Quick answer

Ask your pharmacist or doctor before combining. Three official sources, NIH, MedlinePlus and the penicillamine label, say zinc can reduce how much penicillamine the body absorbs and should be taken apart from it. The label explains that metals can bind penicillamine in the gut, and adds that mineral supplements should not be given.^1,2,3

Key facts

NIH's consumer sheet says zinc supplements can reduce the amount of penicillamine the body absorbs.¹
NIH's sheet for health professionals says zinc can reduce both the absorption and the action of penicillamine.⁴
The label says to take penicillamine apart from any other drug, food, milk, antacid, zinc or iron-containing preparation, because metals can bind it in the gut.³
The label also says penicillamine's chelating action may increase the body's excretion of zinc and other heavy metals.³
MedlinePlus gives separate waiting times for zinc products and iron products, and the two are not the same.²

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.^1,3,4

On the medicine's label

What do NIH, MedlinePlus and the label say about zinc and penicillamine?

NIH's consumer sheet on zinc describes penicillamine as a drug used for rheumatoid arthritis and Wilson disease and says zinc supplements can reduce the amount of penicillamine the body absorbs. The sheet for health professionals says zinc can reduce both its absorption and its action. Both sheets give a minimum gap between the two.^1,4

The label says penicillamine should be taken apart from any other drug, food, milk, antacid, zinc or iron-containing preparation. That allows the most absorption and makes it less likely that metal binding in the gut will inactivate it. The label also says mineral supplements should not be given, since they may block the response.³

MedlinePlus asks people to tell their doctor and pharmacist about vitamins and nutritional supplements, and to take zinc products and iron products apart from penicillamine. It gives a separate waiting time for each, and they are not the same.²

Why would a metal change how penicillamine works?

MedlinePlus describes penicillamine as a heavy metal antagonist and says it works by binding extra copper so that it leaves the body in urine. The label points to the same chemistry in the gut: metals bind penicillamine and can inactivate it before it is absorbed. Zinc and iron appear by name in the label's list, along with food, milk and antacids.^2,3

The label adds that penicillamine is absorbed rapidly but incompletely, with wide differences between people, and that food, antacids and iron reduce how much is absorbed.³

Does penicillamine also lower zinc?

The label's list of side effects includes a note that the chelating action of the drug may cause increased excretion of other heavy metals such as zinc, mercury and lead. So the pairing can matter in two directions: zinc can lower how much medicine gets in, and the medicine can lower the body's zinc.³

The sources do not say how much zinc is lost, or whether zinc is checked as a matter of routine. Those are questions for the prescriber, and they are a reason not to settle the matter by adding or dropping a zinc product on your own.

Where does zinc turn up besides zinc tablets?

Almost all multivitamin and mineral supplements contain zinc.¹

NIH adds that zinc is available alone or combined with calcium, magnesium or other ingredients, and that it is also found in some denture adhesive creams and in over-the-counter products, including some labeled as homeopathic cold medications. The label's line that mineral supplements should not be given is general, so ask whether a multivitamin and mineral product counts. The sources do not address creams or cold products, which is not a finding either way.^1,3

Why does this page not state a gap between zinc and penicillamine?

NIH, the label and MedlinePlus each say to take zinc apart from penicillamine, and each gives a minimum wait. The right schedule depends on your whole day: the label says penicillamine is taken on an empty stomach and apart from food and milk, and MedlinePlus gives a different wait for iron products than for zinc products. Only a pharmacist who can see all your medicines and meals can set it, so this page does not copy a number.^2,3,4

Which of my products contain zinc, including a multivitamin or a cold product?
How should my zinc and penicillamine be spaced around meals and my other medicines?
Should my zinc level be checked while I take penicillamine?
Why am I taking penicillamine, and does that change the answer?

Questions people ask

Can you take zinc with penicillamine?

Ask your pharmacist or doctor first. NIH says zinc supplements can reduce the amount of penicillamine the body absorbs, and the label says to take penicillamine apart from zinc and iron products.^1,3

Do penicillamine and zinc need to be taken at different times?

Yes, according to NIH, the label and MedlinePlus, which all say to take them apart. Each gives a minimum wait, and your pharmacist can fit it to your own schedule.^1,2,3

Does the zinc in a multivitamin count for penicillamine?

NIH says almost all multivitamin and mineral supplements contain zinc, and the label says mineral supplements should not be given. Ask your prescriber before using one.^1,3

Can penicillamine lower zinc in the body?

The label says its chelating action may increase excretion of heavy metals such as zinc. It does not say how much, so ask your prescriber about monitoring.³

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Sources

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