What are the pre-evaluation and monitoring required for prescribing D-penicillamine/bucillamine?

Before starting D-penicillamine or bucillamine, it is necessary to conduct CBC, creatinine, urine routine, and dip stick for urine protein (Chakravarty K et al. 2008). Patients with low count, proteinuria, and pre-existing renal conditions are relative contraindications for starting these drugs. CBC, creatinine, and urine routine should be conducted once in 2 weeks initially, and once in 2 to 3 months subsequently (Chakravarty K et al. 2008).

REFERENCE
1. Chakravarty K, McDonald H, Pullar T, Taggart A, Chalmers R, Oliver S, Mooney J, Somerville M, Bosworth A and Kennedy T. BSR/BHPR guideline for diseasemodifying anti-rheumatic drug (DMARD) therapy in consultation with the British Association of Dermatologists. Rheumatology. 2008; 1-16.