Penicillamine belongs to the chelator class of drugs. It is primarily indicated for the treatment of severe active rheumatoid arthritis and Wilson's disease.
This medication is rarely used today in the treatment of the former and is limited to patients who have failed to respond to conventional therapy.
The latter is a genetic disorder characterized by abnormal copper metabolism resulting to increased deposits in the body.
Penicillamine binds with the accumulated copper which then leads to elimination in the urine. This medication can also be used to treat cystinuria, scleroderma, Felty's syndrome, heavy metal toxicity, rheumatoid vasculitis and other conditions as per your physician.
It is usually available in capsule and tablet forms. It can only be purchased with a prescription.
Penicillamine can have serious side effects. Before starting treatment, discuss the advantages and disadvantages of using this medication with your primary care physician.
This medication may be contraindicated if you are allergic to penicillin or any of its components. Inform your physician of allergies to food, dry, preservatives, and/or animals.
Penicillamine is expected to work in the same manner in children as it does in adults although no specific information is available regarding this. This medication should be used with caution in elderly patients since they can be more prone to developing side effects.
Studies have found that penicillamine can put the fetus at risk. Tell your doctor if you are pregnant or plan to get pregnant. You may be advised to stop nursing your baby if you need to take penicillamine. Concomitant use of aurothioglucose is not recommended.
Using auranofin or gold sodium thiomalate is not usually recommended but can be necessary at times. If you are on iron therapy, take your iron medication 2 hours before or after taking penicillamine. Take this medication at least 30 minutes before meals with a glass of water.
Penicillamine is to be used with caution in patients who have blood disease caused by previous penicillamine treatment or kidney disease.
3 Proper Usage
The way you take this medication will depend on your condition. So make sure you understand the purpose of your treatment and always follow your physician’s instructions.
If you have questions, do not hesitate to talk with your healthcare provider. If you need this medication to treatment kidney stones, take it on an empty stomach and drink 2 glasses of water at bedtime.
For treatment of rheumatoid arthritis, keep taking this medication as directed by your doctor. It usually takes 2 to 3 months for its therapeutic effects to manifest.
For Wilson's disease, take it 2 hours after meals or 1 hour before meals and follow the prescribed diet.
For lead poisoning, take this medication 2 hours before and 3 hours after meals. Generally, you should take it on an empty stomach and follow your physician’s instructions. Dosage and timing depend on the condition being treated.
For Wilson's disease, it is usually 2000 mg daily in divided doses. Do not take more than that in 1 day. For rheumatoid arthritis, dosage can be 125 mg-250 mg once a day for the first month. The dose may be adjusted after that.
For treatment of cystinuria, 1000-3000 mg daily in divided doses is usually prescribed. If used to prevent cystinuria, 500-1000 mg before bedtime can be prescribed.
For lead poisoning, your doctor may prescribe 1000-1500 mg daily in divided doses until urine lead levels are normalized. If you forget a dose, take it immediately.
However, resume the normal schedule if the next timing is near. Keep your medications away from children’s reach and extreme temperature.
4 Precautions to Take
Your doctor needs to monitor your condition regularly to make sure the medication is working and to prevent side effects. This is why it’s imperative to go to your follow-up appointments.
Your healthcare provider may also need to run laboratory tests on a regular basis. You need to take special precautions when you are on penicillamine treatment.
Notify your surgeon and dentist that you are taking penicillamine before undergoing any kind of surgical or dental treatment. Clean your teeth and gums carefully. Do not use toothbrushes or dental flosses harshly.
As mentioned earlier, you need to take iron supplements or medications with iron at least 2 hours before taking penicillamine. Iron supplements can hamper penicillamine’s effects.
You need to watch out for signs and symptoms of blood problems. These can include:
You should also take note of serious lung problem symptoms including noisy breathing, trouble breathing, or an unexplained cough. Notify your doctor right away if you experience those.
Penicillamine can cause side effects. Stop taking this medication and inform your doctor immediately if you have serious allergic reactions, blood in urine, easy bruising and bleeding, extreme weakness, ulcers of the mouth, blistering of the skin, fever, and pallor.
Tell your physician if you experience the following side effects:
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