Depen and/or Equivalents
|Drug||Related Drug Names|
|Depen 125mg and/or Equivalents||Penicillamine|
|Depen 250mg and/or Equivalents||Distamine, Penicillamine|
Depen Drug Description
Depen is an immunosuppressive drug mainly used to cure rheumatoid arthritis. The immunosuppressive are ones which suppress the activity of the immune system. They are sometimes necessary to control progressive arthritic disease, especially when it is resistant to other treatments. The blood needs to be monitored carefully for signs of toxicity while Depen is being used by a patient. Penicillamine, the main ingredient of Depen, was first used for its antirheumatic effect in the 1960s. Depen is a safe and effective drug in about 70% of rheumatoid arthiritis patients. It combines with metal ions inside cells, inhibiting those chemical reactions which lead to the formation and release of damaging free radicals. The drug is well absorbed, reaching maximum concentration in plasma within a couple of hours after its administration. 80% of the drug is excreted in feces and urine within 48 hours after intake, although trace amounts can be detected in plasma even after a few days. An unusual side effect of this drug is a loss of taste. This is the result of penicillamine combining with zinc ions, which are needed for the normal sensory activity of the taste buds. Although it is similar to penicillin, patients with an allergy to penicillin can usually take Depen safely.
Conditions Treated by Depen
If NSAIDs (non-steroidal anti-inflammatory drugs) are not effective enough to control the arthritis, or if a rapid response is needed, one of the best drugs is Depen. It inhibits the synthesis of DNA, preventing the dividion and multiplication of immune cells. It does so by inhibiting activity of dihydrofolate reductase (the enzyme which produces tetrahydrofolic acid and folic acid supplements are sometimes needed to avoid folic acid deficiency. Depen is useful for both rheumatoid arthritis and for systemic lupus erythematosus (SLE). It suppresses the immune system by interfering with the synthesis of DNA in the white blood cells, preventing cell division. Depen can also be applied for the treatment and cure of multifactorial liver fibrosis and poisoning from lead, copper, mercury, arsenic and thallium.
In Wilson's disease (hepatolenticular degeneration) patients, penicillamine’s chelate molecular structure comes into play. The thiol group has a high affinity for copper, and in case of this disease, the excess copper binds to the molecule of the drug and is excreted from the body through urine. Depen can be also be used in the treatment of heavy metal poisoning. Heavy metals can irreversibly bind to enzymes and inhibit their function by completely disabling them. In this case also, the chelating property of penicillamine is used. The molecule acts like a vacuum cleaner for heavy metals in the body. Cystine kidney stones occur when excessive cystine and homocysteine agglomerate to form a disulfide bridge. The thiol group of penicillamine is able to cleave the disulfide bonds and thus dissolve the urinary stones.
Depen Dosage Information
a.) Typical Dosage Recommendations
Depen is a powerful drug which can suppress the symptoms of arthritis. In many patients, it can suppress the disease process itself, so reducing the amount of joint damage. For this reason, it is often better to take them soon after a diagnosis of arthritis to try to prevent joint damage from developing. The drug is administered at a doctor's prescription. In the absence of a prescription, it is normally recommends to consume 1-2 tablets daily after meals for adults and children. In severe cases, the dose can be increased up to 5 tablets. In children (over 6 months’ age) one tablet per day is advisable. For rheumatoid arthritis, a gradually increasing dose of 0.500 to 1.750 mg each day is administered and combined with vitamins, especially vitamin B6 and iron products. Do not use during pregnancy and lactation. An exception is Wilson's disease in pregnancy, in which case the dose should be reduced to 1 mg each day.
b.) Missing a Dose
Try not to miss any dose as it may reduce the effectiveness of the drug. Take the skipped dose as soon as you remember about it. However, a skipped dose should not be taken together with the subsequent dose. That could result in overdosing.
Seek advice from your physician immediately if you think you’ve been overdosed. Nausea is the most common symptom of a Depen overdose.
Depen Side Effects
Since penicillamine is an acidic compound, it is absorbed well in the acid contents of the stomach. When it has passed into the cells it changes into an ionized form which means that it cannot easily escape from the cells. In other words, it tends to become trapped, and accumulate in the cells lining the stomach. In a normal person, prostaglandins are secreted by the stomach wall and tend to limit the amount of acid produced. They also promote the formation of a thick layer of mucus which helps to protect the stomach from being damaged by its own acid and they facilitate the repair of cells when damaged. Since Depen reduces the production of prostaglandins, there will be fewer of these hormones in the stomach of a person taking frequent doses of this drug. As a result, the stomach produces more acid but less protective mucus. Together, these effects irritate the stomach wall, perhaps with bleeding and ulcer formation.
Rare adverse effects of penicillamine include teratogenicity (hence in childbearing women it is important to ensure an effective contraceptive), skin lesions, renal impairment, bone marrow damage, Myasthenic syndrome.
As a rule, Depen should not be taken by anyone with a history of stomach or duodenal ulcers unless under close medical supervision. The intake of Depen may also induce chronic pemphigus and autoimmune syndrome similar to lupus with the appearance of antinuclear antibodies (ANA) and myasthenia gravis. Hypersensitive reactions such as rashes, itching, fever, hematuria, proteinuria, leucopenia, thrombocytopenia, hemolytic anemia, agranulocytosis, hepatitis, pancreatitis, anorexia, nausea, dysgeusia, vomiting, and epigastric pain have also been reported in some patients being treated with Depen.
Possible Drug Interactions With Depen
NSAIDs can interfere with the effects of Depen and should not be taken at the same time (for example, for a headache) unless a doctor has prescribed them. Such as the following:
Severe bleeding from the stomach can occur in occasional, unfortunate patients, particularly if Depen is taken when the stomach lining is already irritated by alcohol. So alcohol should be absolutely avoided during treatment with Depen.
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Notice: The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.