Penicillamine Other names: beta-Thiovaline D-Mercaptovaline D-Penamine D-Penicilamine D-Penicillamine D-Penicyllamine beta,beta-Dimethylcysteine Dimethylcysteine L-Penicillamine

The safety of penicillamine for use during pregnancy has not been established.

Wilson’s disease

There have been several cases of reversible cutis laxa in infants born to mothers taking penicillamine throughout pregnancy. Although there have been no controlled studies on the use of penicillamine during pregnancy, two retrospective studies have reported the successful delivery of 43 normal infants to 28 women receiving between 500 mg and 2000 mg of penicillamine daily. There are also anecdotal reports both of congenital abnormalities and of successful outcomes in patients who have remained on penicillamine during pregnancy. If treatment with penicillamine is to be continued following a risk-benefit analysis, consideratsion should be given to reducing the dose of penicillamine to the lowest effective dose.

Cystinuria

Whilst normal infants have been delivered, there is one report of a severe connective tissue abnormality in the infant of a mother who received 2000 mg penicillamine daily throughout pregnancy. Whenever possible, penicillamine should be withheld during pregnancy, but if stones continue to form, the benefit of resuming treatment must be weighed against the possible risk to the foetus.

Rheumatoid arthritis or chronic active hepatitis

Penicillamine should not be administered to patients who are pregnant, and therapy should be stopped when pregnancy is diagnosed or suspected, unless considered to be absolutely essential by the physician.

Due to the lack of data on the use in breast-feeding patients and the possibility that penicillamine may be transmitted to newborns through breast milk, penicillamine should only be used in breast-feeding patients when it is considered absolutely essential by the physician.

None known.