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 is this drug given?

• All products:
• 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.
• 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.
• Liquid:
• Shake well before use.
• 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.
• 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.

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?

• 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?

• 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.
• Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
• 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 or clot more easily. Have him/her be more careful and avoid injury. Keep your child from rough-housing or playing contact sports.
• 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 has been an overdose, call 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room (ER) right away.http://www.aapcc.org), or emergency room (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?

• Tablets and capsules:
• Store at room temperature.
• Store in a dry place. Do not store in a bathroom.
• Liquid:
• 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.
• If you have any questions about this drug, please talk with your doctor, pharmacist, or other health care provider.
• 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.
• These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
• 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.

This information should not be used to decide whether or not to take this medicine or any other medicine. Only your healthcare provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your healthcare provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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