Penicillamine is used to treat Wilson's disease (a rare inherited disease that causes the buildup of copper in the body) and cystinuria (an inherited disease that causes the formation of stones in the kidneys or bladder due to high levels of a certain amino acid called cystine in the body).
This medicine may also be used to treat severe rheumatoid arthritis (inflammation in the joints of fingers, wrist, feet, and ankles) in individuals who do not respond to conventional therapy.
Penicillamine may be used to treat other conditions as decided by your doctor.
Take Penicillamine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take it on an empty stomach, at least 1 hour before or 2 hours after a meal.
This medicine is available as a tablet or capsule.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on the type of your condition and your response to the medication.
Penicillamine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Do not take Pencicillamine if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or any of its ingredients.
Alert your doctor if you have the following conditions:
- systemic lupus erythematosus (autoimmune disease that causes inflammation of certain organs in the body)
- history of blood disorders after previously taking this medicine
- moderate to severe kidney disease
as Pencicillamine may not be suitable for you.
Inform your doctor if you have the following conditions:
- allergy to a group of antibiotics known as penicillin
- previously experienced side effects when treated with medicines containing gold
- mild kidney disease
Let your doctor know if you are pregnant, planning to have a baby soon or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Penicillamine to a child or the elderly. Children and elderly people may be more sensitive to the side effects.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. complete blood count, kidney or liver function, urine tests) may be done before and while you are being treated with Penicillamine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring for signs of allergic reactions, infection, and bleeding problems may also be needed.
Penicillamine may cause any of the following side effects: headache, dizziness, nausea, vomiting, diarrhoea, stomach pain, impaired or loss of taste, loss of appetite, and joint pain.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the face, eyes or mouth
- pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
- fever with pain, swelling or ulceration of the mouth or throat
- muscle pain, rash on the cheeks or other parts of the body, easily sunburnt skin, chest pain, swelling of the arms
This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, cough, or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- NSAIDs (medicines for pain and inflammation) e.g. ibuprofen, naproxen, phenylbutazone, oxyphenbutazone
- medicines for cancer
- medicines containing gold
- clozapine (medicine for mood disorders)
- digoxin (medicine for heart disease)
This list does not include all medicines that may interact with Penicillamine.
This medicine should not be taken with antacids (medicines that neutralise stomach acids) and medicines or supplements containing iron and zinc as they could reduce the effectiveness of Penicillamine. If you must take these medicines, take Penicillamine at least 1 hour before or after taking these medicines.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Depending on your condition, your doctor may give you pyridoxine (vitamin B6) supplementation while you are being treated with Penicillamine.
Do not take this medicine with dairy products such as milk, cheese, yoghurt, or ice cream. Dairy products may reduce the effectiveness of this medicine when taken at the same time. Take Penicillamine at least 1 hour before or after you have taken any dairy products.
If you are being treated for Wilson's disease, do not take multivitamins or supplements containing copper. Avoid taking too much food that is high in copper, such as shellfish, liver, mushrooms, broccoli, chocolate, nuts, and molasses.
If you are being treated for cystinuria, it is important to ensure adequate fluid intake to maintain the flow of your urine.
Depending on your condition, it is important to adhere to the diet prescribed by your doctor.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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