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Cilamin 250mg Capsule 10'S
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INTRODUCTION
CILAMIN 250MG contains Penicillamine which belongs to the group of medicines called Disease Modifying Anti-rheumatic Drugs (DMARDS). It is used to provide relief from the symptoms of rheumatoid arthritis (joint pain), including Still’s disease in both adults and in children when other medicines have not worked adequately. Due to its chelating property, it is also indicated for the management of Wilson’s disease (a genetic disorder characterized by accumulation of copper in the liver causing local degeneration), lead poisoning and cystinuria (presence of cysteine stones in the kidneys, ureter or bladders) in both adults and in children. It can also be used to treat chronic active hepatitis (a type of liver disease caused by copper accumulation) in adult patients.
Penicillamine acts by increasing the renal excretion of copper, lead and cysteine. It also suppresses body’s immune response and helps in reducing inflammation, pain and stiffness caused by rheumatoid arthritis. It promotes liver detoxification and protects your liver from further damage. Before and during treatment with CILAMIN 250MG, your doctor will ask you to take several blood test and urine test in order to monitor your blood count and kidney function, so that he can adjust your dose and prevent you from any unwanted side effects.
It works best when taken on an empty stomach. It is not a painkiller and so it will not make you feel better immediately. You should wait at least for a few weeks before you see any improvement in your condition. Avoid concomitant use of this medicine with iron products, antacids or digoxin as it may reduce its effectiveness.
The most common side effects of taking this medicine are unusual bleeding and protein in your urine. Before taking this medicine, inform your doctor if you have any blood problems. CILAMIN 250MG is highly contraindicated for use in patients having kidney disease and in pregnant and breastfeeding women. It should be used with caution in children and adolescents under 18 years of age. Suitable dose titration and careful monitoring are required in such patients.
USES OF CILAMIN 250MG
- Treats Wilson’s disease, cystinuria, lead poisoning and rheumatoid arthritis in both adults and in children
- Treats chronic active hepatitis in adults
HOW CILAMIN 250MG WORKS
Penicillamine is a chelating agent. It effectively chelates heavy metals such as copper and lead and promotes the excretion of these metals in urine. It also forms a soluble complex with cysteine which helps in the dissolution of cysteine calculi present in the kidneys, ureters or bladder. In rheumatoid arthritis, it acts by depressing the activity of T-lymphocytes and by increasing the levels of soluble collagen which reduces pain, stiffness, inflammation and swelling. In chronic hepatitis, it acts by enhancing liver detoxification and protects your liver from further damage.
DIRECTIONS FOR USE
Take CILAMIN 250MG as directed by your physician. It must be taken on an empty stomach either one hour before or two hours after meals. Swallow the medicine as whole with a sip of water. Do not crush or chew the medicine. Avoid consumption of milk while taking this medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and health condition. Continue to take this medicine, as long as your doctor tells you to do so, to obtain better results.
SIDE EFFECTS OF CILAMIN 250MG
SERIOUS
- allergic reaction (such as skin rash, itching, sudden swelling, difficulty in breathing, chest pain or fever)
- signs of thrombocytopenia (bruising easily, nose bleeds or bleeding gums)
- blood in urine
- signs of anemia (feeling tired or weak and paleness of the skin)
COMMON
- proteinuria (protein in urine)
RARE
- mouth ulcers or soreness
- swollen breast tissue
- hair loss
- wrinkles in the skin
- clusters of the small reddish bumps usually on the neck or arms
HOW TO MANAGE SIDE EFFECTS
Skin rash or itching:
Avoid hot showers because hot water can irritate the skin. Do not rub or scratch the affected area. Use sunscreen and protective clothing when outdoors. Regularly use moisturizers to soothe and hydrate the affected area. If it does not get better, speak to a doctor.
Hair loss:
Regularly wash your hair with mild shampoo. Take vitamin and enriched protein diet to reduce the hair loss. Part your hair and massage with essential oils. Avoid brushing your wet hair. Try to keep yourself hydrated.
WARNING & PRECAUTIONS
PREGNANCY
CILAMIN 250MG is not recommended for use in pregnant women unless necessary. Consult your doctor for advice before taking.
BREASTFEEDING
CILAMIN 250MG is not recommended for use in breastfeeding women unless necessary. Consult your doctor for advice before taking.
DRIVING AND USING MACHINES
Do not drive or operate any machines if your ability is affected by this medicine.
KIDNEY
CILAMIN 250MG is not recommended for use in patients with severe kidney disease. Consult your doctor for advice before taking.
ALLERGY
Do not take this medicine if you are allergic to penicillamine.
OTHERS
Before taking CILAMIN 250MG, inform your doctor if you:
- have Goodpasture's syndrome (bleeding from the lungs, glomerulonephritis and kidney failure)
- have myasthenia gravis (muscle weakness)
- have proteinuria (protein in urine)
- have blood in your urine
- have leucopenia (low white blood cells)
- are elderly (aged above 65 years)
INTERACTIONS
Talk to your doctor, if you are taking,
- gold-therapy products (used to treat rheumatoid arthritis) such as aurothioglucose, auranofin or gold sodium thiomalate)
- non-steroidal anti-inflammatory drugs (e.g. naproxen, phenylbutazone or ibuprofen)
- clozapine (a medicine used to treat schizophrenia)
- medicines used to treat anemia (e.g. iron supplements)
- antacids (used to neutralize stomach acid) e.g. aluminium hydroxide, magnesium hydroxide
- medicines used to treat malaria (e.g. mefloquine, quinine, chloroquine, hydroxychloroquine, primaquine, or pyrimethamine)
- medicines used to treat cancer (e.g. methotrexate, doxorubicin)
- digoxin (used to treat irregular heartbeat)
SYNOPSIS
| Drug | : | Penicillamine |
| Pharmacological Category | : | Chelating agent, Disease Modifying Anti-rheumatic drugs |
| Therapeutic Indication | : | Wilson’s disease, Cystinuria, Rheumatoid arthritis, Lead poisoning |
| Dosage Forms | : | Hard gelatin capsule |
MORE INFORMATION
Store below 20-25°C and keep out of reach of children.
FAQs ABOUT CILAMIN 250MG
Is CILAMIN 250MG is same as penicillin?
No. It is not a penicillin. However, discovered from the urine of patients taking penicillin, this medicine cannot kill or inhibit the growth of microorganism.
Is CILAMIN 250MG an antibiotic?
No. It is a chelating agent and does not kill or inhibit the growth of microorganism. It helps in the elimination of cysteine, copper and few other toxic heavy metals accumulated in the body.
Can CILAMIN 250MG be used during pregnancy?
No. It is highly contraindicated for use in pregnant women and is not recommended for use in them. Consult your doctor before taking.
REFERENCES
1. KD. Tripathi. Chelating Agents. Essentials of medical pharmacology. Seventh edition. 2013. Page – 907.
2. Michel C. Byrns and Trevor M. Penning. Environmental Toxicology: Carcinogens and heavy metals. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page – 1875.
3. Gerald G. Briggs and Roger K. Freeman. P. A reference guide to fetal and neonatal risk: Drugs in Pregnancy and Lactation. Tenth Edition. 2015. Page – 3026-3028.
4. FDA Office of Orphan Products Development. Penicillamine Chelation for Children with Lead Poisoning. NIH U.S. National Library of Medicine ClinicalTrials.gov. [Revised on March 2015] [Accessed 11th January 2021] https://clinicaltrials.gov/ct2/show/NCT00552630
5. Stuart K. Pitman, Tony Huynh, Thorarinn A. Bjarnason, Josiah An and Karen A. Malkhasyan. A case report and focused literature review of d-penicillamine and severe neutropenia: A serious toxicity from a seldom-used drug. NCBI; PMC US National Library of Medicine, National Institute of Health. April 2019. [Accessed 11th January 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509885/
6. B M McClements, M E Callender. D-penicillamine therapy in patients with HBsAg-negative chronic active hepatitis and major prednisolone-induced adverse effects. NIH National Library of Medicine. National Center for Biotechnology Information. Pubmed.gov. November 1990. [Accessed 11th January 2021] https://pubmed.ncbi.nlm.nih.gov/2290022/
7. Panacea Biotec Limited. CILAMIN CAPSULES (Wilson’s disease – Chelating agent). [Revised on September 2019] [Accessed 11th January 2021] https://media.panaceabiotec.com/documents/2019/7/27/ProductMonograph-CILAMIN.pdf
8. Kent Pharmaceutical Limited. Electronic Medicines Compendium (EMC); [Revised on June 2016] [Accessed 11th January 2021] https://www.medicines.org.uk/emc/files/pil.1240.pdf
9. Gerard Laboratories. Electronic Medicines Compendium (EMC); [Revised on September 2020] [Accessed 11th January 2021] https://www.medicines.org.uk/emc/files/pil.2712.pdf
USEFUL DIAGNOSTIC TESTS
- Rheumatoid Factor - Agglutination
- Rheumatoid Factor - Turbidometry
- Rheumatoid Factor IgG Antibody
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