penicillamine

What is the most important information I should know about penicillamine?

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 are breast-feeding;
• you have kidney disease (if using penicillamine to treat rheumatoid arthritis); or
• you have developed an infection or damaged blood cells after taking penicillamine in the past.

Some medicines can cause unwanted or dangerous effects when used with penicillamine. Your doctor may change your treatment plan if you also use:

• gold injections;
• medicine to treat or prevent malaria; or
• cancer medicine.

Tell your doctor if you have ever had:

• kidney disease;
• liver disease;
• an allergy to penicillin;
• a stomach ulcer;
• a weak immune system; or
• if you are malnourished.

• 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.

How should I take penicillamine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You will need frequent urine tests.

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.

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.

You may need to follow a special diet while using penicillamine. Follow all instructions of your doctor or dietitian. Learn about the foods to eat or avoid to help control your condition.

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.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

What should I avoid while taking penicillamine?

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.

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

If you have Wilson's disease, 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.

What are the possible side effects of penicillamine?

• new or worsening joint pain;
• 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;
• blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;
• skin rash, peeling, or watery blisters;
• pain or burning when you urinate, foamy or bloody urine, lower back pain;
• swelling in your hands, legs, and feet; or
• low blood cell counts --fever, chills, tiredness, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath.

Common side effects may include:

• decreased sense of taste;
• 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 affect penicillamine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your doctor or pharmacist can provide more information about penicillamine.