Depen (penicillamine)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Penicillamine is a heavy metal antagonist that chelates copper, iron, mercury, lead, and probably other heavy metals as well as cystine and also is a disease-modifying antirheumatic drug.
USES: This medication is used to treat rheumatoid arthritis, Wilson's disease (a condition in which high levels of copper in the body cause damage to the liver, brain, and other organs), and a certain disorder which causes kidney stones (cystinuria). For the treatment of rheumatoid arthritis, penicillamine is known as a disease-modifying antirheumatic drug (DMARD). It helps to decrease pain/tenderness/swelling in the joints.
For the treatment of Wilson's disease, penicillamine binds to copper and helps it to be removed from the body. Decreasing copper levels helps to improve liver function and the mental/mood/nerve problems (such as confusion, difficulty speaking/walking) caused by the disease. For the treatment of cystinuria, penicillamine helps to decrease the amount of a certain substance (cystine) in the urine which can cause kidney stones.
Generic name: penicillamine
Pronunciation: (PEN-i-SIL-a-meen)
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Depen
Indications
The following indications are listed for Depen:
- Cystinuria
- Rheumatoid Arthritis
- Wilson's Disease
Also known as: Arthritis Deformans, Arthrosis Deformans, Hepatolenticular Degeneration, Lenticular Progressive Degeneration, Nodose Rheumatism, Rheumatic Arthritis, Rheumatic Gout, Strumpell-Westphal Disease, Westphal's Disease, Westphal's Pseudosclerosis, Westphal-Strumpell Pseudosclerosis, Wilson's Syndrome.
Dosing
Dosage of penicillamine must be individualized according to the condition being treated and the response of the patient.
Penicillamine is administered orally. For patients who cannot swallow capsules or tablets, the contents of a capsule may be administered in 15-30 mL of chilled pureed fruit or fruit juice. Penicillamine should be given on an empty stomach (i.e., at least 1 hour before or 2 hours after meals, and at least 1 hour apart from any other drug, food, or milk). The last dose should be given at least 3 hours after the evening meal.
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Drug interactions
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There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
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There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
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There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
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One cystinuric patient treated with penicillamine throughout pregnancy delivered a child with a generalized connective tissue defect which may have been caused by penicillamine. The manufacturers state that, if possible, the drug should not be administered during pregnancy to women with cystinuria. If stones continue to form in cystinuric women, the potential benefits of penicillamine therapy must be weighed against the possible risks.
One woman with rheumatoid arthritis treated with less than 900 mg of penicillamine daily during pregnancy delivered (by cesarean section) an infant with growth retardation, flattened face with broad nasal bridge, low-set ears, short neck with loose skin folds, and unusually lax body skin. The manufacturers state that penicillamine is contraindicated in women with rheumatoid arthritis who are pregnant. The drug should not be used in women with rheumatoid arthritis who may become pregnant unless the possible benefits outweigh the risks; if pregnancy is suspected or occurs in these women during penicillamine therapy, the drug should be discontinued. Women with rheumatoid arthritis receiving penicillamine should be informed about the possible hazards of the drug to the fetus and should be advised to promptly report to their physician any missed menstrual periods or other indication of possible pregnancy.
To date, there have been no reports of serious adverse fetal effects when penicillamine was used for the treatment of Wilson disease in pregnant women. One woman with Wilson disease who received 1.5 g of penicillamine daily during pregnancy delivered an infant with loose body skin; at 9 weeks of age the infant's skin was normal. It appears that continued penicillamine therapy in these patients prevents relapse of Wilson disease and that discontinuance of the drug may be deleterious to the mother; however, dosage should be limited to 750 mg daily. In patients with Wilson disease in whom a cesarean section is planned, dosage of penicillamine should be limited to 250 mg daily during the 6 weeks before delivery and postoperatively until wound healing is complete in order to preclude impairment of wound healing.
Although there are no studies to date using penicillamine in nursing women, the manufacturers state that nursing should not be undertaken by women receiving the drug.
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ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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