Depen

Depen contains the active ingredient penicillamine, which is a type of medicine called a chelating agent. This means it attaches to certain metals and toxins in your body so they can be removed more easily.

In Wilson's disease, a genetic condition where copper builds up in organs like the liver and brain, penicillamine binds to the excess copper and helps your body flush it out in urine.

For cystinuria, a genetic disorder where cystine stones form in the kidneys and bladder, penicillamine works by binding to cystine in the urine. This makes it easier for your body to get rid of, lowering the risk of stone formation and helping break down existing ones.

Depen is also used for rheumatoid arthritis, a condition where the immune system attacks the joints. While it’s not fully clear how penicillamine helps in RA, it has been found to reduce symptoms like swelling and pain.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Depen. However, the following is a synopsis of the general guidelines for the use of Depen:

• Take Depen on an empty stomach—either at least an hour before or two hours after meals.
• Make sure to stay well hydrated while using Depen.
• Avoid drinking milk for at least one hour before or after taking your dose.
• You'll need regular urine tests to monitor how the medication is working.
• When you first begin treatment, your symptoms might seem to get worse for a short time. Don’t adjust your dose or change how you take the medication without your doctor’s guidance. Ongoing medical supervision is essential for anyone taking Depen.
• Your doctor might also advise you to take specific supplements, like iron or vitamin B6. Only take those recommended by your doctor.

The most common side effects of Depen seen in clinical trials as compared to placebo include:

• Protein in the urine.
• Lupus-like symptoms, like muscle pain or feeling tired.
• Loss of appetite.
• Joint pain.
• Trouble breathing.
• Loss of taste.
• Skin wrinkling.
• Myasthenia gravis.

Some individuals may experience serious side effects while using Depen. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Low white blood cell count is indicated by frequent fevers, sore throats, or chills.
• Low platelets cause bruising and bleeding.
• Kidney disease manifests as blood in your urine.
• Allergic reaction to the medication, like blisters, skin rash, or hives.

These are not all of the possible side effects of Depen. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Depen, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• Are breastfeeding.
• Kidney disease.
• Developed an infection or have damaged blood cells after taking Depen in the past.
• Liver disease.
• Allergy to penicillin.
• Stomach ulcer.
• Weak immune system.
• Malnourished.

Currently pregnant (save for those with Wilson's illness or specific cystinuria cases)

Currently nursing.

History of blood issues following penicillamine (Depen).

Have rheumatoid arthritis and kidney issues.

History of penicillamine-related aplastic anemia.

Patients receiving this medication for rheumatoid arthritis: This medication should be taken on an empty stomach (at least 1 hour before or 2 hours after meals), and at least 1 hour before or after any other food, milk, or medicine. After you start taking this medication, it may take 2 to 3 months before you see any effects.

When Depen is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

Phenylbutazone.

This drug is available as pills and capsules. Take penicillamine (Depen) on an empty stomach, away from other mineral-containing meals or drugs. For additional information on how to take penicillamine (Depen), see Pharmacist Tips.

Wilson's Disease

Adults: Your dose is often determined by the amount of copper in your urine and bloodstream. The typical daily dose is between 750 mg and 1,500 mg, divided into two doses. If you are unable to tolerate greater doses, your provider may recommend starting with 250 mg per day and gradually increasing your dose to avoid side effects.

Children: Consult your child's provider to determine the right dose.

Cystinuria

Adults: A usual dose is 1 to 4 grammes given orally every day, divided into four doses during the day. Start with 250 mg each day. Then, your provider might gradually increase the dose. This allows for better control over how well the medication works and prevents negative effects.

Children: The dosage will be determined by your child's weight. The normal dose is 30 mg/kg of weight administered orally four times each day.

Rheumatoid arthritis.

Adults: The typical starting dose is 125 mg or 250 mg administered orally every day. Depending on how you respond to the drug, your doctor may gradually increase your dose to a common maintenance dose of 500 mg to 700 mg per day. Dosages more than 500 mg per day should be divided into many doses throughout the day.

Children: It is unclear whether penicillamine (Depen) performs well in children with juvenile RA. Consult your child's doctor about alternate drugs.

Store at room temperature and keep out of reach of children.

Aspen Pharmacare is the company that manufactures Depen.

There are several lower-cost generic name versions available of Depen/

Do not discontinue penicillamine without consulting your doctor, especially if your symptoms worsen.

Depen may harm an unborn baby and should not be taken to treat cystinuria or rheumatoid arthritis when pregnant.

Depen can be administered during pregnancy to avoid a return of Wilson's illness. If this illness is not treated during pregnancy, the mother may suffer serious or fatal complications. The benefits of avoiding a relapse of Wilson's illness may exceed the dangers to the newborn.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.