Drug General Information (ID: DDI62PJLZN)
Drug Name			Penicillamine		Drug Info		Hydroxychloroquine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidotes				Antimalarial Agents
Structure

Mechanism of Penicillamine-Hydroxychloroquine Interaction (Severity Level: Moderate)
Additive immunosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Penicillamine				Hydroxychloroquine
Mechanism		Myelosuppressive effects				Myelosuppressive effects
Key Mechanism Factor 1
		Factor Name		Immunosuppressive effects
		Factor Description		Immunosuppression is when your immune system is not functioning as it should. The immune system is made up of cells, tissues and organs that help the body fight off infections. If the immune system is suppressed, an infection that your body was able to control may become serious or even fatal.
Mechanism Description		Additive immunosuppressive effects by the combination of Penicillamine and Hydroxychloroquine

Recommended Action
Management		In general, penicillamine and chloroquine or hydroxychloroquine therapy should not be administered concurrently. Caution is advised if these drugs must be used together. Pharmacologic response to penicillamine should be monitored more closely whenever chloroquine is added to or withdrawn from therapy, and the penicillamine dosage adjusted as necessary. Patients should be advised to notify their physician if they experience signs and symptoms of toxicity such as fever, chills, sore throat, unusual bruising or bleeding, hematuria, coughing, wheezing, unexplained shortness of breath, muscle weakness, or visual disturbances.

References
1	Haagsma CJ "Clinically important drug interactions with disease-modifying antirheumatic drugs." Drugs Aging 13 (1998): 281-9. [PMID: 9805209]
2	Product Information. Cuprimine (penicillamine). Merck &amp Co, Inc, West Point, PA.
3	Seideman P, Linstrom B "Pharmacokinetic interactions of pencillamine in rheumatoid arthritis." J Rheumatol 16 (1989): 473-4