Write a review
Reviews: 0
Manufacturers: Teva (Pharmaceutical company)
Active ingredients
- Penicillamine
Disease class
- Not indicated. See instructions
Clinical and pharmacological group
- Not indicated. See instructions
Pharmacological action
- Anti-inflammatory
- Immunosuppressive
- Complexing agent
Pharmacological group
- Immunosuppressants
- Detoxifying agents, including antidotes
Cuprenyl oral tablets
Instructions for medical use of the drug
Description of pharmacological action
Cuprenil has high complexing activity towards metals, mainly copper, mercury, arsenic, lead, iron and calcium. The drug reduces the resorption of copper from food and eliminates its excess from tissues. It affects various parts of the immune system (suppression of T-helper function of lymphocytes, inhibition of neutrophil chemotaxis and the release of enzymes from the lysosomes of these cells, enhancing the function of macrophages). It has the ability to disrupt collagen synthesis by breaking down cross-links between newly synthesized tropocollagen molecules. Penicillamine is a pyridoxine antagonist; has an anti-inflammatory effect.
Indications for use
— Wilson-Konovalov disease; - poisoning with copper, inorganic compounds of mercury, lead (with the exception of further penetration of lead through the gastrointestinal tract), gold, zinc, iron; - cystine nephrolithiasis; - systemic scleroderma; - rheumatoid arthritis.
Release form
film-coated tablets 250 mg; contour packaging 15, cardboard pack 2; film-coated tablets 250 mg; jar (jar) 100, cardboard pack 1; Composition Film-coated tablets 1 tablet. active substance: penicillamine 250 mg excipients: potato starch - 43.75 mg; lactose monohydrate - 166.25 mg; povidone - 25 mg; talc - 10 mg; magnesium stearate - 5 mg shell: hypromellose - 10.51 mg; macrogol 4000 - 0.8 mg; titanium dioxide (E171) - 2.51 mg; azorubine dye (E122) - 1.18 mg in a blister of PVC and aluminum foil 15 pcs.; 2 blisters in a cardboard pack or 100 pcs in a jar; in a cardboard pack 1 jar.
Pharmacodynamics
Cuprenil has high complexing activity towards metals, mainly copper, mercury, arsenic, lead, iron and calcium. The drug reduces the resorption of copper from food and eliminates its excess from tissues. It affects various parts of the immune system (suppression of T-helper function of lymphocytes, inhibition of neutrophil chemotaxis and the release of enzymes from the lysosomes of these cells, enhancing the function of macrophages). It has the ability to disrupt collagen synthesis by breaking down cross-links between newly synthesized tropocollagen molecules. Penicillamine is a pyridoxine antagonist; has an anti-inflammatory effect.
Pharmacokinetics
The drug forms chelates with heavy metal ions - stable complex compounds that are soluble in water and excreted in the urine. Easily absorbed from the digestive tract, reaching Cmax in the blood within 1-3 hours. Up to 50% of penicillamine is absorbed into the gastrointestinal tract. The drug is metabolized in the liver. Elimination of the drug occurs in 2 phases: T1/2 for the first is 1 hour, for the second it reaches 90 hours. About 70-80% of the absorbed drug is excreted in the form of metabolites (cysteine-penicillamine, disulfide) in the urine.
Use during pregnancy
Contraindication: pregnancy and breastfeeding (with the exception of Wilson-Konovalov disease at a dose of up to 1 g/day).
Contraindications for use
- agranulocytosis; - renal failure; - hematopoiesis disorders; - pregnancy and breastfeeding (with the exception of Wilson-Konovalov disease in a dose of up to 1 g); - children under 3 years of age (for this dosage form); - hypersensitivity to penicillamine and other components of the drug. Should not be used in combination with gold drugs, aminoquinoline and cytostatic drugs, phenylbutazone. With caution: during surgical interventions, anemia, proteinuria.
Side effects
Anorexia, nausea, vomiting, diarrhea, aphthous stomatitis, glossitis; intrahepatic cholestasis, pancreatitis; skin rash; epidermal necrolysis; complete loss or distortion of taste, reversible polyneuritis (associated with pyridoxine deficiency); nephritis, hematuria; eosinophilia, thrombocytopenia, leukopenia; anemia (aplastic or hemolytic), agranulocytosis; allergic alveolitis, interstitial pneumonitis, diffuse fibrosing alveolitis, Goodpasture's syndrome; myasthenia gravis, polymyositis, dermatomyositis, polyneuritis; fever; lupus-like reactions (arthralgia, myalgia, erythematous rash, the appearance of antinuclear antibodies and antibodies to DNA); enlargement of the mammary glands with the development of galactorrhea (in women); alopecia.
Directions for use and doses
Orally, at least 30 minutes before meals, washed down with water, or 2 hours after meals or other drugs. Wilson-Konovalov's disease Adults - 1.5–2 g/cen in divided doses. After achieving remission of the disease, the dose can be reduced to 0.75 or 1 g/day. In patients with negative copper balance, the minimum effective dose of penicillamine should be used. A dose of 2 g per day should be used for no more than 1 year. Elderly patients - 20 mg/kg/day in divided doses. The dose should be selected in such a way as to achieve remission of the disease and maintain a negative copper balance. Children - usually 20 mg/kg/day in divided doses. The minimum dose is 500 mg/day. Cystinuria It is best to establish the minimum effective dose after quantifying the concentration of amino acids in urine by chromatography. Dissolution of cystine stones Adults - 1–3 g/day in fractional doses. Urinary cystine concentrations should be kept below 200 mg/L. Prevention of cystine lithiasis Adults - 0.5–1 g/day until the concentration of cystine in the urine reaches below 300 mg/l. Elderly patients - prescribe the minimum dose until the concentration of cystine in the urine is below 200 mg/l. Children - prescribe the minimum dose that allows you to achieve a concentration of cystine in the urine below 200 mg/l. During treatment, it is recommended to drink plenty of fluids - at least 3 liters per day. The patient should drink 500 ml of water before going to bed, and then 500 ml at night, when the urine is more concentrated and more acidic than during the day. Typically, the more fluid a patient drinks, the lower their need for penicillamine. A diet low in methionine is also recommended to reduce cystine synthesis. Due to its low protein content, this diet is not recommended for children during the growing period and pregnant women. Lead poisoning Adults - 1–1.5 g per day in fractional doses until the excretion of lead in urine reaches 0.5 mg/day. Elderly patients - 20 mg/kg/day in fractional doses until urinary lead excretion is within 0.5 mg/day. Children - 20 mg/kg/day. Rheumatoid arthritis Adults - 250 mg/day during the first month of using the drug. The dose is then increased every 4–12 weeks by 250 mg until disease remission is achieved. After this, the minimum effective dose is used, which allows you to inhibit the symptoms of the disease. If the therapeutic effect is not achieved within 6 months of using the drug, treatment should be discontinued. The maintenance dose is usually 500–750 mg/day. Do not exceed the dose of 1.5 g/day. After achieving remission of the disease, which lasts 6 months, it is recommended to gradually reduce the drug dose by 250 mg every 12 weeks. Elderly patients - the initial dose should not exceed 250 mg / day during the first month of using the drug. The dose can then be increased every 4–12 weeks by 250 mg until disease remission is achieved. Do not exceed the dose of 1 g of the drug per day. Children - 15–20 mg/kg/day. The initial dose is 2.5–5 mg/day, it can be increased gradually every 4 weeks for 3–6 months to the minimum effective dose, but not more than 500 mg. Systemic scleroderma 250 mg/day during the first month of using the drug. Then the dose is increased every 4–12 weeks by 250 mg to 1 g/day, followed by a decrease to 250–500 mg/day. The effect is assessed after 6–12 months of use of the drug.
Overdose
There have been no cases of overdose. Antidote unknown. Treatment is symptomatic.
Interactions with other drugs
Cuprenil is a vitamin B6 antagonist. The drug should not be used with drugs that can cause bone marrow dysfunction. The drug forms stable complex compounds with heavy metals. Antimalarial drugs, levamisole and phenylbutazone increase the risk of side effects. Antacids reduce the absorption of the drug.
Storage conditions
List B.: At a temperature of 15–25 °C.
Best before date
36 months
ATX classification:
M Musculoskeletal system
M01 Anti-inflammatory and antirheumatic drugs
M01C Basic antirheumatic drugs
M01CC Penicillamine and similar drugs
M01CC01 Penicillamine
Cuprenyl®
The drug should be taken orally at least 30 minutes before meals with water, or 2 hours after meals or other medications.
Wilson-Konovalov disease
For adults
: 1.5 - 2 g per day in fractional doses. After achieving remission of the disease, the dose can be reduced to 0.75 g or 1 g per day. In patients with negative copper balance, the minimum effective dose of penicillamine should be used.
A dose of 2 g per day should be used for no more than 1 year.
Elderly patients
: 20 mg/kg body weight per day in divided doses. The dose should be selected in such a way as to achieve remission of the disease and maintain a negative copper balance.
For children
: usually 20 mg/kg body weight per day in divided doses.
The minimum dose is 500 mg per day.
Cystinuria
It is best to establish the minimum effective dose after quantifying the concentration of amino acids in urine by chromatography.
Dissolution of cystine stones.
For adults
: 1-3 g per day in fractional doses. Urinary cystine concentrations should be kept below 200 mg/L.
Prevention of cystine lithiasis.
For adults
: 0.5 - 1 g per day until the concentration of cystine in the urine is below 300 mg/l.
Elderly patients
: the minimum dose is prescribed until the concentration of cystine in the urine is below 200 mg/l.
For children
: Prescribe the minimum dose that allows you to achieve a concentration of cystine in the urine below 200 mg/l.
Attention
: During treatment, it is recommended to drink plenty of fluids - at least 3 liters per day. The patient should drink 500 ml of water before going to bed, and then 500 ml at night, when the urine is more concentrated and more acidic than during the day. Typically, the more fluid a patient drinks, the lower their need for penicillamine.
A diet low in methionine is also recommended to keep cystine synthesis as low as possible. Due to its low protein content, this diet is not recommended for children during the growing period and pregnant women.
Lead poisoning.
For adults
: 1-1.5 g per day in fractional doses until the excretion of lead in urine is within 0.5 mg per day.
Elderly patients
: 20 mg/kg body weight per day in fractional doses until the excretion of lead in urine is within 0.5 mg per day.
For children
: 20 mg/kg body weight per day.
Rheumatoid arthritis.
For adults
: 250 mg per day during the first month of using the drug. The dose is then increased every 4-12 weeks by 250 mg until disease remission is achieved. After this, the minimum effective dose is used, which allows you to inhibit the symptoms of the disease; if the therapeutic effect is not achieved within 6 months of using the drug, treatment should be stopped.
The maintenance dose is usually 500-750 mg per day. Do not exceed the dose of 1.5 g of the drug per day. After achieving remission of the disease for 6 months, it is recommended to gradually reduce the dose of the drug by 250 mg every 12 weeks.
Elderly patients
: The initial dose should not exceed 250 mg per day during the first month of using the drug. The dose can then be increased every 4-12 weeks by 250 mg until disease remission is achieved. Do not exceed the dose of 1 g of the drug per day.
For children
: usually 15-20 mg/kg body weight per day. The initial dose is 2.5 - 5.0 mg per day, it can be increased gradually every 4 weeks for 3-6 months to the minimum effective dose, but not more than 500 mg.
Systemic scleroderma
.
250 mg per day during the first month of using the drug. Then the dose is increased every 4-12 weeks by 250 mg to 1 g per day, followed by a decrease to 250-500 mg per day. The effect is assessed after 6-12 months of using the drug.
Similar drugs:
- Artamin Capsule
** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before starting to use the drug Cuprenil, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.
Are you interested in the drug Cuprenil? Do you want to know more detailed information or do you need a doctor's examination? Or do you need an inspection? You can make an appointment with a doctor - the Euro lab is always at your service! The best doctors will examine you, advise you, provide the necessary assistance and make a diagnosis. You can also call a doctor at home . Euro lab clinic is open for you around the clock.
** Attention! The information presented in this medication guide is intended for medical professionals and should not be used as a basis for self-medication. The description of the drug Cuprenil is provided for informational purposes and is not intended for prescribing treatment without the participation of a doctor. Patients need to consult a specialist!
If you are interested in any other drugs and medications, their descriptions and instructions for use, information about the composition and form of release, indications for use and side effects, methods of use, prices and reviews of drugs, or you have any other questions and suggestions - write to us, we will definitely try to help you.
