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The safety and warnings for penicillamine (Depen) are crucial for users to understand, as this medication can pose several health risks. Below are the key points to consider while using this drug:

• Close Monitoring Required: Ensure you are under your healthcare provider’s close supervision while taking penicillamine (Depen). Regular lab tests and follow-up appointments are essential to monitor for potential side effects such as blood, kidney, or skin issues, as well as fever. Report any side effects to your provider immediately.

• Blood Complications: This medication can lead to serious blood issues, including reduced counts of white and red blood cells, and platelets. Your risk increases if you have a history of blood problems or are using specific medications like gold therapy, antimalarials, cytotoxics, oxyphenbutazone, or phenylbutazone. Regular blood tests will be necessary. Immediate medical attention is advised if you experience fever, sore throat, chills, bruising, or unusual bleeding.

• Kidney Concerns: Penicillamine (Depen) may cause protein or blood to appear in urine, indicating potential kidney damage. Those with a history of kidney issues or taking certain medications should avoid this treatment. Regular urine tests are required to check kidney health. Report any blood in your urine promptly.

• Fever Risk: A fever may occur, typically in the second or third week of treatment. If this happens, stop the medication and inform your provider immediately. Your provider might adjust your treatment depending on the condition being treated.

• Allergic Reactions: Rashes can develop at any stage of treatment. Inform your provider if you notice a rash, especially if accompanied by fever, swollen lymph nodes, or joint pain. Treatment might need to be adjusted.

• Vitamin and Mineral Deficiencies: Penicillamine (Depen) can lead to decreased levels of vitamin B6 and potentially low iron, especially in children, menstruating women, or those on specific diets. Consult your provider about the need for supplements.

• Nerve Issues: Some users may experience nerve problems, including drooping eyelids, double vision, or muscle weakness. These symptoms should be reported to a healthcare provider immediately.

• Skin Conditions: The medication may cause pemphigus, a serious skin condition resulting in blisters and sores. Consult your provider if you develop these symptoms.

Contraindications: Avoid using penicillamine (Depen) if you are currently pregnant (except for specific indications such as Wilson’s disease or cystinuria), breastfeeding, have a history of blood issues with this medication, or suffer from rheumatoid arthritis with kidney problems. Discuss with your healthcare provider if these conditions apply to you.

Always communicate with your healthcare provider regarding any concerns or unusual symptoms while taking penicillamine (Depen).

Common side effects:

• stomach or abdominal discomfort
• nausea
• vomiting
• diarrhea
• loss of appetite
• decreased sense of taste
• rash
• presence of protein in urine

Less common but important to monitor:

• fever
• lupus-like symptoms
• muscle pain
• fatigue
• hives
• skin changes
• wrinkling or flaking
• mouth sores
• ringing in the ears
• vision changes
• movement issues
• anxiety
• mood disturbances
• low platelet count
• low white blood cell count

Serious side effects:

• signs of significant infection
• persistent sore throat
• fever
• swollen lymph nodes
• easy bruising or bleeding
• coughing up blood
• difficulty breathing
• unusual fatigue
• rapid breathing
• skin blisters
• severe joint pain
• kidney problems
• change in urine output
• blood in urine
• liver issues
• persistent nausea or vomiting
• severe stomach pain
• dark urine
• yellowing of the eyes or skin
• muscle weakness
• eye problems
• drooping eyelids
• blurred vision
• serious allergic reaction
• rash
• swelling
• severe dizziness
• trouble breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Aurothioglucose

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Auranofin
• Gold Sodium Thiomalate

Interactions with low risk that usually do not require a change in therapy:

• Iron
• Digoxin
• Chloroquine
• Phenylbutazone
• Azathioprine
• Cancer chemotherapy
• Trimethoprim/sulfamethoxazole