Kuprenil (penicillin)

1 table contains:

Active substance:

penicillin 250 mg;

Auxiliary substances:

potato starch;

PVP;

talc;

magnesium stearate;

oxymethylpropyl cellulose;

polyoxyethylene glycol;

titanium dioxide;

dye (E122)

Kuprenil has a complex-forming, immunosuppressive, suppressive collagen synthesis effect.

Forms chelate complexes with ions of copper, mercury, lead, iron, arsenic, calcium, zinc, cobalt, gold. Reduces the absorption of copper from food and eliminates its excess in tissues.

Couprenil affects various parts of the immune system (suppression of T-helper function of lymphocytes, inhibition of neutrophil chemotaxis and isolation of enzymes from the lysosomes of these cells, enhancement of macrophage function).

It has the ability to disrupt collagen synthesis by splitting cross-links between newly synthesized tropocollagen molecules. It has an anti-inflammatory effect. Penicillin is an antagonist of pyridoxine (vitamin B ₆ ).

• rheumatoid arthritis,
• scleroderma,
• Wilson's disease,
• poisoning with lead, mercury, arsenic.

• hypersensitivity;
• agranulocytosis;
• systemic lupus erythemasus;
• myasthenia myasthenia;
• renal failure.

• distortion of taste sensations,
• nausea,
• vomiting,
• diarrhea,
• pain in the muscles and joints,
• violation of the blood pattern,
• impaired kidney function,
• allergic reactions.

Iron preparations reduce the absorption of penicillinamine and weaken its therapeutic effect.

Penicillin increases the neurotoxic effect of isoniazide.

Simultaneous use with penicillin may reduce the level of digoxin in blood plasma.

Kuprenil is taken orally, 1-2 hours before meals or 2 hours after meals or other MES. Wash down only with water.

In Wilson-Konovalov's disease: adults - at the beginning of treatment 250 mg/day, gradually increasing the dose to 1500 mg, rarely to 2000 mg/day. The daily dose is taken fractionally during the day. The Kuprenil dose is considered effective if the daily excretion of copper with urine (after 1 week of treatment) exceeds 2 mg. In the future, the adequacy of the dose is determined on the basis of the level of free copper in blood serum (at least 10 μg/ml). For children - 20 mg/kg/day, the maximum daily dose is 500 mg.

In case of acute metal poisoning: adults - 750-1500 mg/day, children - 30-40 mg/kg/day.

In case of cystinuria: adults - 750-2000 mg/day with simultaneous administration of vitamin B6 and compensation for copper deficiency, children - 90 mg/kg/day.

In rheumatoid arthritis and scleroderma: the initial dose of Kuprenil is 125 mg/day during the first week with regular general blood and urine tests. From the second week, the dose is increased to 250 mg/day, from the third - to 375 mg/day. Treatment with the last dose (375 mg/day) is carried out every day for 3 months. The maximum dose of Kuprenil is 500 mg/day, if it is ineffective, treatment is canceled. If the condition improves, treatment continues for 1-2 years, gradually reducing the dose to 250 mg, taken once every 2 days.

In case of alcoholic cirrhosis of the liver: on an empty stomach, at least 1 hour before or 2 hours after meals (recommended before dinner), and not earlier than 1 hour after taking any other LS, 250-125 mg once a day. The therapy is carried out under careful monitoring of ALT and AST activity in blood plasma.

Given the possibility of developing serious, sometimes life-threatening adverse reactions (especially frequent in patients with rheumatoid arthritis), penicillin is used only under constant medical supervision. During treatment, you should monitor a urine test and a clinical blood test 1 time in 2 weeks during the first 6 months of treatment, then monthly; once every 6 months, liver function is monitored.

In case of Konovalov-Wilson disease or cystinuria, vitamin B6 is prescribed simultaneously with penicillin for constant use (due to dietary restrictions used to treat these diseases); for long-term treatment, these patients should regularly undergo X-ray or ultrasound examination of the kidneys and urinary tract. In case of development of signs of vitamin B6 deficiency in patients with rheumatoid arthritis, as well as if the symptoms of this deficiency do not go away on their own, vitamin B6 is additionally prescribed at a dose of 25 mg/day.

A slow, gradual increase in the dose of penicillin can reduce the frequency of some adverse reactions. In case of development against the background of treatment of high temperature, lung, liver damage, pronounced hematological or neurological disorders, myasthenia, hematuria, lupus-like reactions or other severe adverse reactions, penicillin is canceled and, if necessary, prescribed GCS. In case of the development of isolated proteinuria, if it does not increase and does not exceed 1 g/day, treatment with penicillin continues, in other cases it is canceled.

Tablets