penicillamine /pen′isil″əmēn/ , a chelating agent. ▪ INDICATIONS: It is prescribed for the treatment of Wilson’s disease and cystinuria and can be prescribed to bind with and remove heavy metals from the blood when there is poisoning resulting from metals such as copper, lead, mercury, arsenic, and gold (succimer is preferred for lead and mercury toxicity). It is also prescribed as a palliative in the treatment of systemic sclerosis (scleroderma) and rheumatoid arthritis when other medications have failed. ▪ CONTRAINDICATIONS: Known hypersensitivity to this drug or penicillamine-related aplastic anemia prohibits its use. It is not given to patients who are pregnant or who have kidney dysfunction. ▪ ADVERSE EFFECTS: Among the more serious adverse effects are fever, rashes, and blood dyscrasias. Severe bone marrow depression and immune disorders have been associated with long-term use of this drug. d-penicillamine is less toxic than the l form, and much of the reported toxicity is caused by the use of the l or dl form.
