Single Centre Experience of Chelating Agents in Cystinuria

    April 2022 in “ The Journal of Urology
    Bitar Nadia, Purvor Trevor, Foran Niamh, Wells Hayley, Rottenberg Giles, Game David, Bultitude Matthew, Thomas Kay
    TLDR Both penicillamine and tiopronin have significant side effects, but trying the alternative drug can be beneficial if the first is not tolerated.
    The study examined the use of chelating agents, penicillamine and tiopronin, in 63 cystinuric patients at a single center. It found that both medications had significant side effects leading to discontinuation, with 36% stopping penicillamine and 30% stopping tiopronin due to adverse effects like nausea, dizziness, and hair loss. Despite previous reports suggesting a worse side effect profile for penicillamine, this study did not find a marked difference between the two drugs. Importantly, 50% of patients who could not tolerate the first medication were able to tolerate the second, indicating a benefit in trying the alternative drug if the first is not tolerated.
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