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drug-medicine : distamine

 

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Medicine: distamine

 

Information for Patients

Please read this leaflet carefully before you start to take your medicine. It contains important information about Distamine tablets.

What's in your medicine?

The tablets come in two strengths (different sized tablets). Each Distamine tablet contains either 125 milligrams (mg) or 250mg D-penicillamine base (active ingredient) in bottles of 100 tablets. They all have a white coating. The 125mg tablets are 8mm across and are marked DS on one side and 125 on the other. The 250mg tablets are 10mm across and are marked DM on one side and 250 on the other.

They also contain the following inactive ingredients:

  • microcrystalline cellulose, povidone, sodium starch glycolate (Type A) and magnesium stearate. The coating contains glycerol, titanium dioxide (E171) and hypromellose.

Penicillamine is one of a group of drugs called disease-modifying antirheumatic drugs (DMARDS). Distamine is a chelating agent. This means that it binds to certain metals, including lead and copper, to help remove them from your body if necessary. Distamine also helps to relieve the pain and stiffness of rheumatoid arthritis if other medicines and rest have not worked.

What's this medicine used for?

Distamine is used to treat serious, active rheumatoid arthritis, including Still’s disease in children. It also treats Wilson’s disease, a condition where the body cannot get rid of copper properly; a kidney problem called cystinuria; lead poisoning; and chronic active hepatitis (a liver disease).

Distamine is not a painkiller so you should not expect to feel better straight away. After a few weeks you should feel better and your joints will be less stiff and painful.

Before taking your medicine

Your doctor will ask you to have a blood test and have your kidneys checked before you start taking Distamine. He or she will test your blood and urine regularly while you are taking your medicine. This is so that your doctor can adjust your dose and look out for any side effects.

Tell your doctor if any of the following applies to you.

  • You have ever had a rash or other possible allergic reaction to penicillamine or related compounds, or to any of the other ingredients in Distamine tablets (these are listed in ‘What’s in your medicine?’).
  • You have ever had agranulocytosis (fever, mouth ulcers and severe weakness) after taking penicillamine.
  • You have ever had lupus erythematosus (LE).
  • You are pregnant, trying to become pregnant or breast feeding.
  • You suffer from kidney problems.
  • You have ever had side effects with gold.
  • You are taking any other medicines for arthritis, including a non-steroidal anti-inflammatory drug (NSAID).
  • You are taking any other medicines (including those you have bought yourself). Some medicines can interfere with your treatment, so please check with your doctor or pharmacist before you take any medicines.

Treatment with Distamine

Your doctor will decide when and how to treat you with Distamine. Distamine can help to treat rheumatoid arthritis but not other kinds of arthritis.

 

Distamine should be taken on an empty stomach, at least half an hour before meals or at bedtime.

Usual doses: Adults

If you have kidney problems your doctor will start you on a lower dose.

Rheumatoid arthritis: take 125mg to 250mg a day for the first month. Your doctor will then tell you how to increase the dose gradually over several months until you are feeling better. He or she may then change your dose to keep you well. This new dose is usually 500mg to 750mg a day, but it can be as high as 1500mg. It may be several months before you feel better. If there is no improvement you should stop taking the tablets after a year. If you stay well for six months your doctor may reduce your dose. If you are elderly, you may be given a smaller dose. Do not take more than 1000mg a day.

Wilson’s disease: take 1500mg to 2000mg a day spread over three or four doses. Once you are better, your doctor may reduce your dose. It is best not to take 2000mg a day for more than a year. If you are elderly, your dose will depend on your weight. The usual dose is 20mg a day for each kilogram of body weight.

Cystinuria: if you have cystine stones your dose will be 1000mg to 3000mg a day. If you are taking the tablets to prevent stones you will take 500mg to 1000mg at bedtime. If you are elderly, your dose may be smaller.

Lead poisoning: take 1000mg to 1500mg a day in three or four doses until your doctor tells you that the amount of lead in your urine is normal. If you are elderly, your dose will depend on your weight. The usual dose is 20mg a day for each kilogram of body weight.

Chronic active hepatitis: start with 500mg a day. Your doctor will gradually increase the dose over three months, to 1250mg a day.

Children

The dose depends on the weight of the child.

Rheumatoid arthritis: 15mg to 20mg a day for each kilogram of body weight. You will start with a low dose for the first month and increase gradually.

Wilson’s disease: start with 500mg a day. Your doctor will tell you when to increase the dose to 20mg a day for each kilogram of body weight.

Cystinuria: the dose will depend on how ill the child is.

Lead poisoning: 20mg a day for each kilogram of body weight.

If you are not sure how many tablets to take, ask your doctor or pharmacist or the staff at the hospital you visit for tests and treatment.

  • Swallow the tablets with water
  • Always take your tablets at least half an hour before a meal, or at bedtime
  • If you are taking iron tablets, take them at least two hours after you have taken Distamine
  • Take your tablets for as long as your doctor tells you to
  • Do not take more tablets than your doctor tells you to

What to do if you take too much Distamine

If you accidentally take too many tablets, or someone else takes any of your medicine, you should tell your doctor at once or contact your nearest casualty department. Show any left-over medicines or the empty packet to the doctor.

What to do if you miss a dose

If you forget to take a dose, take it as soon as possible, unless it is almost time to take the next dose.

DO NOT take a double dose. Then go on as before. If you miss several doses, tell your doctor.

Side effects

Distamine tablets sometimes cause the following side effects in some people. Increasing the dose very slowly will help to control these side effects.

When you start taking the tablets you may feel sick or even be sick. You may lose your appetite or notice that food tastes different. These side effects usually wear off, but tell your doctor if they trouble you.

You will have regular blood and urine tests, especially when you start taking the tablets and when you increase the dose. These are to check for changes in your blood cell counts and to look for protein or blood in your urine.

Tell your doctor if you get any of the following.

  • Redness, a rash or itching
  • Fever or frequent infections
  • Boils
  • Blistery, swollen skin (pemphigus)
  • Unexplained bruising or bruising more easily
  • Muscle weakness
  • Painful, swollen joints
  • Sore mouth
  • Wrinkly skin
  • Hair loss
  • Rarely, both men and women have had swollen breast tissue
  • Severe abdominal pain
  • Vomiting

Other side effects that some patients have experienced: Allergic reactions. Anaemia. Lung or kidney problems. Other skin problems such as lupus erythematosus (LE), pancreatitis or jaundice.

If you suffer from Wilson’s disease and you experience a worsening of muscle spasms, muscle stiffness, tremor or slurred speech you should tell your doctor.

If your medicine upsets you in any other way, tell your doctor.

Storing your medicine

The expiry date for this medicine is printed on the bottle and carton. Do not use after this date.

Do not store above 25°C. Keep the bottle tightly closed. Keep out of the reach and sight of children. Your tablets could harm them.

If your doctor decides to stop your treatment, return any unused medicine to the pharmacist. Only keep it if your doctor tells you to.

Further information

Remember: This medicine is for you. Only a doctor can prescribe it for you. Never give it to others. It may harm them, even if their symptoms are the same as yours.

The information in this leaflet applies only to Distamine. If you have any questions or are unsure about anything, ask your doctor or pharmacist.

 

Medicamentweb.com, the website for Patient Information Leaflets, is dedicated to share information about pharmaceutical products with the general public, and is particularly interested in making PILs available online. Of course, this information cannot replace the advice of your GP, doctor or pharmacist. If you should be worried in any way about your health, we urge you to see a doctor.

 

 

 

 

 

 

 

 

 

 

 

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