See also How to Use section.
The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.
To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.
Some products that may interact with this drug include: digoxin, gold salts (such as auranofin), drugs to treat malaria (such as chloroquine), phenylbutazone, other drugs that decrease bone marrow function (such as azathioprine, cancer chemotherapy, trimethoprim/sulfamethoxazole).
This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.
In a double-blind study with ten healthy people, guar gum reduced penicillin absorption. Until more is known, to avoid this interaction, people taking penicillin should take it two hours before or after any guar gum-containing supplements. It remains unclear whether the smaller amounts of guar gum found in many processed foods would have a significant effect.
- Huupponen R, Seppala P, Iisalo E. Effect of guar gum, a fibre preparation, on digoxin and penicillin absorption in man. Eur J Clin Pharmacol 1984;26:279-81.
People taking penicillamine should discuss with their doctor whether it would be appropriate to take a zinc supplement (at a separate time of day from the penicillamine). However, people taking penicillamine should not supplement with zinc, unless they are being supervised by a doctor.
- Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 201.
Penicillamine therapy has been associated with sodium depletion. The frequency of this association remains unclear.
- Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 202
Penicillamine may increase vitamin B6 excretion, reduce activity, and increase the risk for vitamin B6 deficiency. It makes sense for people taking penicillamine to supplement with small (5–20 mg per day) amounts of vitamin B6. Some researchers have suggested that as much as 50 mg per day of vitamin B6 may be necessary.
- Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 203.
- Rothschild B. Pyridoxine deficiency. Arch Intern Med 1982;142:840.
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
One report found bromelain improved the action of antibiotic drugs, including penicillin and erythromycin, in treating a variety of infections. In that trial, 22 out of 23 people who had previously not responded to the antibiotics did so after adding bromelain four times per day. Doctors will sometimes prescribe enough bromelain to equal 2,400 gelatin dissolving units (listed as GDU on labels) per day. This amount would equal approximately 3,600 MCU (milk clotting units), another common measure of bromelain activity.
- Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143-60.
One of the main uses of penicillamine is to reduce toxic copper deposits in people with Wilson’s disease. People taking a copper supplement can make Wilson’s disease worse and may negate the benefits of drugs used to remove copper from the body.