The drug should be administered inside at least 30 minutes before meals, washed down with water, or 2 hours after eating or other medications.
Wilson-Konovalov's disease
Adults: 1.5 - 2 g per day in divided doses. After achieving remission, the dose can be reduced to 0.75 g or 1 g per day. In patients with a negative balance of copper, the minimum effective dose of penicillamine should be used.
A dose of 2 g per day apply for not more than 1 year.
Elderly patients: 20 mg / kg body weight per day in divided doses. The dose should be selected in such a way as to achieve remission of the disease and to maintain a negative balance of copper.
Children: usually 20 mg / kg of body weight per day in divided doses.
The minimum dose is 500 mg per day.
Cystinuria
It is best to establish the minimum effective dose after quantitative determination of the concentration of amino acids in the urine by chromatographic method.
Dissolution of cystine stones.
Adults: 1-3 g per day in divided doses.It is necessary to keep the concentration of cystine in the urine below 200 mg / l.
Prevention of cystine lithiasis.
Adults: 0.5-1 g per day until the cystine concentration in the urine is below 300 mg / l.
Elderly patients: prescribe a minimum dose until the concentration of cystine in the urine is below 200 mg / l.
Children: Assign a minimum dose, which allows you to achieve a cystine concentration in the urine below 200 mg / l.
Attention: during treatment it is recommended to drink a large amount of liquid - at least 3 liters per day. The patient should drink 500 ml of water before bedtime, and then 500 ml at night, when the urine is more concentrated and more acidic than during the day. Usually, the more liquid the patient drinks, the lower his need for penicillamine.
A diet with a low methionine content is also recommended, so that the synthesis of cystine is as low as possible. In view of the low protein content, such a diet is not recommended for children during growth and pregnant women.
Poisoning by lead.
Adults: 1-1.5 g per day in fractional doses until the moment when lead excretion in the urine reaches the limit of 0.5 mg per day.
Elderly patients: 20 mg / kg of body weight per day in fractional doses until the moment when lead excretion in the urine reaches the limit of 0.5 mg per day.
Children: 20 mg / kg body weight per day.
Rheumatoid arthritis.
Adults: 250 mg per day during the first month of application. Then the dose is increased every 4-12 weeks by 250 mg until remission of the disease is achieved. After that, apply the minimum effective dose, which allows you to slow down the symptoms of the disease, relapse within 6 months of the drug, the therapeutic effect is not achieved, treatment should be discontinued.
The maintenance dose is usually 500-750 mg per day. Do not exceed the dose of 1.5 grams of medicinal product per day. After achieving remission of the disease lasting 6 months, the dose of the drug is recommended to be gradually reduced by 250 mg every 12 weeks.
Elderly patients: the initial dose should not exceed 250 mg per day during the first month of application. Then the dose can be increased every 4-12 weeks by 250 mg until remission of the disease is achieved. Do not exceed the dose of 1 g of drug per day.
Children: usually 15-20 mg / kg body weight per day. The initial dose is 2.5 - 5.0 mg per day, it can be increased gradually every 4 weeks for 3-6 months to the minimum effective dose, but not more than 500 mg.
Systemic scleroderma.
250 mg per day during the first month of application. Then the dose is increased every 4-12 weeks by 250 mg to 1 g per day, followed by a decrease to 250-500 mg per day.The effect is estimated after 6-12 months of the drug.