What is Penicillamine?
Penicillamine is a chelating agent which is primarily used in heavy metal poisoning. Penicillamine has strong copper chelating property and is used for the treatment of Wilson’s disease. Penicillamine is available in capsule form – 150mg and 250mg capsule.
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Uses of Penicillamine
Penicillamine is a drug of choice for prevention, treatment, and control of:
- Wilson’s disease – it is caused due to a genetic deficiency of ceruloplasmin which binds and disposes of copper from the body. Absence or deficiency of ceruloplasmin leads to high copper content in the liver and brain leading to degenerative changes.
- Rheumatoid arthritis – Penicillamine is a disease-modifying antirheumatic drug (DMARD)
- Cystinuria – a disorder causing kidney stones.
- Copper and mercury poisoning
- Lead poisoning
- Scleroderma – Penicillamine benefits by increasing soluble collagen.
How does Penicillamine work?
- In Wilson’s disease and heavy metal poisoning, Penicillamine works by chelating with heavy metal especially copper and thus excreting heavy metal (responsible for degenerative changes) out of the body.
- In cystinuria patients, it promotes excretion of cysteine and prevents its precipitation in urine which can cause kidney stones.
Penicillamine Price in India
|125 mg Capsules||Rs 54.1|
|250 mg Capsules||Rs 54.1|
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How to Take Penicillamine
- The dosage and duration of Penicillamine intake should be decided by the doctor. Do not take more than or less than the recommended dose.
- Penicillamine should be taken on an empty stomach at least 1 hour before or 2 hours after the meals and 1 hour apart from any other medicine, milk or food.
- The capsule can be swallowed as a whole or without crushing or chewing it along with plenty of fluids.
- It may take up to 3 months for any symptomatic relief. Keep taking the medicine as advised and do not stop on your own.
- Regular monitoring of blood and platelet level should be done at regular intervals when on Penicillamine therapy.
- When administered in elderly patients, careful monitoring is advised as chances of toxicity are high in such patients.
Common Dosage for Penicillamine
- The optimum dosage for Wilson’s disease is 0.5 to 1gm daily 1 hour before or 2 hours after the meals to avoid chelating of dietary metals.
- For copper and mercury poisoning, 1-1.5gm daily is given for a few days.
- In patients with Rheumatoid Arthritis, 250mg daily for one month. The dose can be gradually increased up to a maximum dose of 1500mg per day. Maintenance dose is around 750mg.
- In patients with cystinuria, 500mg daily followed by plenty of fluids for stone dissolution. The dose should not exceed 2000mg per day.
- In case of non-improvement of symptoms or symptoms getting worse, seek medical attention immediately.
When to Avoid Penicillamine
Penicillamine should be avoided or used with caution in:
- Allergy to any of its components
- Patients with severe liver and kidney disease (consult your physician in such case)
- Patients on anti-malarial drugs
- Pregnant and breastfeeding females
- Patients with previous sensitive reaction to penicillamine (aplastic anaemia, thrombocytopenia)
Side-effects of Penicillamine
Although Penicillamine is not well absorbed orally, few reported side effects include:
- Abdominal pain
- Loss of appetite
- Decreased taste sensation
- Skin rash
- Proteinuria (presence of proteins in urine)
- Joint pain
In addition, it may also cause some allergic or unwanted effects. In such cases, seek medical attention immediately.
Effect on Organs
No such adverse effect observed on any organ.
Reported Allergic Reactions
Report to your doctor if you are allergic to any of the ingredients of Penicillamine. Signs of allergic reaction include:
- Rashes/itching of the skin
- Shortness of breath
- Swelling of face, lips, tongue, or throat
- Loss of consciousness
Drug Interactions to Be Careful About
Many medicines when taken along side some other drug have shown some interaction, resulting in decreased therapeutic effects and increased chances of side effects. It is always advised that the patient must inform the physician about all the drugs/over the counter products/vitamin supplements being used along with Penicillamine. All the possible drug interactions might not be listed here. Penicillamine may interact with the following drugs and products:
- Oral iron therapy
- Anti malarial drugs
Shows Effects / Results In
Symptomatic relief following oral administration with Penicillamine is usually seen after 2-3 months.
Is Penicillamine addictive?
No such tendency has been reported with Penicillamine.
Can I have Penicillamine with alcohol?
Interaction of Penicillamine with alcohol is unknown. Consult your doctor before consumption.
Any particular food item to be avoided?
No such interaction seen with any food product.
Can I have Penicillamine when pregnant?
- The safety of Penicillamine in pregnant women has not been established therefore it is not recommended for use during pregnancy as it may harm the developing fetus.
- It should only be taken if the benefits outweigh the risks and under the supervision of a doctor.
Can I have Penicillamine when feeding a baby?
It is not known whether Penicillamine is excreted in breast milk or not and the effect of Penicillamine on new born infants is also not known. Thus avoid using Penicillamine while breast feeding.
Can I drive after taking Penicillamine?
- Penicillamine doesn’t usually affect your ability to drive. However, few patients on may experience side effects like dizziness.
- Caution must be exercised in such patients while driving and operating heavy machinery.
What happens if I overdose on Penicillamine?
- It should not be administered in more than recommended dose as it may have deleterious effects.
- Patients suspected of over-dosage should seek supportive medical care immediately.
What happens if I take expired Penicillamine?
Taking a single expired dose may not cause any major adverse effect. However, the potency of the medicine may well have been reduced and it might not be effective against the parasitic infection.
What happens if I miss a dose of Penicillamine ?
In case of a missed dose of Penicillamine, always take as soon as you remember it. But if it is already time for the next dose, do not double the dose.
Storage Requirements for Penicillamine
- Stored at room temperature away from direct sunlight and heat.
- Keep medicines away from children and pets.
Pro Tips When Taking Penicillamine
- Patients on Penicillamine therapy should be regularly monitored by blood tests and urine analysis for decreased platelet count, increased protein in the urine.
- Concomitant uptake of penicillamine along with other NSAIDs (a group of pain killer) may increase the risk of kidney damage in patients especially the elderly.
- If concomitant oral iron, zinc or antacid therapy has to be given, it should be given at least 2 hours after oral penicillamine.
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