Also known as (?)-penicillamine, .beta.,.beta.-Dimethylcysteine, Atamir, Beta,Beta-dimethylcysteine, Beta-thiovaline, Cuprenil, Cuprimine, Cupripen, D-Mercaptovaline, D-Penicillamine, Depamine, Depen, Distamine, Kelatin, Mercaptyl, Metalcaptase, PA, Pendramine, Perdolat, Sufortan, Trolovol

A beta dimethyl analog of the amino acid cysteine. As a degradation product of penicillin antibiotics, penicillamine chelates with heavy metals and increases their urinary excretion. Possessing antineoplastic properties, penicillamine induces apoptosis by a p53-mediated mechanism and inhibits angiogenesis by chelating with copper, a cofactor for angiogenesis. (NCI04)

Originator: NCI Thesaurus | Source: The website of the National Cancer Institute (http://www.cancer.gov)

Can I take Penicillamine while breastfeeding?

Limited information indicates that penicillamine is not detectable in breastmilk. Copper and zinc levels in breastmilk are reduced in mothers receiving penicillamine.[1][2][3][4][5] Penicillamine has been used with apparent safety during nursing of 3 infants. In infants who breastfeed infrequently, taking the drug right after nursing and waiting 4 to 6 hours before nursing again should minimize the amount of penicillamine in breastmilk. Copper and zinc levels in breastmilk are reduced in patients taking penicillamine. The implications for infants of this effect are not known.

Drug levels

Maternal Levels. Four patients received penicillamine for Wilson’s disease in dosages of 800, 600 (2 patients) and 500 mg daily. Penicillamine was not detectable by HPLC in the breastmilk of any of the mothers’ milk samples.[4]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Maternal Levels. Four patients received penicillamine for Wilson’s disease in dosages of 800, 600 (2 patients) and 500 mg daily. Penicillamine was not detectable by HPLC in the breastmilk of any of the mothers’ milk samples.[4]

Infant Levels. Relevant published information was not found as of the revision date.

Possible effects on lactation

Milk concentrations of zinc and copper are reduced during therapy of Wilson’s disease with penicillamine.[3][7][8][9]

Alternate drugs to consider

Auranofin, Etanercept, Gold Sodium Thiomalate, Hydroxychloroquine, Infliximab, Methotrexate, Sulfasalazine, Trientine

References

1. Byron MA. Treatment of rheumatic diseases. Br Med J. 1987;294:236-8. PMID: 3101825

2. Ramsey-Goldman R, Schilling E. Optimum use of disease-modifying and immunosuppressive antirheumatic agents during pregnancy and lactation. Clin Immunother. 1996;5:40-58.

3. Shiga K, Kaga H, Kodama H et al. Copper and zinc concentrations in the breast milk of mothers with Wilson disease and effects on infants. J Inherit Metab Dis. 2006;29 (Suppl 1):139. Abstract.

4. Izumi Y. [Can mothers with Wilson’s disease give her breast milk to their infant?]. Teikyo Med J. 2012;35:17-24.

5. Kaga F, Kodama H, Siga K et al. Copper and zinc status in the breast milk of mothers with Wilson disease. J Inherit Metab Dis 2008;31 (Suppl 1):157. Abstract.

6. Gregory MC, Mansell MA. Pregnancy and cystinuria. Lancet. 1983;2:1158-60. PMID: 6139526

7. Messner U, Gunter HH, Niesert S. [Wilson disease and pregnancy. Review of the literature and case report]. Z Geburtshilfe Neonatol. 1998;202:77-9. PMID: 9654718

8. Demir K, Soyer OM, Karaca C et al. The course of pregnancy in Wilson’s disease-one center, 20 years’ experience. Gastroenterology. 2014;146:S-1009. Abstract TU1834.

Last Revision Date

20140708

Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Source: LactMed – National Library of Medicine (NLM)

3D Model of the Penicillamine molecule

MolView – data visualization platform