Quick answer

Ask your pharmacist or doctor before combining. The penicillamine label, MedlinePlus and NIH document 2 supplements: copper, where the label says multivitamins must be copper-free during treatment for Wilson's disease, and zinc, which can lower how much penicillamine is absorbed. The label names iron products as well.^1,2,3

Key facts

MedlinePlus says penicillamine is used for Wilson's disease, cystinuria and severe rheumatoid arthritis.⁴
The label says multivitamins taken during treatment for Wilson's disease must be copper-free.¹
The label says mineral supplements should not be given, because they may block the response to penicillamine.¹
NIH says zinc supplements can reduce the amount of penicillamine the body absorbs.³
MedlinePlus gives iron products and zinc products their own schedules apart from penicillamine.⁴

What is penicillamine used for, and why do minerals matter with it?

MedlinePlus says penicillamine is used for Wilson's disease, an inherited condition in which copper builds up, for cystinuria, which can lead to kidney stones, and in combination with other treatments for severe rheumatoid arthritis. It belongs to a class called heavy metal antagonists, and in Wilson's disease it works by binding extra copper so that it leaves in the urine.⁴

A medicine whose job is to bind metals can be disturbed by other metals. The label gives that reason itself: it says metals bind and inactivate penicillamine, so it should be taken apart from other drugs, food, milk, antacids, and zinc or iron products.⁵

Do copper supplements and multivitamins affect penicillamine?

Copper is the one entry here tagged avoid, the strongest of the four tags, because it works against what penicillamine does in Wilson's disease. The label calls for a diet that leaves out supplements enriched with copper, and MedlinePlus describes a low-copper diet that avoids cereals and dietary supplements enriched with copper.^1,2

Avoid the combination unless your doctor advises it

Penicillamine removes excess copper in Wilson's disease. Its label says multivitamins taken during treatment for Wilson's disease must be copper-free, that the diet should leave out supplements enriched with copper, and that mineral supplements should not be given because they may block the response to penicillamine.^1,2

On the medicine's label

The copper wording is written for people treated for inherited copper overload. The sources checked do not address copper for people who take penicillamine for cystinuria or arthritis. That is not a finding either way, so ask your pharmacist.¹

What does the label say about zinc and iron with penicillamine?

NIH's consumer sheet describes penicillamine as a drug used for rheumatoid arthritis and Wilson disease, and says zinc supplements can reduce how much of it the body absorbs. MedlinePlus gives iron products and zinc products schedules that differ from each other, which is one reason the schedule has to come from your pharmacist.^3,4

Ask your pharmacist how far apart to take them

Zinc can reduce how much penicillamine is absorbed and how well it works. NIH advises taking them apart, and the penicillamine label says to take it apart from zinc and iron products and not to give mineral supplements.^3,5,6

On the medicine's label

The label names iron products in the same sentence as zinc. No iron entry is listed for penicillamine on this page, so treat that wording as a prompt to ask about iron as well.^4,5

Can a prescriber add vitamin B6, and does that change the list?

MedlinePlus says your doctor will probably tell you to take a vitamin B6 supplement during treatment with penicillamine. That is a prescriber's instruction, so it is a reason to ask about any change to your supplement list in either direction, and not a reason to start or stop a vitamin on your own.⁴

How are the copper and zinc entries tagged?

Both entries are on the label. Copper carries the tag avoid, because the label uses must for copper-free multivitamins. Zinc carries the tag separate doses, because the sources ask for the two to be kept apart. Neither tag gives a schedule, and this page lists none.

What should you ask your pharmacist about penicillamine and supplements?

Is my multivitamin copper-free, and does my diet or any fortified product add copper?
Which of my products contain zinc or iron?
What schedule applies to my zinc and iron products around each dose of penicillamine?
Did my prescriber ask me to take vitamin B6, and which product should I use?
Does any of this change because of the condition I take penicillamine for?

Questions people ask

What supplements should I avoid with penicillamine?

The label and MedlinePlus point to copper, with a copper-free requirement for multivitamins during treatment for Wilson's disease, and to zinc and iron, which need their own schedules. Ask your pharmacist about any mineral product.^1,2,4

Can I take a multivitamin with penicillamine?

The label says multivitamins taken during treatment for Wilson's disease must be copper-free, and that mineral supplements should not be given because they may block the response. Ask your pharmacist about any multivitamin.¹

Does zinc interact with penicillamine?

NIH says zinc supplements can reduce the amount of penicillamine absorbed and how well it works. The label says to take penicillamine apart from zinc and iron products.^3,5

What vitamins should not be taken with penicillamine?

The sources document the minerals copper and zinc, and the label names iron. For vitamins, MedlinePlus says a doctor will probably add vitamin B6, so ask your pharmacist before you change any vitamin.^2,4

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Sources

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.