Distamine tablets contain the active ingredient penicillamine, Penicillamine has various properties that allow it to be used for several different conditions. (NB. Penicillamine tablets are also available without a brand name, ie as the generic medicine.)
Penicillamine is mainly used to treat rheumatoid arthritis and is referred to as a disease-modifying antirheumatic drug (DMARD). Unlike painkillers, these medicines work by suppressing the excessive activity of the immune system that causes the inflammation of the joints in rheumatoid arthritis. This actually slows progression of the underlying disease. DMARDs are used when painkillers called non-steroidal anti-inflammatory drugs (NSAIDs, eg ibuprofen, diclofenac, naproxen) do not provide sufficient relief from the pain of the arthritis. However, unlike NSAIDs, they can take up to six months to produce their full effect, so they don't provide immediate relief from the pain.
It is not understood exactly how penicillamine works when used to treat rheumatoid arthritis. However, it is known that it reduces the blood levels of certain inflammatory chemicals that the body's immune system produces in rheumatoid arthritis. Once these have fallen, the inflammation of the joints lessens, which helps relieve the pain.
You should not expect this medicine to reduce the pain in your joints for at least 6 to 12 weeks after starting treatment, because it can take this long to start working. If it has had no effect after one year of treatment then your doctor will ask you to stop taking it.
Penicillamine is also a type of molecule called a chelating agent. It binds to several heavy metals, including copper, lead and mercury, forming complexes. These complexes are readily removed from the body by the kidneys and are excreted in the urine.
This property of penicillamine means that it can be used to treat poisoning with heavy metals such as lead. It is also how it works in Wilson's disease, where there is a harmful build-up of excess copper in the body. Penicillamine binds to the excess copper, and allows the body to get rid of it in the urine.
Finally, penicillamine can be used to treat a condition called cystinuria, where excessive amounts of the amino acid cystine are excreted in the urine due to a problem with the kidneys. The excessive cystine passing through the kidneys into the urine can cause stones of cystine to form in the kidneys. Penicillamine reduces the amount of cystine that the kidneys filter into the urine. This helps prevent stones forming and allows existing stones to gradually dissolve.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
You should tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
You should not take iron tablets, zinc, or indigestion remedies (antacids) in the two hours before or after taking your penicillamine tablets, as these medicines reduce the absorption of penicillamine from the gut and could make it less effective.
You should not take digoxin in the two hours before or after taking your penicillamine tablets, as the penicillamine may reduce the absorption of digoxin from the gut and could make it less effective.
Penicillamine should ideally not be used in combination with gold treatment, as this may increase the risk of side effects.
There may be an increased risk of side effects on the blood cells if penicillamine is taken with other medicines that can reduce the ability of the bone marrow to make blood cells. These include the following:
There may be an increased risk of kidney problems if penicillamine is taken in combination with other medicines that can cause kidney problems. These include the following:
Penicillamine tablets are also available without a brand name, ie as the generic medicine.