Distamine

What is it?

A penicillin derivative penicillamine, available as film-coated, white tablets in two strengths, containing 125mg of penicillamine (marked DS and 125) or 250mg of penicillamine (marked DM and 250).

Medical Uses

Severe active rheumatoid arthritis, heavy metal poisoning, chronic hepatitis, cystinuria, Wilson's disease (a defect in copper metabolism causing deposition of copper in the liver or brain, producing jaundice and cirrhosis, and mental retardation respectively) .

Dosage

Adults, for arthritis, 125-250mg each day for 4 weeks increasing by 125-2500mg at intervals of 4 to 12 weeks. Usual maintenance dose in the order of 500-750mg. Maximum daily dose 1.5g. Elderly patients, 125mg each day at first, increasing to 500750mg, with a maximum of 1 g per day. Children aged over 8 years, 2.5 to 5mg per kg of body weight each day at first for 1 month, increasing after 4-weeks as required. Maintenance 15-20mg/kg of body weight per day. For poisoning, adults and children, according to manufacturer's prescribing notes and as directed by physician.

Special Care

Insufficient kidney function, sensitivity to penicillin, blood, urine and functioning of kidneys should be monitored regularly during treatment.

Avoid Use

Pregnancy, breastfeeding, agranulocytosis (abnormal blood condition involving a reduction in the number of granulocytes), thrombocytopenia (abnormal condition in which there is a reduction in the number of blood platelets, leading to bleeding), lupus erythematosus (an inflammatory disease affecting the skin and some internal organs, regarded as an autoimmune disease).

Possible Drug and Food Interactions

Antacids, gold, zinc or iron salts, cytotoxic or antimalarial drugs, phenylbutazone.

Known Side Effects

Fever, rash, anorexia, polymyositis (inflammation of numerous muscles), nausea, blood disorders, Goodpasture's syndrome (cough, fainting, anaemia, kidney failure), loss of taste, pemphigus (a rare, severe disorder of the skin and mucous membranes), proteinuria (protein in urine), Stevens -Johnson syndrome (severe inflammatory disorder), myasthenia gravis (severe autoimmune disorder), haemolytic anaemia, SLE (Systemic Lupus Erythematosus), nephrotic syndrome (a kidney disorder). Rarely, blood in urine, baldness, enlargement of breasts, ulcerated mouth, infection and inflammation of lower respiratory tract and lungs.