Penicillamine
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
It is a metabolite of penicillin although it has no antibiotic properties. The pharmceutical form is D-penicillamine as L-penicillamine is toxic.
Indications
- Used as immunosuppressant in rheumatid arthritis. It works by reducing the number of T-lymphocytes, inhibiting macrophage function, decreasing IL-1 and preventing collagen from cross linking.
- It is used as chelating agent
- Used in wilson disease as it binds copper and enhance its elimination through urine.
- Also used in mercury poisoning
• Wilson's Disease
- 250 mg PO QID; dosage range 500-1500 mg/day
• Arsenic Poisoning
- 100 mg/kg/day PO divided q6hr x5 days
• Rheumatoid Arthritis
- Initial: 125-250 mg/day PO
- Maintenance: May be increased by 125-250 mg/day q1-3Months up to 500-750 mg/day, may be increased further if no response and patient tolerates
• Lead Poisoning
- 1-1.5 g qDay PO or divided BID-TID x1-6 months