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Indications

REMS

Unlabeled Uses:

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Derm: pemphigus, ecchymoses, hives, itching, rash, wrinkling.

EENT: blurred vision, eye pain.

GI: altered taste, anorexia, cholestatic jaundice, diarrhea, dyspepsia, epigastric pain, hepatic impairment, nausea, oral ulceration, PANCREATITIS, vomiting.

GU: proteinuria.

Hemat: leukopenia, anemia, APLASTIC ANEMIA, eosinophilia, thrombocytopenia, thrombocytosis.

MS: arthralgia, migratory polyarthritis.

Neuro: myasthenia gravis syndrome.

Resp: coughing, shortness of breath, wheezing.
Misc: allergic reactions, GOODPASTURE’S SYNDROME (GLOMERULONEPHRITIS AND INTRA-ALVEOLAR HEMORRHAGE), fever, lymphadenopathy, systemic lupus erythematosus–like syndrome.

Interactions

Drug-Drug:

Drug-Food:

Availability

(Generic available)

Route/Dosage

see Calculator

US Brand Names

Cuprimine, Depen

Action

Therapeutic Effects:

Classifications

Therapeutic Classification: antidotes, antirheumatics (DMARD), antiurolithics

Pharmacologic Classification: chelating agents

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Crosses the placenta.

Metabolism/Excretion: Some excreted in urine as heavy metal–penicillamine complex, some excreted in urine as cystine-penicillamine complex, some metabolized by the liver.

Half-life: 1–7.5 hr (4–6 days during long-term use).

Time/Action Profile

ROUTEONSETPEAKDURATION
PO (antirheumatic)2–3 mounknown1–3 mo
PO (Wilson’s disease)1–3 mounknownunknown

Patient/Family Teaching

Pronunciation

pen-i-SILL-a-meen