Cuprimine - Penicillamine

Cuprimine (Penicillamine). Merck Co., Inc. US Prescribii information, October 2004. 

Although chelation is not helpful for Alzheimer s disease patients, it is the key to treating patients with dementia due to Wilson s disease. Wilson s disease is a genetically inherited disorder that usually strikes before age 30. The disease causes toxic levels of copper to accumulate in the liver, brain, eyes, and kidney. Untreated, Wilson s disease leads to tremors, cirrhosis, depression, psychosis, dementia, and ultimately death. Chelation with penicillamine (Cuprimine) can stop and even reverse the accumulation of copper. 

Penicillamine (Cuprimine) can be used to treat acute, severe rheumatoid arthritis, producing reductions in joint pain, edema, and stiffness. The response to penicillamine is usually delayed (4-12 weeks), and remissions can last several months after withdrawal of treatment. Radiographic evidence of this drug s efficacy is limited thus, penicillamine is seldom used to treat rheumatoid arthritis. The mechanism of action of penicillamine is unknown, but some evidence suggests that it may involve the inhibition of angiogenesis, synovial fibroblast proliferation, or transcriptional activation. Because penicillamine can chelate copper and promote its excretion, it is used to treat Wilson s disease (hepatolenticular degeneration) and has also been used in mercury and lead intoxication. 

Oral 100 mg tablets Oral sustained-release 100 mg tablets Parenteral 30 mg/mL for injection Penicillamine (Cuprimine, Depen)... 

Penicillamine Cuprimine, Depen Oral 125 or 250 mg/d can be increased to a maximum of 1.5 g/d. Relatively high incidence of toxicity with long-term use. 

Penicillamine (Cuprimine), a derivative of penicillin, is officially classified as a chelating agent that is often used in the treatment of heavy metal intoxication (e.g., lead poisoning). In addition, this drug has been used in patients with severe rheumatoid arthritis, and seems to be as effective as other DMARDs such as methotrexate, sulfasalazine, and gold therapy.68 98 Penicillamine, however, tends to be substantially more toxic than other DMARDs, and is therefore used rarely in the treatment of specific patients with rheumatoid arthritis.68... 

SYNS CUPRENIL CUPRIMINE DEPEN DI-METHYLCYSTEINE P.P-DIMETHYLCYSTEINE d-MERCAPTOVALINE METALCAPTASE PCA d-PENAMINE PENICILLAMIN (5)-PENICILLAAnN PENICILEYAHNE d-PENICILLAMINE REDUCED-d-PENICILE-UkllNE TROLOVOL... 

D-penicillamine (D-3-mercaptovaline, Cuprimine), a breakdown product of penicillin, was, after the discovery of its chelating properties of copper ion (Fig. 2-6), introduced as an antidote to copper poisoning. It was also found useful in the treatment of Wilson s disease, where excess copper accumulation causes liver cell damage. Heavy metal poisoning treatment is not limited to copper. Mercury and lead poisoning are also successfully reversed. Formation of cysteine calculi (cystinuria) can also be reversed with penicillamine by forming a soluble disulfide compound. 

Penicillamine (CUPRIMINE, DEPEN) is available for oral administration. For chelation therapy, the usual adult dose is 11.5 g/day in 4 divided doses (see sections under individual metals). The drug should be given on an empty stomach to avoid interference by metals in food. 

Penicillamine (e.g., Cuprimine) Suppresses immune response. May induce remission. Mechanism unknown. GI upset, i taste perception, proteinurea, rash, thrombocytopenia, leukopenia. PO. Rapid absorption, extensive metabolism. 

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