Cuprimine (Penicillamine)

Indications

Cuprimine is a medication that is used to treat Wilson's disease (a condition where there is too much copper in the body), cystinuria (a condition where there is excess amount of cysteine in urine), and in some cases, severe, active rheumatoid arthritis that have not responded to other treatments. Cuprimine contains the active ingredient called penicillamine, which is a chelating agent that can bind to excess copper and remove it from the blood stream.

In the case of Wilson's disease, Cuprimine reduces the amount of copper in the body by binding to it, and allowing it to leave through the urine. In cystinuria, it prevents the formation of kidney stones by binding them to the substance that leads to their formation. In rheumatoid arthritis, Cuprimine decreases the activity of the immune system, reducing inflammation in joints. Cuprimine comes in the form of capsules, which are taken orally.

Use and Dosage

Penicillamine is taken orally in the form of capsules. It should be taken on an empty stomach at least 1 hour before or 2 hours after a meal, as well as at least 1 hour before or after consuming any food or milk. Penicillamine is taken four times a day for the treatment of Wilson's disease and cystinuria, and once a day for the treatment of rheumatoid arthritis, with the option of increasing the frequency up to four times a day at higher doses.

The initial dose of penicillamine is typically low and will be gradually increased by the doctor. For the treatment of Wilson's disease and rheumatoid arthritis, it may take one to three months or longer before the full benefits of penicillamine are experienced. Even if there are no symptoms, continue to take penicillamine as prescribed by the doctor. Do not stop taking the capsules without consulting the doctor, as this can increase the risk of an allergic reaction when resuming the medication.

Penicillamine should be taken at the same time every day, in accordance with the doctor's instructions. Follow the prescription label and seek clarification from the doctor or pharmacist for any unclear instructions. Do not take more than the recommended dose or take it more often without consulting the doctor.

Side Effects

Common Side Effects of Cuprimine (Penicillamine):

• Abdominal pain
• Change in the way things taste
• Decreased sense of taste
• Diarrhea
• Loss of appetite
• Nail changes
• Nausea
• Numbness or tingly feeling
• Ringing in your ears
• Skin changes such as wrinkling or pimples
• Stomach pain
• Vomiting
• Wound that will not heal
• Wrinkling of skin

Serious Side Effects of Cuprimine (Penicillamine):

• Back pain
• Cough
• Difficulty breathing
• Difficulty urinating or blood in urine
• Double vision
• Drooping eyelids
• Edema symptoms (swelling) of the hands or feet
• Fatigue, chills, and fever
• Fever
• Fever, sore throat, chills, unusual bleeding, or bruising
• Foamy or pink, red, brown, or bloody urine
• Joint pain
• Mouth ulcers
• Muscle weakness
• Muscle weakness, drooping eyelids, or double vision
• Painful or itchy blisters and sores on the skin, mouth, and genitals
• Rash, itching, hives, shedding skin, fever, joint pain, or swollen lymph nodes
• Shortness of breath, unexplained cough or wheezing
• Skin sores
• Swollen gums
• Trouble chewing
• Unusual bleeding

Forms and Strength

Cuprimine (Penicillamine) is available in the following forms and strength:

Penicillamine: Capsule

• 125 mg
• 250 mg

Cautions

• Penicillamine may cause bone marrow suppression, reducing the ability to produce red blood cells, white blood cells, and platelets in the bone marrow.
• Penicillamine may cause hypersensitivity reactions in some people, which can include fever, skin rash, opportunistic infections, and abnormal liver function tests.
• Penicillamine may interact with other medications, such as zinc supplements and anti-inflammatory drugs, and may cause adverse effects.
• Penicillamine may cause worsening of pre-existing autoimmune disorders.
• Penicillamine may lower the levels of zinc in the body, which could result in a copper deficiency.
• Cuprimine may cause fetal harm if used during pregnancy.

• Cuprimine can cause skin reactions, including rashes, hives, and Stevens-Johnson syndrome.
• The medication may cause complications with the kidneys, leading to proteinuria or hematuria.
• Cuprimine may increase the risk of infections, as it can suppress the immune system.
• Penicillamine may cause neurological symptoms, such as seizures and peripheral neuropathy.
• The drug may interfere with some laboratory tests, such as blood and urine tests, and may cause false results.
• Cuprimine may increase the risk of developing cancer, particularly skin cancer.

Frequently Asked Questions (FAQ)

Is it safe to take penicillamine while pregnant?

No, it is not safe to take penicillamine while pregnant. It can cause harm to your unborn baby. Talk to your provider about alternative medications if you are pregnant or planning to become pregnant.

How long does it take for Penicillamine to work?

The time it takes for Penicillamine to work can vary depending on the condition being treated. Follow your doctor's instructions and be patient if results are not immediately noticeable.

Can Penicillamine be used in children?

Penicillamine can be used in children, but the dose and duration of treatment may vary depending on the child's age, weight, and condition being treated.

Can Penicillamine be used in older adults?

Penicillamine can be used in older adults, but caution should be taken due to an increased risk of side effects, especially bone marrow suppression and skin reactions.

Resources

• https://medlineplus.gov/druginfo/meds/a618021.html
• https://www.webmd.com/drugs/2/drug-7559/cuprimine-oral/details
• https://www.drugs.com/mtm/cuprimine.html
• https://www.goodrx.com/penicillamine/what-is
• https://www.cuprimine.com/
• https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/19853s012,014lbl.pdf