Penicillamine


Generic Medicine Info
Administration
Should be taken on an empty stomach. Take on an empty stomach 1 hr before or 2 hr after meals, & at least 1 hr apart from any other drug, food, milk, antacid, Zn- or Fe-containing prep.
Contraindications
Hypersensitivity to penicillamine. History of agranulocytosis, aplastic anaemia or severe thrombocytopenia w/ penicillamine; SLE. Moderate to severe renal impairment. Pregnancy (except in the treatment of Wilson's disease) and lactation. Concomitant use w/ antimalarials, immunosuppressants, clozapine, gold.
Special Precautions
Patient w/ hypersensitivity to penicillin. Patients undergoing surgery. Mild renal impairment. Elderly, childn. Pregnancy (patients treated w/ Wilson's disease). Monitoring Parameters Monitor urinalysis, CBC w/ differential, platelet count, skin and lymph nodes reactions and body temp twice wkly for 1 mth, then every 2 wk for 5 mth; LFT every 6 mth; signs and symptoms of hypersensitivity. Monitor urinary cystine and perform annual X-ray for renal stones in patients w/ cystinuria; serum lead conc, Hb or haematocrit, Fe status, free erythrocyte protoporphyrin or zinc protoporphyrin and neurodevelopmental changes in patients w/ lead poisoning; serum non-ceruloplasmin bound copper, 24-hr urinary copper excretion, ophth status in patients w/ Wilson's disease.
Adverse Reactions
Significant: Oral ulcerations, hypogeusia, worsening of neurological symptoms (e.g. dystonia, rigidity, tremor, dysarthria), breast enlargement, leucopenia, rash w/ or w/o fever, arthralgia and lymphadenopathy (e.g. epidermolysis bullosa); pemphigus foliaceus, pemphigus vulgaris, increased soluble collagen levels (leading to increased skin friability, extravasation, increased wrinkling of the skin and development of small, white papules at venipuncture and surgical sites), Fe deficiency, drug fever w/ or w/o macular cutaneous eruption, lupus erythematosus, intrahepatic cholestasis or toxic hepatitis, allergic reactions. Rarely, cheilosis, glossitis, gingivostomatitis, obliterative bronchiolitis, proteinuria and haematuria may or may not lead to glomerulonephritis, renal failure. GI: Anorexia, epigastric pain, nausea, vomiting, diarrhoea.
Potentially Fatal: Agranulocytosis, aplastic anaemia, thrombocytopenia, myasthenia syndrome leading to myasthenia gravis (manifested by ptosis, diplopia, weakness of extraocular muscles). Rarely, Goodpasture's syndrome, renal vasculitis.
Drug Interactions
Increased risk of renal adverse effects w/ NSAIDs and other nephrotoxic drugs. May decrease the absorption of digoxin. Decreased absorption w/ Fe and other heavy metals. Increases requirement for pyridoxine.
ATC Classification
M01CC01 - penicillamine ; Belongs to the class of penicillamine and similar antirheumatic agents.
Disclaimer: This information is independently developed by CIMS based on penicillamine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in