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Cuprimine

 

Contents:

Penicillamine

 

Dosage:

Wilson's Disease

Initially 1 g/day, may increase as indicated by urinary copper analysis; seldom > 2 g/day.

Cystinuria

Adult 2 g/day. Range : 104 g/day. Children 30 mg/kg/day. Patient should drink 1 pint of fluid at bedtime & 1 pint during the night.

Rheumatoid arthritis

Initial 125-250 mg daily, increase at 1-3 month interval by 125-250 mg/day until remission or signs of toxicity develop. If no improvement after 304 months of 1000-1500 mg/day, discontinue. If the patient has been in remission for ≥ 6 months, may gradually reduce dosage by < 125 mg-250 mg/day at approximately 3 months interval. Dose ≤ 500 mg may be given as single dose, > 500 mg in divided dose.

 

Contraindications:

Pregnancy ( except for Wilson's disease) & lactation. History of penicillamine-related aplastic anemia or agranulocytosis. Rheumatoid arthritis (RA) patients with history or evidence of renal insufficiency.

 

Special Precautions:

Use associated with fatalities due to aplastic anemia, agranulocytosis, thrombopenia, Goodpasture's syndrome & myasthenia gravis. serious hematological & renal side effects may occur. Discotinue if proteinuria or hematuria continue. Abnormal urinary findings associated with hemoptysis & pulmonary infiltrates on X-ray require immediate cession of penicillamine. If drug fever occurs in patient with Wilson's disease or cystinuria, penicillamine should be temporarily discontinue until reaction subsides. discontinue use if drug fever occurs in RA patients. Sideroblastic anemia, renal vasculitis.

 

Adverse Reactions:

Gastrointestinal (GI) effects, skin reactions, hematological, central nervous system (CNS) & neuromuscular effects. Obliterative bronchiolitis (rare). Positive antinuclear antibody test with or without lupus erythematosus-like syndrome. Iron deficiency. drug fever  renal effects. Increased amount of soluble collagen which may be the cause of increased skin friability at sties subject to pressure or trauma.

 

Drug interactions:

Avoid use with gold therapy, antimalarial or cytotoxic drugs, oxyphenbutazone or phenylbutazone.

 

Presentation/Packing

Cap 250 mg x 100's.

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