Penicillamine Capsules or Tablets

What is this medication?

PENICILLAMINE (pen uh SIL uh meen) treats Wilson disease, a condition that causes high levels of copper in your body. It works by binding to copper so your kidneys can remove it through the urine. It may also be used to prevent kidney stones caused by too much of the amino acid cystine in the body. It works by lowering cystine levels in your urine. It can also be used to treat rheumatoid arthritis when other medications have not worked or cannot be tolerated.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Cuprimine, D-PENAMINE, Depen

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Anemia or other blood disorders
• Kidney disease
• Myasthenia gravis
• An unusual or allergic reaction to penicillamine, penicillin, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth with a glass of water. Follow the directions on the prescription label. Take this on an empty stomach, at least 1 hour before or 2 hours after food. Do not take with food. Take this at least one hour apart from milk or other medications. Take your medication at regular intervals. Do not take your medication more often than directed. Do not skip doses or stop your medication even if you feel better. Skipping doses for even a few days may cause you to have allergic reactions after restarting this medication. Do not stop taking except on your care team's advice.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Medications for malaria

This medication may also interact with the following:

• Certain antacids that contain aluminum, magnesium
• Chemotherapy
• Gold compounds used for arthritis
• Iron tablets
• Multi-vitamins with metals, minerals or iron
• Oxyphenbutazone, phenylbutazone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular check-ups. It may take 2 to 3 months to improve your symptoms. Tell your care team if your symptoms do not improve or if you get any new symptoms. You will need to have important blood work done while on this medication.

You may need to be on a special diet while taking this medication. Check with your care team. Ask if you need to take extra vitamin B6 or a multi-vitamin while taking this medication.

If you are taking this medication to prevent kidney stones you need to drink plenty of water. Drink at least 2 full glasses of water at bedtime and 2 more full glasses of water during the night.

If you are going to have surgery, tell your care team that you are taking this medication.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Aplastic anemia—unusual weakness or fatigue, dizziness, headache, trouble breathing, increased bleeding or bruising
• Infection—fever, chills, cough, or sore throat
• Kidney injury (glomerulonephritis)—decrease in the amount of urine, red or dark brown urine, foamy or bubbly urine, swelling of the ankles, hands, or feet
• Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
• Pain, redness, or swelling with sores inside the mouth or throat
• Unusual bruising or bleeding
• Wheezing or trouble breathing

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Agitation, feeling irritable or restless
• Anxiety, nervousness
• Change in taste
• Diarrhea
• Loss of appetite
• Nausea
• Pain, tingling, or numbness in the hands or feet

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep the medication container closed tightly. Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.