Last update June 17, 2017

Пеницилламин

Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

A chelating agent that helps remove heavy metals such as copper, lead and mercury from the body.
Used to treat Wilson's disease, cystinuria, severe rheumatoid arthritis and chronic active hepatitis.

It is excreted in breast milk in clinically insignificant amounts (undetectable levels: Izumi 2012) and no problems have been observed in infants whose mothers have taken it (Sternlieb 2000, Messner 1998, Gregory 1983).

Oral bioavailability decreases by half in the presence of food, so its passing to the infant’s plasma via ingested breast milk would be very difficult

Copper and zinc levels in breast milk of mothers treated with penicillamine, trientine or zinc are normal according to more recent studies (Izumi 2012) and lower than normal according to older ones (Bunke 1989).

Cases of breast hyperplasia and hyperprolactinemia have been reported in patients treated with penicillamine (Craig 1988, Kahl 1985, Thew 1980).

Alternatives

  • Aurothiomalate Sodium (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Etanercept ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Hydroxychloroquine Sulfate ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Infliximab ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Zinc Salts ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Пеницилламин is Penicillamine in Cyrillic.

Is written in other languages:

Пеницилламин is also known as

Group

Пеницилламин belongs to this group or family:

Tradenames

Main tradenames from several countries containing Пеницилламин in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 40 - 70 %
Molecular weight 149 daltons
Protein Binding > 80 %
VD 0.8 l/Kg
Tmax 1 - 3 hours
1 - 3 hours

References

  1. Izumi Y. Can mothers with Wilson's disease give her breast milk to their infant? Teikyo Med J. 2012;35:17-24. 2012 Full text (link to original source) Full text (in our servers)
  2. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006 Jul;131(1):283-311. Review. Abstract Full text (link to original source) Full text (in our servers)
  3. Merck. Penicillamine. Drug Summary. 2004 Full text (in our servers)
  4. Sternlieb I. Wilson's disease and pregnancy. Hepatology. 2000 Abstract Full text (link to original source) Full text (in our servers)
  5. Messner U, Günter HH, Niesert S. [Wilson disease and pregnancy. Review of the literature and case report]. Z Geburtshilfe Neonatol. 1998 Abstract
  6. Ostensen M. Treatment with immunosuppressive and disease modifying drugs during pregnancy and lactation. Am J Reprod Immunol. 1992 Abstract
  7. Bunke H, Cario WR, Schneider M. [Variations in the composition of breast milk in Wilson's disease]. Kinderarztl Prax. 1989 Abstract
  8. Craig HR. Penicillamine induced mammary hyperplasia: report of a case and review of the literature. J Rheumatol. 1988 Abstract
  9. Kahl LE, Medsger TA Jr, Klein I. Massive breast enlargement in a patient receiving D-penicillamine for systemic sclerosis. J Rheumatol. 1985 Abstract
  10. Gregory MC, Mansell MA. Pregnancy and cystinuria. Lancet. 1983 Abstract
  11. Thew DC, Stewart IM. D penicillamine and breast enlargement. Ann Rheum Dis. 1980 Abstract

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