Description medication: Penicillamine (Penicillaminum)
D-2-Amino-3-mercapto-3-methylbutyric acid or D-3, 3-dimetiltsistein.
Synonyms: Artamin, kuprenil, Artamin, Beracilline, Cuprenil, Cuprimine , Cupripen, Depamine, Distamine, b-Mercaptovalin, Mercaptyl, Metalcaptase, d-Penicillamin, Sulredox, Troloval and others.
Penicillamine - synthetic drug, which structure can be viewed as part of the penicillin molecules and amino acid derivative is dimethyl cysteine. The preparation of optically active. Used as D-form, as L-form and the racemate more toxic.
The main property is its high penicillamine complexing activity against metal ions. It relates mainly ions of copper, mercury, lead and iron, and calcium. The resulting complexes are removed by the kidneys.
Penicillamine is used for acute and chronic poisoning of these metals, as well as disease Westphal - Wilson - Konovalov (gepatotserebralnoy dystrophy). The drug enhances the removal of the urine excess copper from the tissues of patients suffering from this disease, and, according to available data, more effective than the typical connections (see. Unitiol).
Furthermore, penicillamine inhibits collagen synthesis in the body and normalizes the ratio between its soluble and insoluble fractions, thus contributing to inhibition of tissue sclerosing process. Under the influence of the drug reduced the level of pathological macroglobulin, including rheumatoid factor.
If ingestion is rapidly absorbed and penicillamine long time is found in the blood plasma; half-life is 24 - 75 hours.
Assign Penicillamine adults with various forms of rheumatoid arthritis in the case of absence of the effect of the use of conventional anti-inflammatory drugs. Penicillamine is regarded as one of the basic ( "basic") in the treatment of this disease.
Also used in systemic sclerosis and some other diseases.
Drug inside through 2 - 2, 5 hours after the meal.
In rheumatoid arthritis begin with a dose of 150 - 300 mg per day. Every 2 - 4 weeks to increase the dose up to 150 mg total daily dose of 600 mg. " The first signs of clinical improvement (. A decrease in arthralgia, morning stiffness, exudative phenomena in the joints, etc.) usually appear after 2 - 3 months, at least at a later date. Upon reaching the therapeutic effect of drug taking in supporting daily dose of 0.15 - 0.3 g
Systemic scleroderma penicillamine administered in a daily dose of 0.15 - 0.3 g for 7 - 10 days. With good tolerability daily dose increased by 0.15 grams per week and it is adjusted to 1 - 2 In this dose, the drug is used for 6 months, and then the dose is reduced to 0.15 g per week to about 0.3 grams per day. The maintenance dose is 0.3 grams per day.
Duration of treatment is 1 year or more.
When disease Westphal - Wilson - Konovalov used high doses (2 g in the early days), under the control of the general condition and the content of copper in the urine. Children older than 6 years appoint 0.25 g 1 per day.