This medication is used to treat rheumatoid arthritis and Wilson's disease (high levels of copper in the body that can result in damage to the liver and other organs). It is also used to prevent kidney stones. Penicillamine belongs to a class of drugs known as disease-modifying anti-rheumatoid drugs (DMARDs) and chelating agents.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This drug may also be used to treat lead poisoning, certain liver conditions, and certain skin conditions.

Take this medication by mouth without food on an empty stomach (1 hour before or 2 hours after meals) 1 to 4 times daily or as directed by your doctor. Take each dose with a full glass of water (8 ounces or 240 milliliters). Avoid taking any other medication, food, or milk within at least 1 hour of taking penicillamine. Iron can interfere with the absorption of this medication. If you take supplements containing iron, take them at least 2 hours apart from your dose of this medication. Take the last dose at least 3 hours after the evening meal.

Drink plenty of water while taking this medication unless your doctor directs you otherwise.

Dosage is based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Tell your doctor if your condition persists or worsens.

Upset stomach, nausea, loss of appetite, diarrhea, temporary hair loss, and changes in taste may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: signs of infection (e.g., fever, persistent sore throat), easy bruising or bleeding, unusual tiredness, unexplained cough, trouble breathing, vision problems (e.g., trouble seeing), ringing ears, unusual weakness, new or worsening joint pain, butterfly-shaped rash around the nose and cheeks, skin blisters, mouth sores.

Tell your doctor immediately if any of these rare but very serious side effects occur: persistent nausea/vomiting, stomach/abdominal pain, dark urine, change in the amount of urine, blood in urine, yellowing eyes/skin.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking penicillamine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: blood problems (aplastic anemia, agranulocytosis) caused by certain drugs, rheumatoid arthritis with kidney disease.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver problems, certain blood disorders (low white or red blood cells, low platelets), a certain muscle disease (myasthenia gravis).

Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, elderly people may be more sensitive to this drug and to side effects such as skin rash and changes in taste.

Penicillamine is not recommended for use during pregnancy due to the risk of harm to an unborn baby. However, if you are taking this medication to treat Wilson's disease, your doctor may continue treatment during pregnancy with a lower dose. Consult your doctor for more details.

It is not known if this medication passes into breast milk. Consult your doctor before breast-feeding.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

This drug should not be used with the following medications because very serious interactions may occur: drugs for malaria (e.g., atovaquone/proguanil, mefloquine), gold salts (e.g., auranofin), drugs that weaken the immune system (e.g., azathioprine, tacrolimus), phenylbutazone.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: antacids, iron supplements, digoxin, cancer drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

Do not share this medication with others.

This medication may increase your need for vitamin B6 (pyridoxine) and iron. Ask your doctor if you should take a vitamin supplement while taking this medication.

Laboratory and/or medical tests (e.g., urine tests, complete blood count, physical exam, liver function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Information last revised October 2008 Copyright(c) 2008 First DataBank, Inc.