About penicillamine
Chelating agent and immunosuppressant
Used for
- Wilson disease
- Cystinuria
- Severe active rheumatoid arthritis
Usual adult dose
Wilson disease: usually 750–1,500 mg daily in divided doses. Cystinuria: usually 1–2 g daily. Rheumatoid arthritis: start 125–250 mg daily, increased gradually.
Usual dose in children
Wilson disease: usually 20 mg/kg daily in divided doses. Cystinuria: specialist-directed dosing; commonly 20–30 mg/kg daily.
Common side effects
- Nausea, vomiting, loss of appetite
- Rash, itching, altered taste
- Low blood-cell counts
- Kidney problems, including protein in urine
Important warnings
- Can cause serious blood, kidney, or lung problems; regular monitoring is essential.
- Take on an empty stomach, at least one hour before or two hours after food.
- Separate from iron, zinc, and antacids by at least two hours.
- Do not use for rheumatoid arthritis with a history of penicillamine-related kidney or blood disorders.
Pregnancy
May harm the fetus. Use is generally avoided; Wilson disease may require continued treatment under specialist supervision.
Breastfeeding
Breastfeeding is generally not recommended during treatment because of potential serious infant effects.
Interactions
- Iron, zinc, and antacids reduce absorption; separate doses.
- Gold, antimalarials, and cytotoxic medicines may increase serious blood or kidney effects.
- Digoxin absorption may be reduced.
- Vitamin B6 supplementation may be needed during prolonged treatment.
AI-generated from general medical knowledge, not from this product's official leaflet. It may be incomplete or out of date. Not medical advice — ask a pharmacist or doctor before making any decision.