Medically reviewed by Last updated on Sep 12, 2023.

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

Applies to penicillamine: oral capsule, oral tablet.


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 D-Penamine

Along with its needed effects, penicillamine (the active ingredient contained in D-Penamine) 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

Less common


Other side effects of D-Penamine

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

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]


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]


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]


Common (1% to 10%): Proteinuria

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

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


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]


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]


Rare (less than 0.1%): Bronchial asthma

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


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]


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


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]


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


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


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


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]


Rare (less than 0.1%): Allergic reactions including hypersensitivity[Ref]


Frequency not reported: Confusion[Ref]


1. (2001) "Product Information. Cuprimine (penicillamine)." Merck & Co., Inc

2. Cerner Multum, Inc. "UK Summary of Product Characteristics."

3. Cerner Multum, Inc. "Australian Product Information."

Further information

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

Some side effects may not be reported. You may report them to the FDA.