Penciclovir

Cuprenil take orally, 1-2 hours before meals or 2 hours after a meal or other drugs. To wash down exclusively with water.

When Wilson's disease - Konovalov: for adults - at the beginning of treatment 250 mg / day, gradually increasing the dose to 1500 mg, rarely up to 2000 mg / day. The daily dose is taken fractionally during the day. The dose of Cuprenil is considered effective if the daily excretion of copper in the 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 the serum (not less than 10 μg / ml). Children - 20 mg / kg / day, the maximum daily dose - 500 mg.

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

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

In rheumatoid arthritis and scleroderma: Initial dose of Cuprenyl is 125 mg / day for 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 Cuprenil is 500 mg / day; if it is ineffective, treatment is canceled. With the improvement of the condition, the treatment is continued for 1-2 years, gradually reducing the dose to 250 mg, taken 1 time in 2 days.

With alcoholic cirrhosis of the liver: on an empty stomach, no less than 1 hour before or 2 hours after a meal (recommended before dinner), and no earlier than 1 hour after taking any other drugs, 250-125 mg once a day. Therapy is carried out under careful control of the activity of ALT and AST in the blood plasma.

During pregnancy in patients with Konovalov-Wilson's disease or cystinuria, penicillamine therapy is continued at a dose of no more than 1 g / day, in patients with rheumatoid arthritis, penicillamine is canceled.

If necessary, the use of penicillamine during lactation should stop breastfeeding.

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

In case of Konovalov-Wilson's disease or cystinuria, along with penicillamine, vitamin B is prescribed to be taken continuously.₆ (due to dietary restrictions used to treat these diseases); With prolonged treatment, these patients should be regularly X-ray or ultrasound of the kidneys and urinary tract. If signs of vitamin B deficiency develop₆ In patients with rheumatoid arthritis, as well as if the symptoms of this deficiency do not go away on their own, vitamin B is also prescribed.₆ at a dose of 25 mg / day.

A slow, gradual increase in the dose of penicillamine reduces the incidence of some adverse reactions. If a fever, lung, liver, severe hematological or neurological disorders, myasthenia, hematuria, lupus-like reactions, or other serious adverse reactions develop during the treatment, penicillamine is canceled and, if necessary, GCS is administered. In the case of the development of isolated proteinuria, if it does not increase and does not exceed 1 g / day, treatment with penicillamine is continued, in other cases it is canceled.