Penicillamine
When ATH:
M01CC01
Characteristic.
The hydrolysis product of penicillin. White or almost white crystalline powder. Easily soluble in water, slightly soluble in alcohol and insoluble in ether, acetone, benzene, carbon tetrachloride.
Pharmacological action.
Complexing, detoxification, immunosuppressive.
Application.
Wilson's disease - Konovalova, rheumatoid arthritis (incl. juvenile), primary biliary cirrhosis, chronic hepatitis, scleroderma, cistinuriâ, цistinoz, heavy metal poisoning (copper, cobalt, gold, mercury, lead, zinc).
Contraindications.
Hypersensitivity, violation of hematopoiesis, agranulocytosis, myasthenia, nephropathy, renal failure, Sjogren syndrome.
Side effects.
Artralgii, lymphadenopathy, lupus-like syndrome, alopecia, tireoidit, the appearance of antinuclear antibodies, leukopenia, thrombocytopenia, myasthenia gravis, peripheral neuropathy, polimiozit, dermatomyositis, fever, nephrotic syndrome, hematuria, pulmonary syndrome, hereditary renal insufficiency (Goodpasture), tromboflebit, dyspeptic disorders - nausea, vomiting, epigastric pain; allergic reactions.
Cooperation.
Anti-malarial and anti-tumor agents, phenylbutazone, gold preparations increase the risk of side effects. Incompatible with antibiotics.
Dosing and Administration.
Inside, fasting (should not be taken for food 1,5 hours before and after administration).
Rheumatoid arthritis, hepatitis, scleroderma: 1Sun -4 - more 1 caps. (150 mg) in a day (to 250 mg); 5-8 Sun - more 1 caps. (250 mg) in a day (to 450 mg); 9-13 Sun - more 1 caps. (150 mg) 2 once a day (to 600 mg); increasing the dose of 50-150 mg per day with 4-12 week intervals - up 750 mg per day.
Juvenile rheumatoid arthritis: birth weight less than 20 kg - for 1 caps. (50 mg) in a day, above 20 kg 1 caps. (50 mg) 2 once a day; increasing the dose of 50 with 2-4 mg weekly intervals up to 15-20 mg / kg or 600 mg per day.
Wilson's disease - Konovalova: adults c gradual increase in dose 250 mg 2 g per day, children - with 150 mg 750 mg per day.
Cistinuriâ: 1000 mg / m2 body surface.
Poisoning: 0,91.8 g per day or 2-4 capsules. (150 mg) 3 times.
Precautions.
It should constantly monitor blood and urine (overall analysis, determine the level of alkaline phosphatase, transaminase, etc.).
Cooperation
| Active substance | Description of interaction |
| Algeldrat + Magnesium hydroxide | FKV. Slows absorption (the interval between doses should be at least 2 no). |
| Digoxin | FKV. Against the background of changing penicillamine concentration in serum (the combined use requires monitoring). |
| Pyritinol | FMR. It increases the probability and severity of side effects. |
| Tamoxifen | Strengthens (mutually) the risk of side effects; concomitant use is not recommended. |
| Phenylbutazone | FMR: synergism. Increases (mutually) the risk of side effects. |
| Epirubicin | Strengthens (mutually) the risk of side effects; concomitant use is not recommended. |
