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D-Penicillamine (Cuprimine®)



Indications and Usage


  • This drug chelates nuclides of copper, iron, mercury, lead, gold, and possibly other heavy metals.
  • The chelated metals are excreted in the urine.
  • The adult dose is 250 mg p.o. qd between meals and at bedtime. May increase to 4 or 5 g qd in divided doses.

FDA Product Safety Info

  • Not FDA approved for this indication/off-label use
  • Be very cautious if patient has a penicillin allergy.
  • Adverse events have been reported following use of penicillamine, including neutropenia, thrombocytopenia, and nephrotoxicity.
  • Physicians planning to use penicillamine should thoroughly familiarize themselves with its toxicity, special dosage considerations, and therapeutic benefits. Penicillamine should never be used casually. Each patient should remain constantly under the close supervision of the physician. Patients should be warned to report promptly any symptoms suggesting toxicity.

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References

  1. Marcus, CS. Administration of decorporation drugs to treat internal radionuclide contamination: medical emergency response to radiologic incidents. RSO Magazine, 2004;9(5):9-15. (PDF - 34 KB)
  2. "Radiation Bioterrorism," Tochner ZA, Lehavi O, Glatstein E, Chapter 207 in Harrison's Principles of Internal Medicine, Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, eds. 16th Edition, pp 1294-1300, McGraw-Hill, 2005
 

US Department of Health & Human Services     
U.S. Department of Health & Human Services Office of the Assistant Secretary for Preparedness and Response National Library of Medicine