Skip Navigation

Search Knowledgebase

Penicillamine

Drug Information

Penicillamine is a chelating agent (binds metals and carries them out of the body). Penicillamine is used to treat people with Wilson’s disease, cystinuria, and severe rheumatoid arthritis.

Common brand names:

Cuprimine, Depen Titratabs

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Vitamin B6

    Penicillamine may increase vitamin B6 excretion, reduce activity, and increase the risk for vitamin B6 deficiency.1 It makes sense for people taking penicillamine to supplement with small (5–20 mg per day) amounts of vitamin B6. Some researchers have suggested that as much as 50 mg per day of vitamin B6 may be necessary.2

  • Sodium

    Penicillamine therapy has been associated with sodium depletion.3 The frequency of this association remains unclear.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

  • none

Support Medicine

  • Bromelain

    One report found bromelain improved the action of antibiotic drugs, including penicillin and erythromycin, in treating a variety of infections. In that trial, 22 out of 23 people who had previously not responded to the antibiotics did so after adding bromelain four times per day.4 Doctors will sometimes prescribe enough bromelain to equal 2,400 gelatin dissolving units (listed as GDU on labels) per day. This amount would equal approximately 3,600 MCU (milk clotting units), another common measure of bromelain activity.

Reduces Effectiveness

  • Iron

    Penicillamine binds iron. When taken with iron, penicillamine absorption and activity are reduced.5 Four cases of penicillamine-induced kidney damage were reported when concomitant iron therapy was stopped, which presumably led to the increased penicillamine absorption and toxicity.6

  • Zinc

    People taking penicillamine should discuss with their doctor whether it would be appropriate to take a zinc supplement (at a separate time of day from the penicillamine).7 However, people taking penicillamine should not supplement with zinc, unless they are being supervised by a doctor.

  • Guar Gum

    In a double-blind study with ten healthy people, guar gum reduced penicillin absorption.8 Until more is known, to avoid this interaction, people taking penicillin should take it two hours before or after any guar gum-containing supplements. It remains unclear whether the smaller amounts of guar gum found in many processed foods would have a significant effect.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Potential Negative Interaction

  • none

Explanation Required 

  • Copper

    One of the main uses of penicillamine is to reduce toxic copper deposits in people with Wilson’s disease. People taking a copper supplement can make Wilson’s disease worse and may negate the benefits of drugs used to remove copper from the body.

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 203.

2. Rothschild B. Pyridoxine deficiency. Arch Intern Med 1982;142:840.

3. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 202

4. Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143–60.

5. Threlkeld DS, ed. Miscellaneous Products, Penicillamine. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Aug 1996, 714–6b.

6. Harkness JAL, Blake DR. Penicillamine nephropathy and iron. Lancet 1982;ii:1368–9.

7. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 201.

8. Huupponen R, Seppala P, Iisalo E. Effect of guar gum, a fibre preparation, on digoxin and penicillin absorption in man. Eur J Clin Pharmacol 1984;26:279–81.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.