Penicillamine (Penicillaminum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Detoxifying agents, including antidotes

Antidepressants

Included in the formulation
  • Kuprenil®
    pills inwards 
    Teva Pharmaceutical Enterprises Co., Ltd.     Israel
    • Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

    VED

    ONLS

    АТХ:

    M.01.C.C.01   Penicillamine

    Pharmacodynamics:Complexing compound, antidote of heavy metals: the formation of stable soluble, easily excreted in urine chelate complexes with ions of mercury, lead, copper, iron.

    Antirheumatic effect develops in Wilson-Konovalov's disease in 1-3 months, with rheumatoid arthritis - after 2-3 months.

    Anturolytic action: binding with cystine, the formation of penicillamine-cysteine, soluble and excreted, lowering the concentration of cystine in the urine, preventing the formation of cystine stones, their gradual dissolution with prolonged use.

    Pharmacokinetics:Absorption is 40-70%. Biotransformation in the liver. The half-life is 24-75 hours. Elimination of the kidneys mainly in the form of metabolites and with feces.
    Indications:Wilson-Konovalov's disease, rheumatoid arthritis (including juvenile), systemic scleroderma, cystinuria, cystine nephrolithiasis, copper poisoning, inorganic compounds of mercury, lead, gold, zinc, iron.
    ICD-10

    IV.E70-E90.E72.0   Disruption of amino acid transport

    IV.E70-E90.E83.0   Disorders of copper exchange

    XII.L80-L99.L94.0   Localized scleroderma [morphea]

    XIII.M05-M14.M06.9   Rheumatoid arthritis, unspecified

    XIII.M05-M14.M08   Juvenile [juvenile] arthritis

    XIII.M30-M36.M34.9   Systemic sclerosis, unspecified

    XIV.N20-N23.N22.8 *   Stones of the urinary tract in other diseases classified elsewhere

    XIX.T51-T65.T56.8   Toxic effect of other metals

    XIX.T51-T65.T56.5   The toxic effect of zinc and its compounds

    XIX.T51-T65.T56.4   Toxic effect of copper and its compounds

    XIX.T51-T65.T56.1   Toxic effect of mercury and its compounds

    XIX.T51-T65.T56.0   Toxic effect of lead and its compounds

    Contraindications:Hypersensitivity, violation of hemopoiesis, agranulocytosis, chronic renal failure, pregnancy, lactation.
    Carefully:Precautions should be taken with simultaneous use of anti-inflammatory or other agents that can cause damage to the bone marrow function. Due to the influence of penicillamine on collagen and elastin, any surgical interventions (including dental) during the period of drug use should be performed with caution.
    Pregnancy and lactation:Contraindicated in pregnancy (except for Wilson-Konovalov disease, in a dose of up to 1 g per day.If a cesarean section is planned, the daily dose should not be more than 250 mg in the last 6 weeks of pregnancy and in the postoperative period until complete healing). The action category for the fetus by FDA is D. For the duration of treatment, breastfeeding should be discontinued.
    Dosing and Administration:Inside, on an empty stomach. The dosage regimen is set individually, depending on the indications and patient response to treatment.
    Side effects:Allergic reactions.

    Blood: agranulocytosis, aplastic or hemolytic anemia, leukopenia, thrombocytopenia.

    Urinary system: glomerulopathy, which can progress to a nephrotic syndrome, proteinuria.

    Skin and mucous: pemphigoid, exfoliative dermatitis, toxic epidermal necrolysis.

    Digestive system: stomatitis, diarrhea, nausea or vomiting, stomach pain, loss of appetite, decrease or loss of taste sensations (4.7%), reactivation of pancreatitis or peptic ulcers, cholestatic jaundice.

    Nervous system: myasthenia gravis gravis, optic neuritis, ringing or buzzing in the ears.

    Respiratory system: obstructive bronchiolitis.

    Others: fever, Goodpasture syndrome, lupus-like syndrome.

    Overdose:Overdose is not described.
    Interaction:Antibiotics are incompatible.

    Myelotoxic drugs - increased manifestation of hematotoxicity penicillamine.

    Preparations of gold and iron - the formation of chelate complexes.

    Preparations of gold, phenylbutazone - increased occurrence of serious hematologic and renal side effects, not used together.

    Anti-malarial medicines, levamisole and phenylbutazone - Increased risk of side effects.

    Special instructions:It is necessary to monitor the analysis of urine and peripheral blood every 2 weeks (the first 6 months of treatment), then monthly; 1 time in 6 months control kidney and liver function.
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