Penicillamine

(pen i SIL a meen)

What key warnings do I need to know about before giving this drug to my child?

• This drug is very strong. It may stop your child's bone marrow from making some of the cells that his/her body needs. Your child will need weekly blood work to watch for side effects. Tell your child's doctor right away about any fever, sore throat, signs of infection, bleeding, shortness of breath, or feeling tired.

Is it safe for my child to take this drug?

• Not if your child has an allergy to penicillamine or any other part of this drug.
• Be sure to let the doctor know if your child has any allergies or side effects to drugs, foods, or dyes. Make sure to tell about the allergy and what signs your child had. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
• Not if your child has had low blood cell counts while taking this drug in the past.

Why does my child need this drug?

• It is used to treat Wilson's disease.
• It is used to get rid of a protein called cystine from the body.
• It is used to treat arthritis.
• It is used to take some metals from the body.

How does this drug work?

• Penicillamine helps get rid of cystine from your child's body.
• It binds with some types of metals to take them from your child's body.
• It lowers the body's harmful response to diseases of the immune system.

How is this drug given?

• To gain the most benefit, do not miss giving your child doses.
• Give on an empty stomach. Give 1 hour before or 2 hours after meals.
• There is a liquid (suspension) if your child cannot swallow pills. Shake well before use.
• Children who have feeding tubes may also use the liquid. Flush the feeding tube before and after this drug is given.
• If your child has a feeding tube, open the capsule and mix it with 3 tablespoons (45 mL) of apple juice. Give in the feeding tube. Flush the feeding tube before and after this drug is given.
• Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, get an oral syringe, a dropper, a spoon, or a cup (only for older children) from your pharmacist.
• Have your child take vitamin B6 (pyridoxine) as you were told by your child's doctor.
• Have your child follow the diet and workout plan your child's doctor told you about.
• Have your child drink lots of noncaffeine liquids every day unless told to drink less liquid by your child's doctor.

How long does this drug take to work?

• It may take a few months to see the full effect.

What do I do if my child misses a dose? (does not apply to patients in the hospital)

• Give a missed dose as soon as you think about it.
• If it is close to the time for your child's next dose, skip the missed dose and go back to your child's normal time.
• Do not give 2 doses or extra doses.
• Do not change the dose or stop your child's drug. Talk with your child's doctor.

What safety measures do I need to take when my child is using this drug?

• Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
• If your child has kidney disease, talk with the doctor.
• If your child has liver disease, talk with the doctor.
• If your child has myasthenia gravis, talk with the doctor.
• Have your child's blood work checked often. Talk with your child's doctor.
• Check all drugs your child is taking with your child's doctor. This drug may not mix well with some other drugs.
• Do not give dairy products, bismuth (Pepto-Bismol®), calcium, iron, magnesium, zinc, multivitamins with minerals, colestipol, cholestyramine, didanosine, or antacids within 2 hours of this drug.
• Your child may bleed more easily. Have him/her be more careful and avoid injury. Wear a bike helmet, for example, while riding a bike.
• Tell dentists, surgeons, and other doctors that your child is using this drug.
• Talk with the doctor before giving your child products that have aspirin, ibuprofen or like products, blood thinners (warfarin, ticlopidine, clopidogrel), garlic, ginseng, ginkgo, or vitamin E.

What are some side effects of this drug?

• Upset stomach or throwing up. Many small meals and good mouth care may help. Older children may suck hard, sugar-free candy.
• Loose stools (diarrhea).
• Bad taste in your mouth. This most often goes back to normal.
• Not hungry.
• Muscle weakness.
• Itching.

When do I need to call my child's doctor?

• If any of this news causes you to be worried, any of the unwanted side effects happen, or if your child is not better after taking this drug.
• If you think there was an overdose, call your local poison control center or ER right away.
• If your child shows signs of a very bad reaction, call your child's doctor or the ER right away. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; swelling of face, lips, tongue, or throat; or if your child is not acting normal.
• If your child shows any signs of infection. These include a fever of 100.5°F (38°C) or higher, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color or sputum, pain with passing urine, mouth sores, wound that will not heal, or anal itching or pain.
• If your child has trouble breathing.
• If your child has a very bad upset stomach or is throwing up.
• If your child has very bad muscle pain or weakness.
• If your child has any bruising or bleeding.
• If your child gets a rash.
• If your child’s health problem does not get better or if you believe your child’s health problem is worse.

How do I store and/or throw out this drug?

• Store capsules and tablets at room temperature.
• Protect capsules and tablets from water. Do not store in a bathroom or kitchen.
• Store liquid (suspension) at room temperature or in a refrigerator. Throw away any part not used after 1 month.

General drug facts

• If your child has a very bad allergy, he/she needs to wear an allergy ID at all times.
• You may get this drug by drug order only. If there are refills, call your pharmacy. If your child does not have refills left, you may need to call your child's doctor.
• Get rid of this drug when your child no longer needs it or if the drug is outdated.
• Most drugs may be thrown away in household trash after mixing with coffee grounds or kitty litter and sealing in a plastic bag.
• In Canada, take any unused drugs to the pharmacy. Also, visit http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.
• Do not share your child's drug with others and do not give anyone else's drug to your child.
• Keep all drugs out of the reach of children and pets.
• Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
• Call your doctor for help with any side effects. If in the U.S., you may also call the FDA at 1-800-FDA-1088 or if in Canada, you may also call Health Canada's Vigilance Program at 1-866-234-2345.
• Talk with the doctor before giving your child any new drug, including OTC, natural products, or vitamins.
• If you do not use a drug the right way, it may not be safe. Follow what your child’s doctor tells you.

Copyright © 1978- Lexi-Comp Inc., The Children's Hospital, Denver, CO., and Pediatric Pharmacy Advocacy Group, Inc. All Rights Reserved. This information is protected under US and international copyright law. Unauthorized use or reproduction is prohibited.