ATRMIN 250MG CAPSULE belongs to the group of medicines called ‘chelating agents’ used to treat severe rheumatoid arthritis, Wilsons disease, and cystinuria. Rheumatoid arthritis is a joint disorder in which our immune system attacks our body cells. Wilson disease is a genetic problem characterized by excess copper deposited in body parts like the eye, brain, and liver leading to metal toxicity. Cystinuria is the excess build-up of an amino acid called cystine in the urinary bladder and kidney, leading to harmful effects. 

ATRMIN 250MG CAPSULE contains Penicillamine which works by blocking the action of certain chemical messengers responsible for inflammation and slows the progress of the condition with certain joint diseases. It works in Wilson's disease by binding to the extra copper in the body and causing it to leave the body through the urine. Decreasing copper levels improves liver function, and mental, mood, and nerve problems (like confusion, and difficulty speaking or walking) caused due to Wilson's disease. Besides this, ATRMIN 250MG CAPSULE is also used to treat cystinuria (kidney and bladder stone) and lead poisoning.

Take ATRMIN 250MG CAPSULE exactly as prescribed by your doctor. You are advised to take ATRMIN 250MG CAPSULE for as long as your doctor has prescribed it for you depending on your medical condition. In some cases, you may experience certain common side effects such as protein in the urine, low blood platelets, stomach upset or throwing up, diarrhoea, change in taste, loss of appetite,  mouth irritation, and mouth sores. Most of these side effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side effects persistently.

To treat your condition effectually, continue taking ATRMIN 250MG CAPSULE for as long as your doctor has prescribed. To avoid recurring symptoms, do not stop it midway. Do not take ATRMIN 250MG CAPSULE if you are pregnant or planning for pregnancy as ATRMIN 250MG CAPSULE causes serious congenital disabilities. ATRMIN 250MG CAPSULE should not be taken by breastfeeding mothers as it passes into breast milk. Your doctor may advise you to undergo regular blood tests, and kidney and liver tests to monitor your condition. Inform your doctor about your health condition and medicines to rule out any unpleasant side effects.

ATRMIN 250MG CAPSULE contains Penicillamine primarily used to treat Wilson's disease (copper builds up in the body and may result in serious symptoms) and cystinuria (kidney stones). It is also used in combination with other treatments to treat severe rheumatoid arthritis. The treatment of rheumatoid arthritis ATRMIN 250MG CAPSULE reduces pain, inflammation, and slow joint damage and disease progression over time; hence ATRMIN 250MG CAPSULE is known as a disease-modifying anti-rheumatic drug (DMARD). In Wilson's disease, ATRMIN 250MG CAPSULE works by binding to the extra copper in the body and causing it to leave the body through the urine. Decreasing copper levels improves liver function and the mental, mood, and nerve problems (such as confusion, and difficulty speaking/walking) caused by Wilson's disease. In cystinuria, it helps decrease the amount of a certain substance (cystine) by binding to that substance which can cause kidney stones and prevent it from building up and forming stones. Besides this, ATRMIN 250MG CAPSULE is also used to treat lead poisoning.

• Protein in urine
• Low blood platelets
• Stomach upset 
• Diarrhoea
• Change in taste
• Loss of appetite
• Mouth irritation
• Mouth sores

Do not take ATRMIN 250MG CAPSULE if you are allergic (hypersensitive) to penicillamine or any of the other ingredients in it. Inform your doctor if you have severe kidney problems, lupus erythematosus (an auto-immune disorder), agranulocytosis (a low white cell blood count), aplastic anaemia (symptoms including feeling tired, breathless, having pale skin and more susceptible to infection) or thrombocytopenia (a blood disorder which causes bleeding into your skin, bruising and bleeding more than normal). Do not take ATRMIN 250MG CAPSULE if you are pregnant or planning to get pregnant and breastfeeding. This medicine may cause harm to the unborn baby if you take it while you are pregnant. Caution should be required while taking ATRMIN 250MG CAPSULE by elderly patients as they may be at greater risk of suffering side effects if you are taking ATRMIN 250MG CAPSULE over a long time, especially if you are on a restricted diet, as this medicine increases the requirement for pyridoxine (Vitamin B6) so your doctor may also prescribe this vitamin for you. If you are taking iron tablets, antacids, or digoxin (used to treat heart failure), please maintain two hours gap between these tablets and ATRMIN 250MG CAPSULE. Low blood cell counts have happened while taking ATRMIN 250MG CAPSULE. If blood cell counts get very low, this can lead to bleeding problems, infections, or anaemia, and sometimes, these have been deadly. 

Drug-Drug Interactions: ATRMIN 250MG CAPSULE interacts with medicine used to treat low iron levels or anaemia (carbonyl iron, heme iron polypeptide), medicine used to treat rheumatoid arthritis (gold sodium thoimalate, auranofin, aurothioglucose), a medicine used to treat heart conditions (digoxin), antacids (aluminium hydroxide, aluminium carbonate), non-steroidal anti-inflammatory drugs (NSAIDs) (ibuprofen, indomethacin, naproxen, oxyphenbutazone, phenylbutazone), anti-malarial agents (chloroquine, hydroxychloroquine), the medicine used to treat the mental illness schizophrenia (clozapine), a medicine used in the treatment of Parkinson's disease (levodopa) medicines to treat cancers(azathioprine, cyclophosphamide),  immunosuppressive drugs (mycophenolate, cyclosporine), and zinc. 

Drug-Food Interactions: Do not take copper-containing foods like shellfish, chocolate, nuts, mushroom, and organ meats (liver pate, sweetbreads etc.)

Drug-Disease Interactions: ATRMIN 250MG CAPSULE should not be used in people with bone marrow suppression, kidney dysfunction, liver disease, anaemia, asthma and allergies.

• GOLD SODIUM THIOMALATE
• DIGOXIN
• ALUMINIUM HYDROXIDE
• IBUPROFEN
• INDOMETHACIN
• NAPROXEN
• OXYPHENBUTAZONE
• PHENYLBUTAZONE
• CHLOROQUINE
• HYDROXYCHLOROQUINE
• CLOZAPINE
• LEVODOPA
• AZATHIOPRINE
• CYCLOPHOSPHAMIDE
• MYCOPHENOLATE MOFETIL
• CYCLOSPORINE
• ZINC SULFATE
• CARBONYL IRON
• HEME IRON POLYPEPTIDE
• AURANOFIN
• AUROTHIOGLUCOSE
• ZINC ACETATE
• ZINC GLUCONATE

• Physical activity helps in strengthening muscles and relieves joint stiffness. Gentle activities like 20-30 minutes of walking or swimming would be helpful.
• Performing yoga may also help in improving joint flexibility and pain management.
• Maintain a healthy weight by performing regular low-strain exercises and eating healthy food.
• Get adequate sleep as resting the muscles can help in reducing inflammation and swelling.
• Follow heat or cold therapy, apply a cold or hot compress on the joints for 15-20minutes regularly.
• De-stress yourself by meditating, reading books, taking a warm bubble bath or listen to soothing music.
• Acupuncture, massage and physical therapy may also be helpful.
• Eat food rich in antioxidants such as berries, spinach, kidney beans, dark chocolate, etc.
• Foods containing flavonoids help in reducing inflammation. These include soy, berries, broccoli, grapes and green tea.
• Drink plenty of fluids.
• Limit consumption of spinach, wheat bran, nuts, beets and dairy products.
• Avoid high salt intake and foods containing baking soda.
• Follow work safety regulations if you are at risk of occupational exposure. Wear necessary protective gear while working and do not take any contaminated material such as clothing or work gear to home. 
• Avoid smoking and alcohol consumption.

• Your doctor may advise you to take blood and urine tests while using ATRMIN 250MG CAPSULE to examine your health condition and ensure that this medicine treats your condition.
• People with Wilson disease should avoid using copper-containing foods like shellfish, nuts, chocolate, mushroom, and organ meats. 
• Avoid using copper containers for drinking, cooking and eating. Ensure running water you drink should be reduced copper level up to the minimum. 
• If you are using any nutritional supplements or herbal supplements which contains copper tell your doctor about this. Your doctor may suggest any other alternative to this. 

Rheumatoid arthritis: It is an autoimmune disease (the body's immune system attacks its tissue), leading to joint pain and damage. Symptoms of rheumatoid arthritis include pain, inflammation of joints, difficulty moving, and swelling.

Wilson’s disease: It is a rare genetic disorder that causes excess copper in the body. Copper plays an important role in developing healthy nerves, bones, collagen, and the skin pigment melanin. Normally, copper is absorbed from the food; the liver filters out excess copper and releases it through urine. In People with Wilson’s disease, the liver cannot remove the extra copper properly, and the extra copper then builds up in organs such as the brain, liver, and eyes.

Cystinuria: It is the condition in which the amino acid called cystine in the urine, leading to the formation of cystine stones in the kidneys, ureters, and bladder. Cystinuria symptoms are usually sharp pain in the lower back or side of the abdomen (renal colic), blood in the urine (hematuria), obstruction of the urinary tract, and infections of the urinary tract.