Penicillamine for rheumatoid arthritis

Examples

Generic Name Brand Name
penicillamine Cuprimine, Depen

Penicillamine is given orally, in capsule or tablet form.

How It Works

Penicillamine reduces inflammation from rheumatoid arthritis and slows progression of the disease. Penicillamine is a substance that normally is used to bind and remove metals and toxic chemicals from the blood.

Why It Is Used

Penicillamine may be used when rheumatoid arthritis is not controlled by other medicines. Rheumatologists do not usually give penicillamine as a first treatment for rheumatoid arthritis since methotrexate and other DMARDs are available.

Penicillamine can be used by people with penicillin allergies. But talk to your health professional before taking any other medicines while also taking penicillamine.

How Well It Works

A recent review reports that treatment with penicillamine for about 6 months reduces rheumatoid arthritis activity and joint inflammation. But common and sometimes serious side effects limit its use.1

Side Effects

Penicillamine may cause birth defects and is not used during pregnancy.

Serious side effects from penicillamine include:

  • Serious infection.
  • Low blood counts.
  • Inflammation in the pancreas, causing abdominal pain.
  • Serious skin rash.
  • Excessive bleeding or bruising.
  • Muscle weakness (due to myasthenia gravis or myositis).
  • Protein loss in the kidney

If you experience any of the above serious side effects, contact your health professional or seek emergency medical attention immediately.

Less serious side effects may include:

  • Itchy skin rash.
  • Reduced or changed sense of taste.
  • Sores in the mouth.
  • Nausea, vomiting, diarrhea, or decreased appetite.
  • Decreased sense of smell.

Rare side effects include:

  • Kidney problems.
  • Low blood counts.

In extremely rare cases, this drug triggers autoimmune disorders, such as lupus.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Penicillamine may be more toxic than other disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, and it should be used only under the supervision of a specialist in joint disease (rheumatologist) who is familiar with its side effects.2

Regular blood tests are needed while taking this medicine.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Walker-Bone K, Fallow S (2007). Rheumatoid arthritis, search date June 2005. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
  2. Pisetsky DS, St Clair EW (2001). Progress in the treatment of rheumatoid arthritis. JAMA, 286(22): 2787–2790.

Last Updated: August 18, 2008

Author: Shannon Erstad, MBA/MPH

Medical Review: Anne C. Poinier, MD - Internal Medicine & Stanford M. Shoor, MD - Rheumatology

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