Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
All of these medicines can affect your kidneys and the cells in your bone marrow that produce blood cells. Some antimalarials may slow down how quickly your body removes penicillamine.
What might happen:
If you take these medicines together, you may be at a higher risk of developing problems with your kidneys or blood.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to run some blood tests to check your blood and your kidney function. Let your healthcare professionals know if you have any side effects from your medicines, especially if you notice that you bruise or bleed easily or have a skin rash, fever, sore throat, or chills.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Cuprimine (penicillamine) US prescribing information. Merck & Co., Inc. October, 2004.
2.Seideman P, Lindstrom B. Pharmacokinetic interactions of penicillamine in rheumatoid arthritis. J Rheumatol 1989 Apr;16(4):473-4.
3.Bunch TW, O'Duffy JD, Tompkins RB, O'Fallon WM. Controlled trial of hydroxychloroquine and D-penicillamine singly and in combination in the treatment of rheumatoid arthritis. Arthritis Rheum 1984 Mar;27(3):267-76.