Cuprenil, 250 mg 100 pcs

How to take, the dosage

Cuprenyl is taken orally, 1-2 hours before a meal or 2 hours after taking food or other drugs. Drink only with water.

In Wilson’s disease – Konovalov disease: adults – at the beginning of treatment 250 mg/day, gradually increasing the dose to 1500 mg, rarely to 2000 mg/day. The daily dose is taken fractionally throughout the day. Dose of Cuprenil is considered effective if daily urinary excretion of copper (after 1 week of treatment) exceeds 2 mg. Further adequacy of the dose is determined on the basis of free copper level in blood serum (at least 10 mcg/ml). In children – 20 mg/kg/day, maximum daily dose – 500 mg.

In acute metal poisoning: 750-1500 mg/day in adults, 30-40 mg/kg/day in children.

In cystinuria: in adults 750-2000 mg/day with simultaneous administration of vitamin B6 and compensation for copper deficiency, in children 90 mg/kg/day.

In rheumatoid arthritis and scleroderma: initial dose of Cuprenil – 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 week to 375 mg/day. Treatment with the last dose (375 mg/day) is performed every day for 3 months. The maximum dose of Cuprenil is 500 mg/day, and in case of its ineffectiveness the treatment is stopped. If condition improves, treatment is continued for 1-2 years, gradually reducing the dose to 250 mg taken once every 2 days.

In alcoholic cirrhosis: on an empty stomach, at least 1 h before or 2 h after a meal (recommended before dinner), and not earlier than 1 h after taking any other drugs, 250-125 mg once daily. Therapy is carried out under close monitoring of plasma ALT and AST activity.

Interaction

The iron preparations reduce absorption of penicillamine and weaken its therapeutic effect.

Penicillamine increases the neurotoxic effect of isoniazid.

Concomitant use with penicillamine may decrease plasma levels of digoxin.

Special Instructions

Given the possibility of serious, sometimes life-threatening adverse reactions (especially common in patients with rheumatoid arthritis), penicillamine is used only with continuous medical supervision. During the treatment it is necessary to control urine analysis and clinical blood test once in 2 weeks during the first 6 months of treatment, then monthly; liver function should be controlled once in 6 months thereafter.

In Konovalov-Wilson disease or cystinuria, simultaneously with penicillamine, vitamin B₆ is prescribed for continuous use (due to dietary restrictions used to treat these diseases); during long-term treatment, these patients should undergo regular radiological or ultrasound examination of the kidneys and urinary tract. If there are signs of vitamin B₆ deficiency in patients with rheumatoid arthritis, and if symptoms of this deficiency do not resolve on their own, vitamin B₆ is prescribed additionally at a dose of 25 mg/day.

A slow, gradual increase in the dose of penicillamine can reduce the incidence of some adverse reactions. In case of development during treatment of fever, lung or liver damage, marked hematological or neurological disorders, myasthenia gravis, hematuria, lupus-like reactions or other severe adverse reactions, penicillamine should be stopped and GCS should be prescribed if necessary. In case of isolated proteinuria, if it does not increase and does not exceed 1 g/day, treatment with penicillamine is continued, otherwise it is discontinued.

Contraindications

• hypersensitivity;
• agranulocytosis;
• ystemic lupus erythematosus;
• myasthenia;
• renal failure.

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Side effects

• distortion of taste,
• nausea,
• vomiting,
• diarrhea,
• diarrhea.pain in muscles and joints,
• disorder of blood pattern,
• disorder of kidney function,
• allergic reactions.

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