What is the most important information I should know about penicillamine?
You should not use penicillamine if you are breast-feeding, if you have ever had an infection or damaged blood cells caused by penicillamine, or if you have kidney disease and you need penicillamine to treat rheumatoid arthritis.
Every person taking penicillamine should remain under the close supervision of a doctor.
What is penicillamine?
Penicillamine 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.
Penicillamine is used to remove excess copper in people with an inherited condition called Wilson's disease.
Penicillamine 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.
Penicillamine is also used to treat severe rheumatoid arthritis after other medicines have been tried without success. Penicillamine is not approved to treat juvenile rheumatoid arthritis.
Penicillamine may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking penicillamine?
You should not use penicillamine if you are allergic to it, or:
- if you are breast-feeding;
- if you have kidney disease (if using penicillamine to treat rheumatoid arthritis); or
- if you have developed an infection or damaged blood cells after taking penicillamine in the past.
Some medicines can interact with penicillamine 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 penicillamine 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 penicillamine if you are pregnant. Do not start or stop taking this medicine without your doctor's advice, and tell your doctor right away if you become pregnant.
- Penicillamine may cause harm to an unborn baby and should not be used to treat cystinuria or rheumatoid arthritis if you are pregnant.
- Penicillamine 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 penicillamine?
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 penicillamine 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 penicillamine.
While using penicillamine, 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 penicillamine.
Your doctor may want you to take a multivitamin or take extra iron or vitamin B6 while you are taking penicillamine. Take only the amount of supplements that your doctor has prescribed.
Penicillamine 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 penicillamine should remain under the care of a doctor.
If you do stop taking penicillamine 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 penicillamine?
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 penicillamine. If you take an iron supplement, take it at least 2 hours before or 2 hours after you take penicillamine. Iron can make it harder for your body to absorb penicillamine.
What are the possible side effects of penicillamine?
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 penicillamine?
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.
Where can I get more information?
Your doctor or pharmacist can provide more information about penicillamine.
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.
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