1 tab. contains:
Active substance :
penicillamine 250 mg;
hydroxymethyl propyl cellulose;
Cuprenyl has a complexing, immunosuppressive, inhibitory effect on collagen synthesis.
Forms chelate complexes with ions of copper, mercury, lead, iron, arsenic, calcium, zinc, cobalt, gold. Reduces the absorption of copper from food and eliminates its excess in tissues.
Cuprenyl has an effect on various parts of the immune system (suppression of the T-helper function of lymphocytes, inhibition of neutrophil chemotaxis and the release of enzymes from the lysosomes of these cells, increased macrophage function).
It has the ability to disrupt collagen synthesis by cleaving cross-links between newly synthesized tropocollagen molecules. It has anti-inflammatory effect. Penicillamine is an antagonist of pyridoxine (vitamin B 6 ).
- rheumatoid arthritis,
- Wilson’s disease
- poisoning by lead, mercury, arsenic.
- systemic lupus erythematosus;
- myasthenia gravis;
- renal failure.
- distortion of taste
- muscle and joint pain
- violation of the blood picture,
- impaired renal function,
- allergic reactions.
Iron preparations reduce the absorption of penicillamine and weaken its therapeutic effect.
Penicillamine enhances the neurotoxic effect of isoniazid.
With simultaneous use with penicillamine, a decrease in the level of digoxin in blood plasma is possible.
How to take, course of administration and dosage
Cuprenil is taken orally, 1-2 hours before a meal or 2 hours after a meal or other drugs. Drink exclusively with water.
In Wilson-Konovalov's disease: for adults - at the beginning of treatment 250 mg / day, gradually increasing the dose to 1500 mg, rarely up to 2000 mg / day. The daily dose is taken fractionally throughout the day. The dose of Cuprenil is considered effective if the daily urinary excretion of copper (after 1 week of treatment) exceeds 2 mg. In the future, the adequacy of the dose is determined based on the level of free copper in the blood serum (at least 10 μg / ml). Children - 20 mg / kg / day, the maximum daily dose is 500 mg.
In acute metal poisoning: adults - 750-1500 mg / day, children - 30-40 mg / kg / day.
With cystinuria: adults - 750-2000 mg / day with the simultaneous administration of vitamin B6 and compensation for copper deficiency, children - 90 mg / kg / day.
In rheumatoid arthritis and scleroderma: the initial dose of Kuprenil is 125 mg / day during the first week with regular general blood and urine tests. From the second week, the dose is increased to 250 mg / day, from the third - to 375 mg / day. Treatment with the last dose (375 mg / day) is carried out every day for 3 months. The maximum dose of Cuprenil is 500 mg / day, with its ineffectiveness, treatment is canceled. When the condition improves, treatment is continued for 1-2 years, gradually reducing the dose to 250 mg, taken 1 time in 2 days.
With alcoholic cirrhosis of the liver: on an empty stomach, at least 1 hour before or 2 hours after eating (recommended before dinner), and also not earlier than 1 hour after taking any other drugs, 250-125 mg once a day . The therapy is carried out under close monitoring of the activity of ALT and AST in blood plasma.
Given the possibility of developing serious, sometimes life-threatening, adverse reactions (especially frequent in patients with rheumatoid arthritis), penicillamine is used only with constant medical supervision. During treatment, a urinalysis and a clinical blood test should be monitored once every 2 weeks during the first 6 months of treatment, then monthly; Once every 6 months, liver function is monitored.
In Konovalov-Wilson’s disease or cystinuria, vitamin B 6 is prescribed simultaneously with penicillamine (due to dietary restrictions used to treat these diseases); with prolonged treatment, these patients should undergo regular x-ray or ultrasound examinations of the kidneys and urinary tract. In case of development of signs of vitamin B 6 deficiency in patients with rheumatoid arthritis, as well as if the symptoms of this deficiency do not resolve on their own, vitamin B 6 is additionally prescribed at a dose of 25 mg / day.
A slow, gradual increase in the dose of penicillamine can reduce the frequency of some adverse reactions. In the event of the development of high temperature during treatment, damage to the lungs, liver, severe hematological or neurological disorders, myasthenia gravis, hematuria, lupus-like reactions or other severe adverse reactions, penicillamine is canceled and, if necessary, GCS is prescribed. In the case of the development of isolated proteinuria, if it does not increase and does not exceed 1 g / day, treatment with penicillamine continues, in other cases it is canceled.