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Review
. 2021 May 28;10(6):648.
doi: 10.3390/antibiotics10060648.

D-Penicillamine: The State of the Art in Humans and in Dogs from a Pharmacological and Regulatory Perspective

Michela Pugliese  1 , Vito Biondi  1 , Enrico Gugliandolo  1 , Patrizia Licata  1 , Alessio Filippo Peritore  2 , Rosalia Crupi  1 , Annamaria Passantino  1
Affiliations
Review

D-Penicillamine: The State of the Art in Humans and in Dogs from a Pharmacological and Regulatory Perspective

Michela Pugliese et al. Antibiotics (Basel). .

Abstract

Chelant agents are the mainstay of treatment in copper-associated hepatitis in humans, where D-penicillamine is the chelant agent of first choice. In veterinary medicine, the use of D-penicillamine has increased with the recent recognition of copper-associated hepatopathies that occur in several breeds of dogs. Although the different regulatory authorities in the world (United States Food and Drugs Administration-U.S. FDA, European Medicines Agency-EMEA, etc.) do not approve D-penicillamine for use in dogs, it has been used to treat copper-associated hepatitis in dogs since the 1970s, and is prescribed legally by veterinarians as an extra-label drug to treat this disease and alleviate suffering. The present study aims to: (a) address the pharmacological features; (b) outline the clinical scenario underlying the increased interest in D-penicillamine by overviewing the evolution of its main therapeutic goals in humans and dogs; and finally, (c) provide a discussion on its use and prescription in veterinary medicine from a regulatory perspective.

Keywords: D-penicillamine; copper-associated hepatitis; dog; humans; prescription.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Structure of D-penicillamine.
Figure 2
Figure 2
Evaluating the appropriateness of extra-label use (ELU) in dogs.
See this image and copyright information in PMC

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