Cuprimine

Risk for aplastic anemia, agranulocytosis, thrombocytopenia, Goodpasture's syndrome, and myasthenia gravis; may be fatal. Risk for serious hematological and renal adverse reactions. Obtain routine urinalysis, WBCs with differential, hemoglobin, and direct platelet count twice weekly. Monitor skin, lymph nodes, and body temperature during the 1^st month of therapy, every 2 weeks for the next 5 months, and monthly thereafter. Bone marrow depression. Discontinue if WBC <3500/mm³ occurs. Withold therapy if platelets <100,000/mm³, a progressive fall in either platelet or WBC count in 3 successive determinations occurs. Signs of membranous glomerulopathy leading to nephrotic syndrome; monitor closely if proteinuria and/or hematuria develops. Obtain LFTs every 6 months during therapy; and at least every 3 months during the 1^st year for Wilson’s disease. Discontinue immediately if abnormal urinary findings associated with hemoptysis and pulmonary infiltrates on X-ray occur. Evaluate if pulmonary symptoms develop. Discontinue if pemphigus is suspected; or if late rash (on the trunk) with intense pruritus and is unresponsive to topical corticosteroid therapy, or drug eruption accompanied by fever, arthralgia, lymphadenopathy, or other allergic manifestations occur. Possible lupus erythematosus-like syndrome in certain patients with positive antinuclear antibody (ANA) test. In rheumatoid arthritis (with moderate degrees of proteinuria): obtain quantitative 24-hour urinary protein determinations at 1–2 week intervals (do not increase dosage); discontinue or reduce dose if proteinuria is >1g/24hrs or progressively increasing. In rheumatoid arthritis: discontinue therapy if unexplained gross hematuria, persistent microscopic hematuria, or drug fever (consider alternatives) develops. In Wilson’s disease or cystinuria: consider risks/benefits of continuing treatment in those with potentially serious urinary abnormalities. Withhold therapy if drug fever occurs until reaction subsides. Perform annual X-ray for renal stones in cystinuria. Penicillin allergy. May increase the amount of soluble collagen. Elderly. 

Risk for aplastic anemia, agranulocytosis, thrombocytopenia, Goodpasture's syndrome, and myasthenia gravis; may be fatal. Risk for serious hematological and renal adverse reactions. Obtain routine urinalysis, WBCs with differential, hemoglobin, and direct platelet count twice weekly. Monitor skin, lymph nodes, and body temperature during the 1^st month of therapy, every 2 weeks for the next 5 months, and monthly thereafter. Bone marrow depression. Discontinue if WBC <3500/mm³ occurs. Withold therapy if platelets <100,000/mm³, a progressive fall in either platelet or WBC count in 3 successive determinations occurs. Signs of membranous glomerulopathy leading to nephrotic syndrome; monitor closely if proteinuria and/or hematuria develops. Obtain LFTs every 6 months during therapy; and at least every 3 months during the 1^st year for Wilson’s disease. Discontinue immediately if abnormal urinary findings associated with hemoptysis and pulmonary infiltrates on X-ray occur. Evaluate if pulmonary symptoms develop. Discontinue if pemphigus is suspected; or if late rash (on the trunk) with intense pruritus and is unresponsive to topical corticosteroid therapy, or drug eruption accompanied by fever, arthralgia, lymphadenopathy, or other allergic manifestations occur. Possible lupus erythematosus-like syndrome in certain patients with positive antinuclear antibody (ANA) test. In rheumatoid arthritis (with moderate degrees of proteinuria): obtain quantitative 24-hour urinary protein determinations at 1–2 week intervals (do not increase dosage); discontinue or reduce dose if proteinuria is >1g/24hrs or progressively increasing. In rheumatoid arthritis: discontinue therapy if unexplained gross hematuria, persistent microscopic hematuria, or drug fever (consider alternatives) develops. In Wilson’s disease or cystinuria: consider risks/benefits of continuing treatment in those with potentially serious urinary abnormalities. Withhold therapy if drug fever occurs until reaction subsides. Perform annual X-ray for renal stones in cystinuria. Penicillin allergy. May increase the amount of soluble collagen. Elderly. 

Risk for aplastic anemia, agranulocytosis, thrombocytopenia, Goodpasture's syndrome, and myasthenia gravis; may be fatal. Risk for serious hematological and renal adverse reactions. Obtain routine urinalysis, WBCs with differential, hemoglobin, and direct platelet count twice weekly. Monitor skin, lymph nodes, and body temperature during the 1^st month of therapy, every 2 weeks for the next 5 months, and monthly thereafter. Bone marrow depression. Discontinue if WBC <3500/mm³ occurs. Withold therapy if platelets <100,000/mm³, a progressive fall in either platelet or WBC count in 3 successive determinations occurs. Signs of membranous glomerulopathy leading to nephrotic syndrome; monitor closely if proteinuria and/or hematuria develops. Obtain LFTs every 6 months during therapy; and at least every 3 months during the 1^st year for Wilson’s disease. Discontinue immediately if abnormal urinary findings associated with hemoptysis and pulmonary infiltrates on X-ray occur. Evaluate if pulmonary symptoms develop. Discontinue if pemphigus is suspected; or if late rash (on the trunk) with intense pruritus and is unresponsive to topical corticosteroid therapy, or drug eruption accompanied by fever, arthralgia, lymphadenopathy, or other allergic manifestations occur. Possible lupus erythematosus-like syndrome in certain patients with positive antinuclear antibody (ANA) test. In rheumatoid arthritis (with moderate degrees of proteinuria): obtain quantitative 24-hour urinary protein determinations at 1–2 week intervals (do not increase dosage); discontinue or reduce dose if proteinuria is >1g/24hrs or progressively increasing. In rheumatoid arthritis: discontinue therapy if unexplained gross hematuria, persistent microscopic hematuria, or drug fever (consider alternatives) develops. In Wilson’s disease or cystinuria: consider risks/benefits of continuing treatment in those with potentially serious urinary abnormalities. Withhold therapy if drug fever occurs until reaction subsides. Perform annual X-ray for renal stones in cystinuria. Penicillin allergy. May increase the amount of soluble collagen. Elderly.