Penicillamine

Penicillamine is a prescription-only medicine and classified as a metal binding (chelating) agent. Penicillamine binds copper, iron, mercury, lead and cystine which then are removed from the body through passing urine. This is important in treating genetic diseases such as Wilson's disease (having too much copper in your body).

Penicillamine could also suppress the immune system. Therefore, for patients with rheumatoid arthritis, penicillamine is able to slow the progression of the disease (specifically degeneration of the joints) and improves body functioning.

Penicillamine is also helpful in preventing bladder and kidney stones by removing excess cystine from your urine.

Penicillamine is a prescription drug that is used to decrease pain, swelling and tenderness associated with rheumatoid arthritis. It is also a metal binding (chelating) agent and is used in the treatment of (among others) Wilson’s disease, by removing excess copper from the body. Only healthcare providers who are familiar with this drug and its side effects should prescribe it, because there is a risk of significant negative effects. Patients need to stay under their doctor’s supervision while using this drug.

• Your healthcare provider will decide on the best dose depending on your age, the condition being treated, severity of the condition, other medications and supplements taken and your reaction to the first dose.
• Penicillamine comes as a capsule that is taken by mouth on an empty stomach (1 hour before or 2 hours after meals). Especially milk should be taken 1 hour before or after penicillamine.
• Take this drug at least 1 hour before or after other drugs.
• Combining penicillamine with malaria drugs can cause serious side effects.
• Do not take more than the required dose. If you forgot to take your dose, and it is almost time for the next dose, skip the missed dose.
• To help you remember, take the drug at the same time each day. Putting a daily reminder in your phone will help.

The most common side-effects include:

• Rash or itchy skin.
• Joint pain.
• Swollen and/or painful glands.
• Ulcers, sores or white spots on the lips or in the mouth
• A loss of taste.
• Not feeling hungry.
• Vomiting.
• Diarrhea.
• Unusual bleeding or bruising.
• Fever.
• Protein in the urine, which can cause kidney failure.
• Low white blood cells.

Symptoms and signs of kidney problems may include:

• Swelling of the hands, feet, or face.
• Cloudy or foamy urine.

Mild side effects may disappear within a few days or a couple of weeks. If side effects are severe or do not go away, it is important to speak to your healthcare provider.

Tell your health care provider as soon as possible if you experience severe side effects such as:

• Serious joint pain.
• Severe cough and difficulty breathing.
• Swollen gums and difficulty swallowing.
• Swelling in your face and lips.
• Double vision.

• People with moderate or severe kidney disease should not use this drug.
• Penicillamine should only be used during pregnancy in serious cases where it’s needed to treat a dangerous condition in the mother. Penicillamine can cause birth defects. If you are pregnant, plan to become pregnant, miss a period, or have unprotected sex while taking this medication you should speak to your healthcare provider.
• Penicillamine may pass through breast milk and cause harm to the baby during breast-feeding. Breastfeeding is not recommended while taking penicillamine.
• The safety and effectiveness of penicillamine have not been established in children.
• If your body is not making enough white blood cells, penicillamine can make this worse, leading to infections and other serious side-effects. In this case, your healthcare provider may need to do routine blood tests to monitor your blood cell counts.
• Penicillamine can cause a severe allergic reaction in some people. Anyone who has ever had a serious reaction to this drug should not take it again. Doing so could be fatal.