Common side effects include rash, loss of appetite, nausea, diarrhea, and low blood white blood cell levels. Other serious side effects include liver problems, obliterative bronchiolitis, and myasthenia gravis. It is not recommended in people with lupus erythematosus. Use during pregnancy may result in harm to the baby. Penicillamine works by binding heavy metals; the resulting penicillamine–metal complexes are then removed from the body in the urine.
Bone marrow suppression, dysgeusia, anorexia, vomiting, and diarrhea are the most common side effects, occurring in ~20–30% of the patients treated with penicillamine.
Other possible adverse effects include:
* Nephropathy
* Hepatotoxicity
* Membranous glomerulonephritis
* Aplastic anemia (idiosyncratic)
* Antibody-mediated myasthenia gravis and Lambert–Eaton myasthenic syndrome, which may persist even after its withdrawal
* Drug-induced systemic lupus erythematosus
* Elastosis perforans serpiginosa
* Toxic myopathies
* Unwanted breast growth
* Oligospermia