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Penicillamine Coupon - Penicillamine 250mg capsule

penicillamine

Generic Depen
Used for Rheumatoid Arthritis, Kidney Stones, Wilson's Disease, Cystinuria
Used for Rheumatoid Arthritis, Kidney Stones, Wilson's Disease, Cystinuria

Penicillamine (Depen) is used to treat Wilson's disease, cystinuria, and severe rheumatoid arthritis (RA). It has many side effects, such as upset stomach and changes in taste, and requires careful monitoring by your provider. The dose is taken on an empty stomach, but you'll have to follow specific instructions on how to time penicillamine (Depen) with your meals and other medications. This medication comes as tablets (under the brand name Depen) and capsules (under the brand name Cuprimine). Penicillamine (Depen) is also available as a lower-cost generic.

Last reviewed on June 12, 2023
basics-icon

What is Penicillamine (Depen)?

What is Penicillamine (Depen) used for?

  • Wilson's disease

  • Cystinuria

  • Severe rheumatoid arthritis (RA) when other medications haven’t worked well

How Penicillamine (Depen) works

Penicillamine (Depen) is a chelating agent, meaning that it attaches to heavy metals in your body. It helps your body get rid of certain substances that cause Wilson’s disease and cystinuria.

  • Wilson’s disease is a genetic condition that causes copper to build up in your liver, brain, and other organs. Penicillamine (Depen) attaches to the copper so your body can remove it through your urine.

  • Cystinuria is a genetic condition that causes stones made of cystine (a protein) to form in your kidneys and bladder. Penicillamine (Depen) lowers the amount of cystine in your urine by attaching to it and forming a substance that your body can get rid of more easily. This lowers your risk of forming kidney stones and can help dissolve stones that are already formed.

  • Rheumatoid arthritis (RA) is a condition where your body's immune system attacks your joints, which causes swelling and pain. The way penicillamine (Depen) works to help treat RA isn’t known.

Are you looking for information on penicillin (Penicillin VK) instead?

Drug Facts

Common BrandsCuprimine, Depen
Drug ClassChelating agent
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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Avg retail price
$28707.22(save 97.06%)
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$844.16
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What are the side effects of Penicillamine (Depen)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Stomach problems, such as loss of appetite, stomach pain, nausea, vomiting, or diarrhea (17%)
  • Total or partial loss of taste (12%)
  • Protein in urine (6%)
  • Rash (5%)

Other Side Effects

  • Fever
  • Lupus-like symptoms (muscle pain, feeling tired, rash)
  • Hives
  • Other skin problems (wrinkling, flaking)
  • Mouth sores
  • Ringing in the ears
  • Vision changes
  • Movement problems
  • Anxiety
  • Mood problems
  • Low platelets or white blood cell counts

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Low white blood cells: getting fevers, sore throat, or chills too often or if they don’t go away
  • Low platelets: bruising, bleeding
  • Kidney damage: blood in your urine

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Fever

joint pain

lesions on the face, neck, scalp, and/or trunk

skin rash, hives, or itching

swollen and/or painful glands

ulcers, sores, or white spots on lips or in mouth

Less common

Bloody or cloudy urine

shortness of breath, troubled breathing, tightness in chest, or wheezing

sore throat and fever with or without chills

swelling of face, feet, or lower legs

unusual bleeding or bruising

unusual tiredness or weakness

weight gain

Rare

Abdominal or stomach pain (severe)

blisters on skin

bloody or black, tarry stools

chest pain

coughing or hoarseness

dark urine

difficulty in breathing, chewing, talking, or swallowing

eye pain, blurred or double vision, or any change in vision

general feeling of discomfort or illness or weakness

lower back or side pain

muscle weakness

painful or difficult urination

pale stools

pinpoint red spots on skin

redness, tenderness, itching, burning, or peeling of skin

red or irritated eyes

red, thick, or scaly skin

ringing or buzzing in the ears

spitting blood

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea

lessening or loss of sense of taste

loss of appetite

nausea or vomiting

stomach pain (mild)

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Penicillamine (Depen)

thumbs-up

Pros

Can take long term for maintenance therapy

One of the few recommended treatments for Wilson's disease

Can help control symptoms of Wilson’s disease

Can use in children with cystinuria

thumbs-down

Cons

Need to take on an empty stomach

Might need to take multiple times a day

Can take 2 or 3 months before seeing the full effects of the medication for RA

Not safe for use during pregnancy and in people with kidney problems

pharmacist-tips

Pharmacist tips for Penicillamine (Depen)

pharmacist
  • Take penicillamine (Depen) at least 1 hour before meals or 2 hours after meals. Also make sure to take penicillamine (Depen) at least 1 hour apart from any other foods or medications that contain aluminum, calcium, iron, magnesium, or zinc. Food and products containing these minerals can affect how well penicillamine (Depen) gets absorbed into the body.

    • Tips for taking penicillamine (Depen) to treat cystinuria: If you can't take four equal doses during the day, it's important to take the largest dose at bedtime. Make sure to drink about 2 cups of water at bedtime and another 2 cups during the middle of the night. Your risk of kidney stones is higher at night when your urine is very concentrated and acidic, so it’s important to dilute your urine to prevent stones from forming.

      • Since penicillamine (Depen) can cause serious side effects, including blood, kidney, and liver problems, you might need to get regular blood and urine tests done during treatment. This is how your provider can check for these side effects.

        • Some people who take penicillamine (Depen) experience a change or loss in taste. This can last 2 to 3 months or longer after you start the medication. But, it should go away on its own without any treatment.

          • You might notice skin changes, like red spots in certain areas of your skin or skin that gets damaged more easily, while you're taking penicillamine (Depen). The medication can affect the strength of your skin and prevent normal healing.

            • Make sure to let your provider know if you have a planned surgery. Because penicillamine (Depen) can affect wound healing, your dose might need to be lowered so you can make a full recovery from surgery. Once you've healed completely, your dose can be raised again.

              • Because penicillamine (Depen) raises your body's requirement for vitamin B6, ask your provider about taking supplements during treatment.

                • In addition to taking penicillamine (Depen), you might need to be on a special diet to treat Wilson’s disease or cystinuria. If you have Wilson’s disease, you’ll need to be on a diet containing no more than 1 mg or 2 mg of copper per day. If you have cystinuria, you’ll need to be on a low methionine (protein) diet. Ask your provider or nutritionist about a diet plan that's best for you.

                  • If you've stopped taking penicillamine (Depen), even just for a few days, let your provider know before restarting the medication. It's important that you restart the medication at a low dose to help prevent side effects.

                    faqs

                    Frequently asked questions about Penicillamine (Depen)

                    How long does it take for penicillamine (Depen) to relieve my arthritis symptoms?
                    For RA, penicillamine (Depen) works slowly compared to other medications. It might take 2 or 3 months before you notice the full effects of the medication. Generally, you should see improvement in symptoms, such as pain, tenderness, and swelling, by this time if you respond to penicillamine (Depen).
                    How long does it take for penicillamine (Depen) to improve symptoms of Wilson's disease?
                    It can take about 2 to 6 months of treatment with penicillamine (Depen) for you to see improvement if you have symptomatic Wilson's disease. Symptoms of Wilson's disease can include yellowing of the skin or whites of the eyes (jaundice) and stomach bloating It's important to note that symptoms of Wilson's disease related to the nervous system (trouble speaking, movement problems, changes in behavior) can sometimes get worse when you first start penicillamine (Depen). But, they should improve as you continue treatment. Let your provider know if these symptoms don't improve after a few months of starting penicillamine (Depen).
                    Is penicillamine (Depen) the same as penicillin?
                    No, penicillamine (Depen) isn't the same as penicillin. These two medications are used for different conditions. Penicillamine (Depen) is used to treat Wilson's disease, cystinuria, and severe rheumatoid arthritis. On the other hand, penicillin is an antibiotic that treats several bacterial infections. In the past, penicillamine (Depen) was made from penicillin. But now, penicillamine (Depen) is made in the lab without using penicillin directly.
                    Can I take penicillamine (Depen) if I have a penicillin allergy?
                    If you're allergic to penicillin, it's possible you might have an allergic reaction to penicillamine (Depen). But, the chance of having an allergic reaction from penicillamine (Depen) is quite low since it’s now made without using penicillin directly (unlike in the past).
                    Is it safe to take penicillamine (Depen) while pregnant?
                    No, it's not safe to take penicillamine (Depen) while pregnant. This medication can cause harm to your unborn baby. Talk to your provider about alternative medications if you're pregnant or planning on becoming pregnant. Let your provider know if you become pregnant while you're taking penicillamine (Depen). This is especially important if you have Wilson's disease because stopping the medication can cause your condition to come back and have fatal effects. Discuss with your provider about the risks and benefits of taking penicillamine (Depen) during pregnancy.
                    Does penicillamine (Depen) have any interactions?
                    Yes. Foods, supplements, and medications containing aluminum, calcium, iron, magnesium, and zinc can interact with penicillamine (Depen). These minerals can attach to the medication in your stomach. As a result, penicillamine (Depen) can't get absorbed into your body and work properly. For this reason, it's important to take penicillamine (Depen) on an empty stomach, at least 1 hour before or 2 hours after meals, and at least 1 hour apart from any other foods or medications that contain the minerals mentioned above.
                    What's the difference between penicillamine (Depen) and trientine (Syprine)?
                    Penicillamine (Depen) and trientine (Syprine) are both chelating agents. This means that they both attach to copper in your body to treat Wilson’s disease. Studies suggest that trientine (Syprine) might be better tolerated than penicillamine (Depen). But, trientine (Syprine) isn't approved to treat cystinuria or rheumatoid arthritis. Compare between penicillamine (Depen) and trientine (Syprine), and talk to your provider about which medication is right for you.
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                    What are the risks and warnings for Penicillamine (Depen)?

                    Penicillamine (Depen) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                    risk-warning

                    Requires close monitoring by your provider

                    You should be under close supervision of your provider while you're taking penicillamine (Depen). This medication can cause many side effects, like blood problems, kidney problems, skin problems, and fever. You'll need regular lab work done and follow ups with your provider to make sure penicillamine (Depen) is safe for you. Tell your provider if you have any side effects while taking this medication.

                    risk-warning

                    Serious blood problems

                    • Risk factors: History of blood problems | Taking medications like gold therapy, antimalarial medications, cytotoxic medications, oxyphenbutazone, or phenylbutazone

                      Penicillamine (Depen) can cause potential blood problems. These problems include low white blood cells, low red blood cells, and low platelets (blood cells that help clot blood when you get a cut). Taking certain medications like gold therapy (e.g., Ridaura (auranofin)), antimalarial medications, cytotoxic medications (e.g., methotrexate), oxyphenbutazone, or phenylbutazone can raise your risk of developing blood problems. Let your provider know if you have a history of blood problems or are taking any medications that might cause them before starting penicillamine (Depen). While you're taking this medication, you'll need to get blood tests done so your provider can check your blood cell counts. If you notice a fever, sore throat, chills, bruising, or bleeding, contact your provider right away.

                      risk-warning

                      Serious kidney problems

                      • Risk factors: History of kidney problems | Taking medications like gold therapy, antimalarial medications, cytotoxic medications, oxyphenbutazone, or phenylbutazone

                        Penicillamine (Depen) might cause you to have protein or blood in your urine, which can be a sign of kidney damage. This is more likely to happen if you have a history of kidney problems or take certain medications. Don’t take penicillamine (Depen) if you currently have kidney problems, and talk to your provider about alternative medications. You'll have to get regular urine tests done while you're taking penicillamine (Depen) so your provider can check your kidney health. If you notice any blood in your urine, tell your provider right away.

                        risk-warning

                        Fever

                        Some people might experience a fever in response to taking penicillamine (Depen), usually in the second or third week of therapy. If you experience a fever, stop taking the medication and let your provider know right away. If you're taking penicillamine (Depen) to treat Wilson's disease or cystinuria, your provider might start it again at a low dose once your fever goes away and then raise your dose slowly. For RA, your provider will probably change your medication because there are other options available.

                        risk-warning

                        Allergic reactions

                        Penicillamine (Depen) can sometimes cause rash. Rashes can occur as early as during the first few months of treatment or as late as 6 months or more after starting penicillamine (Depen). Let your provider know if you get a rash. If you get a very itchy rash on your stomach or back after 6 months or longer of penicillamine (Depen) treatment, your provider might stop the medication. And if you experience a rash with fever, swollen lymph nodes, or joint pain, tell your provider right away.

                        risk-warning

                        Vitamin and mineral deficiency

                        • Risk factors: Children | Menstruating women | Low copper or methionine diet

                          Penicillamine (Depen) can cause lower vitamin B6 levels in your body. Vitamin B6 is an important nutrient that helps keep you healthy. Penicillamine (Depen) attaches to vitamin B6 and prevents the vitamin from working in your body. In addition, if you need to be on a special diet for your condition, you might not be getting enough protein from your diet. This can cause low iron levels in your body. Ask your provider if you or your child should take supplements while taking penicillamine (Depen) to make sure your body gets the nutrients it needs.

                          risk-warning

                          Nerve problems

                          Some people using penicillamine (Depen) have experienced nerve problems affecting different parts of the body. Sometimes, these nerve problems are worse when you first start the medication. But, they should get better as you continue treatment. Symptoms of nerve problems can include drooping eyelids, double vision, and muscle weakness. Tell your provider right away if you notice any of these side effects.

                          risk-warning

                          Skin problems

                          Some people taking penicillamine (Depen) have developed pemphigus, a condition where your body's immune system attacks your skin and causes blisters and sores. If this happens, you might need to stop penicillamine (Depen) and get treated with medications called steroids or immunosuppressants. Tell your provider if you notice any blisters or sores on your skin.

                          dosage

                          Penicillamine (Depen) dosage forms

                          The average cost for 90 capsules of 250mg of Penicillamine (Depen) is $844.16 with a free GoodRx coupon. This is 97.06% off the average retail price of $28707.22.
                          capsule
                          Capsule
                          DosageQuantityPrice as low asPrice per unit
                          250mg90 capsules$844.16$9.38
                          tablet
                          Tablet
                          DosageQuantityPrice as low asPrice per unit
                          250mg90 tablets$893.28$9.93

                          Typical dosing for Penicillamine (Depen)

                          This medication is available as tablets and capsules. Take penicillamine (Depen) on an empty stomach and separate from other foods or medications that contain certain minerals. See Pharmacist Tips for more details on how to take penicillamine (Depen).

                          Wilson's disease

                          • Adults: Typically, your dose will depend on how much copper is in your urine and blood. The dose is usually between 750 mg and 1,500 mg taken by mouth every day, split into two doses. If you aren’t tolerating higher doses, you might start with 250 mg per day, and then your provider can raise your dose slowly to avoid side effects.

                          • Children: Ask your child’s provider about the appropriate dose your child should take.

                          Cystinuria

                          • Adults: The typical dose is 1 to 4 grams taken by mouth every day, split into four doses throughout the day. You might start at a dose of 250 mg every day. Then, your provider can raise the dose slowly. This helps better control how well the medication works and avoid side effects.

                          • Children: The dose will depend on your child’s body weight. The typical dose is 30 mg/kg of weight taken by mouth every day, split into four doses throughout the day.

                          Rheumatoid arthritis

                          • Adults: The typical starting dose is 125 mg or 250 mg taken by mouth every day. Depending on how you respond to the medication, your provider might slowly raise your dose to a typical maintenance dose range of 500 mg to 700 mg per day. Dosages of more than 500 mg per day should be split into multiple doses throughout the day.

                          • Children: It isn’t known if penicillamine (Depen) works well in children with juvenile RA. Ask your child’s provider about alternative medications.

                          interactions

                          Interactions between Penicillamine (Depen) and other drugs

                          Penicillamine (Depen) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Penicillamine (Depen). Please note that only the generic name of each medication is listed below.

                          Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                          • Aurothioglucose

                          Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          • Auranofin
                          • Gold Sodium Thiomalate

                          Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          • Iron
                          drug-cost

                          How much does Penicillamine (Depen) cost?

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                          contraindications-icon

                          Penicillamine (Depen) contraindications

                          Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Penicillamine (Depen) will not be safe for you to take.
                          • Currently pregnant (except for people with Wilson’s disease or certain people with cystinuria)

                          • Currently breastfeeding

                          • History of blood problems after taking penicillamine (Depen)

                          • Have rheumatoid arthritis and kidney problems

                          alternatives

                          What are alternatives to Penicillamine (Depen)?

                          There are a number of medications that your doctor can prescribe in place of Penicillamine (Depen). Compare a few possible alternatives below.
                          Penicillamine (Depen)
                          Used for:
                          • Wilson's disease

                          • Cystinuria

                          • Severe rheumatoid arthritis (RA) when other medications haven’t worked well

                          $844.16 Lowest GoodRx priceView Prices
                          Used for:
                          • Prevention of cystine kidney stones

                          $703.39 Lowest GoodRx priceView Prices
                          Used for:
                          • Wilson's disease in people who can't take penicillamine (Depen)

                          $552.12 Lowest GoodRx priceView Prices
                          images

                          Penicillamine (Depen) images

                          White A98 - Penicillamine 250mg Capsule
                          This medicine is White Capsule Imprinted With "A98".White A98 - Penicillamine 250mg Capsule
                          White Amg 309 - Penicillamine 250mg Capsule
                          This medicine is White Capsule Imprinted With "Amg 309".White Amg 309 - Penicillamine 250mg Capsule
                          Yellow Par 146 - Penicillamine 250mg Capsule
                          This medicine is Yellow Capsule Imprinted With "Par 146".Yellow Par 146 - Penicillamine 250mg Capsule
                          White Apo Pen 250 - Penicillamine 250mg Capsule
                          This medicine is White Capsule Imprinted With "Apo Pen 250".White Apo Pen 250 - Penicillamine 250mg Capsule
                          White Amg 309 - Penicillamine 250mg Capsule
                          This medicine is White Capsule Imprinted With "Amg 309".White Amg 309 - Penicillamine 250mg Capsule
                          White Cuprimine Aton 705 - Penicillamine 250mg Capsule
                          This medicine is White Capsule Imprinted With "Cuprimine Aton 705".White Cuprimine Aton 705 - Penicillamine 250mg Capsule

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                          References

                          Best studies we found

                          Arthritis Foundation. (n.d.). Juvenile idiopathic arthritis (JIA).

                          Davison, A. M., et al. (1977). Effect of pencillamine on the kidney. Proceedings of the Royal Society of Medicine.

                          Jaffe, I. A., et al. (1964). The antipyridoxine effect of pencillamine in man. Journal of Clinical Investigation.

                          View All References (7)

                          Meda Pharmaceuticals. (2019). DEPEN- penicillamine tablet [package insert]. DailyMed.

                          Mejias, S. G., et al. (2023). Penicillamine. StatPearls.

                          National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Definition & facts for Wilson disease.

                          National Institutes of Health Office of Dietary Supplements. (2021). Vitamin B6.

                          Navinta LLC. (2022). PENICILLAMINE capsule [package insert]. DailyMed.

                          Schilsky, M. L., et al. (2022). A multidisciplinary approach to the diagnosis and management of Wilson disease: Executive summary of the 2022 practice guidance on Wilson disease from the American Association for the Study of Liver Diseases. Hepatology.

                          Weiss, K. H., et al. (2013). Efficacy and safety of oral chelators in treatment of patients with Wilson disease. Clinical Gastroenterology and Heptaology.

                          GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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