What is it?
Penicillamine is a drug which has been used in arthritis for many years. It can improve joint pain and swelling and sometimes other features relating to arthritis, but often takes about 4-6 months to exert its full effect. It is usually necessary to continue painkillers or anti-inflammatory tablets during the first few months of treatment.
If you are allergic to Penicillin it does not mean that you will be allergic to Penicillamine.
How to take it
It is usually prescribed in tablets of 125mg and the dose is gradually increased. Your doctor will advise on this. It is best to take any other medication (especially iron tablets and antacid tablets) at a different time of day as Penicillamine can interfere with certain other medicines and stop them from working properly. You must avoid oral iron and calcium within two hours of your Penicillamine.
Take on an empty stomach, an hour before a meal, or more than 2 hours after one. Do not take with milk.
Possible Side Effects
Like all medications, this drug can sometimes cause side effects. They are rarely serious. The common side effects include skin rashes and altered taste with or without mouth ulcers. If this occurs it often gets better when the dose of Penicillamine is reduced. Less than 5% of patients may develop blood problems such as a low white cell count (these fight infection) or low platelets (these stop bleeding and bruising). Penicillamine can rarely cause protein to leak from the kidneys, although this is rarely severe and invariably improves on stopping the drug.
These problems can be picked up early with regular blood and urine monitoring. You will need a blood and urine test every 2 weeks for the first 16 weeks, then once a month thereafter. Usually this will be done at your own GP practice. Sometimes your GP may feel that attending the hospital for monitoring would be better. If this is the case or if there is a delay in receiving a reply from your GP, we will arrange for your first and if necessary subsequent blood and urine checks to be done at the hospital. This will be explained to you when you see the rheumatology nurse for education. Where possible avoid making an appointment for a blood test on a Friday. This makes sure blood results are seen before the weekend.
Please report any unexplained bleeding, bruising, sore throat, fever or malaise that occurs during treatment. If any side effects occur contact your GP or the Rheumatology Advice Line number (listed above) for advice. Many people stay on the drug for years without problems and most side effects appear to occur early in treatment (within 6 months).
Pregnancy and breastfeeding
You should not take Penicillamine during pregnancy. Discuss with your Doctor if you are planning to start a family or become pregnant whilst on this treatment.
Choosing the right drug to treat your condition is complex. Your doctor or rheumatology nurse will discuss the risks and benefits of the treatments available in clinic and a decision will be reached with you on the most appropriate treatment. If you have any further questions or concerns and wish to discuss alternative drugs, please speak to the rheumatology nurse when you are seen for education.
For additional information please refer to the patient information leaflet supplied with your medicine or refer to www.medicines.org.uk for the full summary of the product characteristics.
Rheumatology Day Unit
Dr V Saravanan
Dr K Laverick
Dr M Khan
Dr O Jones
Monday – Friday
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