Possible Interaction: Penicillamine and Vitamin B 6

“Therefore the adverse effect of a diet free of vitamin B6 is distinctly increased by additional application of a vitamin antagonist such as D-penicillamine for instance.”

“ Penicillamine reacts with the carbony1 group of pyridoxal to form thiazolidine structures (Wolfe & Elliott, 1955).”

“… d-penicillamine … pyridoxine , lowering seizure threshold, or it may be related to the possible “paradoxical reaction” to excess copper mobilization.[6] Copper deposition in brain causes …, gliosis, laminar necrosis, spongy degeneration, and cavitation causing focal seizure activity,[6] which probable explains seizures as the initial presentation in our patient.”

“Abstract The erythrocyte alanine aminotransferase (Ala-AT) activity, measured in vitro , of rheumatoid arthritis patients under treatment with penicillamine was markedly stimulated by the addition of excess pyridoxal-5′-phosphate ( PLP).”

“We have used the D-isomer of penicillamine rather than the racemic (DL) mixture because L-penicillamine antagonizes pyridoxal phosphate and is known to be toxic in experimental animals (Aposhian and Aposhian, 1959).”

“ Penicillamine and thiosemicarbazide, at doses which lowered brain levels of pyridoxine by only 10%, increased seizure risk.”

“By itself, DPA produced a transitory decrease in both food consumption and body weight, which could be prevented with vitamin B6.”

“Simultaneous injection of vitamin B6 with D-penicillamine produced a recovery in the lowering vitamin B6 levels induced by D-penicillamine in serum and liver and enhanced the urinary excretion of Cu, but did not influence the serum content of Cu.”

“Therapy of a B6-responsive transplantable tumor in mice such as Sarcoma 180, with the use of pyridoxine deficient diet plus administration of L-penicillamine was successful in significantly retarding the in vivo development of the tumor.”

“Examination of cellular vitamin B6 compounds showed that pyridoxal 5'-phosphate was markedly decreased when L-penicillamine was present, in agreement with the probable reaction of the inhibitor with the coenzyme.”

“The following findings indicated that this was because L-penicillamine caused vitamin B6 deficiency in KG980; (a) addition of excess pyridoxine significantly reversed the inhibition, (b) comparison of the growth with various concentrations of pyridoxine showed that the vitamin requirement became higher upon addition of L-penicillamine.”