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Name: Penicillamine

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Indications & Dose:

INDICATIONS AND DOSE


Severe active rheumatoid arthritis (administered on expert advice)



Adult: Initially 125–250 mg daily for 1 month, then increased in steps of 125–250 mg, at intervals of not less than 4 weeks; maintenance 500–750 mg daily in divided doses, then reduced in steps of 125–250 mg every 12 weeks, dose reduction attempted only if remission sustained for 6 months;n maximum 1.5 g per day


Elderly: Initially up to 125 mg daily for 1 month, then increased in steps of up to 125 mg, at intervals of at least 4 weeks; maximum 1 g per day Wilson’s disease



Adult: 1.5–2 g daily in divided doses, adjusted according to response, to be taken before food; maintenance 0.75–1 g daily, a dose of 2 g daily should not be continued for more than one year; maximum 2 g per day


Elderly: 20 mg/kg daily in divided doses, adjusted according to response


Autoimmune hepatitis (used rarely; after disease controlled with corticosteroids)



Adult: Initially 500 mg daily in divided doses, to be increased slowly over 3 months; maintenance 1.25 g daily


Cystinuria, therapeutic



Adult: 1–3 g daily in divided doses, to be adjusted to maintain urinary cystine below 200 mg/litre, to be taken before food


Cystinuria, prophylactic



Adult: 0.5–1 g daily, maintain urinary cystine below 300 mg/litre and adequate fluid intake (at least 3 litres daily), to be taken at bedtime


Elderly: Minimum dose to maintain urinary cystine below 200 mg/litre is recommended


 


 

Contraindications:

Lupus erythematosus

Cautions:

Neurological involvement in Wilson’s disease

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