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详细处方信息以本药内容附件PDF文件（201952015573130.pdf）的“原文Priscribing Information”为准
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部分中文D-PENAMINE处方资料（仅供参考）

【英文名称】D-PENAMINE

【适用证】

严重的活动性类风湿性关节炎。

作为治疗威尔森氏病和铅中毒的螯合剂。 D PENAMINE将增强金和汞以及其他重金属的尿液排泄。

在高流量方案不充分的情况下或与其一起治疗胱氨酸尿症。

【用法用量】

口服给药：

在所有接受D-青霉胺的患者中，重要的是D-PENAMINE空腹服用，至少在饭前一小时或饭后两小时，与其他任何药物，食物或其他药物相比至少一小时牛奶。

类风湿病::

一个月不超过250毫克，每隔不少于一个月增加相同的量，直至达到每日1500毫克的剂量。剂量应保持最低，这是有效的，以尽量减少副作用。许多患者每天服用750毫克的维持剂量，在决定进一步增加之前，让患者保持这个剂量数月可能是值得的。

没有预先确定的D-PENAMINE剂量适合所有患者，必须在几个月内仔细监测每个人的剂量。

D-青霉胺应分剂量给药。对维持剂量变化的治疗反应通常在六到八周内不会变得明显。

尽管继续使用全剂量，有些人仍未做出反应。如果在完全维持剂量的六个月后没有反应，则坚持使用D-PENAMINE没有什么意义。

有时，对特定剂量有反应的患者开始复发。其中大部分都会对应该是渐进的增长作出反应。血清阴性和血清阳性的类风湿性关节炎通常都对D-苯胺有反应。

作为螯合剂：

威尔逊病：

大多数成年患者需要每日剂量为1500毫克至2000毫克的药物。改善通常是缓慢的，虽然cupruresis是立即的，并且最初可能有临床恶化。除了最先进的情况外，通常可以预期实质性的改善。呕吐或不能吞咽的患者应给予肠外注射E.D.T.A.

铅中毒：

呕吐或无法吞咽的患者应给予肠外注射E.D.T.A.，但所有其他患者最好采用D-PENAMINE，每日口服250至1000毫克，分次剂量。

其他重金属中毒： D-PENAMINE将增强金，铁，锑，锌和汞的尿排泄。

胱氨酸尿症：

在白天游离流体后，单次500 mg剂量的退休可能会影响功能性肾脏的结石溶解。每日750至1000毫克，分次剂量通常是足够的，每日不必超过2000毫克。

【禁忌】

---对D-青霉胺过敏，但危及生命的情况除外。

--- D-PENAMINE不应用于接受金疗法或抗疟药物的患者。

【INDICATIONS AND USAGE】

Severe, active rheumatoid arthritis.

As a chelating agent in the treatment of Wilson's disease and lead poisoning. D PENAMINE will enhance the urinary excretion of gold and mercury and other heavy metals.

In the treatment of cystinuria in cases where high-fluid regimens are not adequate, or in conjunction with them.

【CONTRAINDICATIONS】

---Hypersensitivity to D-penicillamine, except in a life-threatening situation.

---D-PENAMINE should not be used in patients who are receiving gold therapy or antimalarial drugs.

【DOSAGE AND ADMINISTRATION】

For oral administration：

In all patients receiving D-penicillamine, it is important that D-PENAMINE be given on an empty stomach, at least one hour before meals or two hours after meals, and at least one hour apart from any other drug, food or milk.

Rheumatoid disease:：

Not more than 250 mg daily for one month, increasing by the same amount at intervals of not less than one month, until a daily dose of 1500 mg has been reached. The dose should be kept to the lowest which is effective in order to minimise side effects. Many patients respond to a maintenance dose of 750 mg daily, and it may be worthwhile to keep patients on this dosage for several months before deciding on a further increment.

There is no pre-determined dose of D-PENAMINE which will suit all patients, and the dose for each individual must be sought by careful monitoring over a period of months.

D-penicillamine should be given in divided doses. Therapeutic response to changes in maintenance dosage usually will not become evident for six to eight weeks.

Some do not respond despite continued use of full doses. There is little point in persevering with D-PENAMINE if there is no response after six months at a full maintenance dose.

Occasionally patients who have responded initially to a particular dose begin to relapse. Most of these will respond to an increase which should be gradual. Both seronegative and seropositive rheumatoid arthritis usually respond to D-PENAMINE.

As a chelating agent:

Wilson's disease:

Most adult patients require the drug in a daily dose of 1500 mg to 2000 mg. Improvement is often slow, though cupruresis is immediate and there may be clinical deterioration at first. Except in the most advanced case, substantial improvement can generally be expected. Patients who are vomiting or unable to swallow should be given parenteral E.D.T.A.

Lead Poisoning:

Patients who are vomiting or who are unable to swallow should be given parenteral E.D.T.A., but all others are best treated by means of D-PENAMINE in an oral dose of 250 to 1000 mg daily, in divided doses.

Other heavy metals poisoning:

D-PENAMINE will enhance the urinary excretion of gold, iron, antimony, zinc and mercury.

Cystinuria:

A single 500 mg dose on retiring, following free fluids during the day, may effect stone dissolution in a functioning kidney. 750 to 1000 mg daily in divided doses is generally adequate and it should not be necessary to exceed 2000 mg daily.

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详细处方信息以本药内容附件PDF文件（201952015573130.pdf）的“原文Priscribing Information”为准
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