effective in approximately 60% of patients within 3 months of commencing treatment (effective in 70% within 6 months)
adults: usual starting dose is 125 mg per day orally (seek expert advice before prescribing)
side effects in about 60% of patients - these will be sufficient to withdraw from penicillamine treatment in about 30% of patients
monitor monthly FBC, platelets, renal function, urine for protein
if a patient tolerates penicillamine, and it is effective, then treatment should be maintained at the lowest possible dose for as long as the RA is active
penicillamine may also be used in patients with connective tissue diseases such as scleroderma
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