VISTAMIN
PENICILLAMINE · by WILSONS
Composition
Tab 250 mg: Penicillamine 250 mg.
Indications & Dosage
Cystinuria: Adults: Treatment: 1-3 gm daily in divided doses before food, adjusted to maintain urinary cystine below 200 mg/L; Prophylaxis: Dose adjusted to maintain urinary cystine below 300 mg/L, 0.5-1gm at bedtime. Elderly and Children: Use minimum dose to maintain urinary cystine below 200 mg/L. Wilsons disease: Adult: 1.5- 2 gm daily in divided doses before food; max 2 gm daily for 1 yr. Maintenance. 0.75-1 gm daily Elderly: 20 mg/kg daily in divided doses, minimum 500 mg daily. Children: Up to 20 mg/kg daily in divided doses; minimum 500 mg daily. Lead poisoning: See product literature. Autoimmune hepatitis (used rarely): Adult: Initially 500 mg daily in divided doses, to beincreased slowly over 3 months; maintenance 1.25 g daily.
Contraindications
Moderate to severe renal impairment, lupus erythematosus, agranulocytosis, aplastic anaemia or thrombocytopenia due to penicillamine.
Precautions
Monitor blood, urine and renal function before and frequently during treatment, especially in the elderly, risk of deterioration of neurological symptoms in Wilsons disease. Consider need for pyridoxine during long-term treatment. Intolerant of gold, renal insufficiency
Interactions
Gold salts, NSAIDs or other nephrotoxic drugs, iron salts, zinc, antacids, digoxin, clozapine.
Pregnancy
Contraindicated, avoid
Lactation
Caution advised
Side Effects
Anorexia, fever, nausea, proteinuria, rash, thrombocytopenia (withdraw), dysgeusia, haematuria (withdraw), leucopenia (withdraw), delayed rash, breast enlargement, aplastic anaemia, blood disorders, bronchiolitis, cholestatic jaundice, dermatomyositis, glomerulonephritis, Goodpastures syndrome