CUPRIMINE/DEPEN (Penicillamine)
CUPRIMINE/DEPEN (Penicillamine)
CUPRIMINE/DEPEN (Penicillamine)
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CUPRIMINE/DEPEN (Penicillamine)

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What is this medication?

CUPRIMINE/DEPEN (Penicillamine)
Chelating Agent

CUPRIMINE/DEPEN (Penicillamine) is indicated for the treatment of Wilson’s disease, cystinuria.

Note: Depen is labelled as D-Penamine in New Zealand.

Patient should be under strict and consistent monitoring by a physician trained in using Penicillamine because of the risk of toxicity.

How does this medication work? 

CUPRIMINE/DEPEN (Penicillamine) is a chelating agent that forms stable, soluble complexes with lead, copper, mercury and other heavy metals which are excreted in urine.

How should I take this medication? 

Oral: Take 1g to 4g daily in 4 divided doses; usual maintenance dose is 2g daily.  Initial dose is 250mg daily and gradually titrate as tolerated.

Note: Dose reduction to 250 mg/day may be considered prior to surgical procedures (including prior to cesarean delivery in pregnant patients with Wilson disease). May resume normal recommended dosing postoperatively once wound healing is complete. Penicillamine administration increases the requirement for pyridoxine. Patients may require a daily supplement of pyridoxine.

How to Take:  Doses ≤500 mg may be administered as a single dose; doses >500 mg should be administered in divided doses. For patients who have difficulty swallowing, the contents of the capsules may be administered in 15 to 30 mL of chilled puréed fruit or fruit juice within 5 minutes of preparation. Administer on an empty stomach (1 hour before or 2 hours after meals) and at least 1 hour apart from other drugs, milk, antacids, iron-containing products, and zinc-containing products.

What should I watch for while using this medication? 

Before starting CUPRIMINE/DEPEN (Penicillamine), make sure your physician is aware of any allergies or medications you currently take, and activities you perform. Cuprimine has been associated with allergic reactions, bronchiolitis obliterans, drug fever usually 2-3 weeks after initiation of therapy, Goodpasture’s syndrome, hematologic toxicities including agranulocytosis, aplastic anemia, and thrombocytopenia, hepatotoxicity, Lupus erythematosus-like syndrome, pemphigus, proteinuria/hematuria, myasthenia gravis, and toxicity.  Patient should be advised to report signs/symptoms of toxicity such as fever, sore throat, chills, bruising or bleeding. Cuprimine should be used with caution in patients on other hematopoietic-depressant drugs.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Diarrhea, dysgeusia, skin rash, proteinuria, thrombocytopenia, leukopenia.

Note this is not a complete list of side effects for CUPRIMINE/DEPEN (Penicillamine), only common ones.