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Bucillamine
General information
Bucillamine (mercaptomethylpropanoylcysteine) is chemically related to penicillamine and is also used in rheumatoid arthritis. Most of the information on bucillamine comes from Japan, its country of origin [ ].
The patterns of adverse reactions to sulfhydryl compounds that are used in rheumatoid arthritis (bucillamine, pyritinol, and tiopronin) show remarkable similarities to those of penicillamine [ ].
Drug studies
Comparative studies
In a retrospective 12-month review of the medical records of 348 patients with rheumatoid arthritis (ACR classification) bucillamine and methotrexate were compared [ ]. There were 74 adverse events in 71 patients; none was life-threatening. Rashes were the most common (47%) followed by proteinuria (25%). One patient had nephrotic syndrome for about 6 months; bucillamine was withdrawn and the patient made a good recovery. Other adverse events were stomatitis, glossitis, cough, and raised transaminase activities. Rashes mainly occurred in the first 3 months of use, while proteinuria often developed after a longer interval. The authors concluded that the effectiveness of bucillamine can usually be judged within 3 months of use and that it is indicated in the treatment of rheumatoid arthritis of moderate severity, either before or after methotrexate.
Organs and systems
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