Penicillamine: uses, dosing, side effects & brands
Penicillamine is an antirheumatic agent sold in the U.S. under 3 brand and generic names, for rheumatoid arthritis, cystinuria and hepatolenticular degeneration. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Antirheumatic Agent
- Treats (across its forms)
- Rheumatoid Arthritis, Cystinuria and Hepatolenticular Degeneration
- Available as
- Capsule · Tablet
- Sold as
- 3 products — Penicillamine, Cuprimine and Depen
- Prescription?
- Prescription only
- Generic available?
- Yes
- Boxed warning
- Boxed warning
How penicillamine is dosed
From the FDA label for Penicillamine (application ANDA211735). Other penicillamine products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
In all patients receiving penicillamine, it is important that penicillamine capsules, USP be given on an empty stomach, at least one hour before meals or two hours after meals, and at least one hour apart from any other drug, food, or milk. Because penicillamine increases the requirement for pyridoxine, patients may require a daily supplement of pyridoxine (see PRECAUTIONS ). Wilson's Disease — Optimal dosage can be determined by measurement of urinary copper excretion and the determination of free copper in the serum. The urine must be collected in copper-free glassware, and should be quantitatively analyzed for copper before and soon after initiation of therapy with penicillamine capsules, USP. Determination of 24-hour urinary copper excretion is of greatest value in the first week of therapy with penicillamine. In the absence of any drug reaction, a dose between 0.75 and 1.5 g that results in an initial 24-hour cupriuresis of over 2 mg should be continued for about three months, by which time the most reliable method of monitoring maintenance treatment is the determination of free copper in the serum. This equals the difference between quantitatively determined total copper and ceruloplasmin-copper. Adequately treated patients will usually have less than 10 mcg free copper/dL of serum. It is seldom necessary to exceed a dosage of 2 g/day. If the patient is intolerant to…
Penicillamine side effects
Penicillamine is a drug with a high incidence of untoward reactions, some of which are potentially fatal. Therefore, it is mandatory that patients receiving penicillamine therapy remain under close medical supervision throughout the period of drug administration (see WARNINGS and PRECAUTIONS ) . Reported incidences (%) for the most commonly occurring adverse reactions in rheumatoid arthritis patients are noted, based on 17 representative clinical trials reported in the literature (1,270 patients). Allergic — Generalized pruritus, early and late rashes (5%), pemphigus (see WARNINGS ), and drug eruptions which may be accompanied by fever, arthralgia, or lymphadenopathy have occurred (see WARNINGS and PRECAUTIONS ). Some patients may show a lupus erythematosus-like syndrome similar to drug-induced lupus produced by other pharmacological agents (see PRECAUTIONS ). Urticaria and exfoliative dermatitis have occurred. Thyroiditis has been reported; hypoglycemia in association with anti-insulin antibodies has been reported. These reactions are extremely rare. Some patients may develop a migratory polyarthralgia, often with objective synovitis (see Dosage and Administration ). Gastrointestinal — Anorexia, epigastric pain, nausea, vomiting, or occasional diarrhea may occur (17%). Isolated cases of reactivated peptic ulcer have occurred, as have hepatic dysfunction including hepatic…
Who shouldn’t take penicillamine
Except for the treatment of Wilson's disease or certain patients with cystinuria, use of penicillamine during pregnancy is contraindicated (see WARNINGS ). Although breast milk studies have not been reported in animals or humans, mothers on therapy with penicillamine should not nurse their infants. Patients with a history of penicillamine-related aplastic anemia or agranulocytosis should not be restarted on penicillamine (see WARNINGS and ADVERSE REACTIONS ). Because of its potential for causing renal damage, penicillamine should not be administered to rheumatoid arthritis patients with a history or other evidence of renal insufficiency.
Every penicillamine product we track (3)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 72/100 | Prescription | Capsule | No data | — | View → | |
| 2 | 70/100 | Prescription | Capsule | No data | — | View → | |
| 3 | Not yet rated | Prescription | Tablet | No data | — | View → |
What penicillamine pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
| Imprint | Strength | Colour | Shape | Maker |
|---|---|---|---|---|
| ATON;705;CUPRIMINE | 250 mg | yellow | capsule | — |
| 37;4401 | 250 mg | white | oval | — |
| IG;609 | 250 mg | yellow | capsule | — |
| A98 | 250 mg | white | capsule | — |
How long penicillamine keeps
No penicillamine label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.
Does penicillamine expire? The in-use limits and storage rules from its labelsPenicillamine and breastfeeding
From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.
Full LactMed record for penicillamine: levels in milk, effects in breastfed infants, and the drugs it would consider insteadLimited information indicates that penicillamine is not detectable in breastmilk and no adverse effects have been reported among breastfed infants whose mothers were taking the drug. Copper and zinc levels in breastmilk are reduced in some mothers receiving penicillamine. Penicillamine has been used with apparent safety during nursing of several infants. Based on available data, it appears that penicillamine is acceptable to use during breastfeeding.
National Institute of Child Health and Human Development, record revised August 15, 2024. LactMed states its information is not a substitute for professional judgement.
What people report to the FDA about penicillamine
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 892 reports naming penicillamine, and the FDA flagged 84% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- drug hypersensitivity180 reports
- arthralgia152 reports
- joint swelling149 reports
- inflammation111 reports
- diarrhoea92 reports
- nausea91 reports
- drug intolerance80 reports
- headache79 reports
Read these as a signal, not a rate. A report does not mean penicillamine caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved August 25, 2026.
Related calculators
Frequently asked questions
What is penicillamine?
Penicillamine is a chelating agent used in the treatment of Wilson's disease. It is also used to reduce cystine excretion in cystinuria and to treat patients with severe, active rheumatoid arthritis unresponsive to conventional therapy (see INDICATIONS ). It is 3-mercapto-D-valine. It is a white or practically white, crystalline powder, freely soluble in water, slightly soluble in alcohol, and insoluble in ether, acetone, benzene, and carbon tetrachloride. Although its configuration is D, it is levorotatory as usually measured: calculated on a dried basis.
What kind of drug is penicillamine?
The FDA classifies penicillamine as an antirheumatic agent. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take penicillamine with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run penicillamine against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is penicillamine sold under?
We track 3 penicillamine-containing products in the U.S.: Penicillamine, Cuprimine and Depen. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does penicillamine come in?
Across the brands we track, penicillamine is currently marketed as capsule and tablet, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic penicillamine?
Yes. Our catalog lists 1 generic penicillamine product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Cite this page
- APA
- pharmaranks. (2026, July 24). Penicillamine: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/penicillamine
- MLA
- “Penicillamine: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/penicillamine.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for penicillamine on DailyMed (NIH) ↗ — including its boxed warning in full.