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Tiopronin Medication: Uses, Dosage, and Side Effects Explained
Summary of Key Points
Tiopronin is a medication primarily used to treat conditions such as cystinuria, kidney stones, and certain autoimmune diseases. It works by reducing the formation of cystine stones in the kidneys and may also help manage conditions like rheumatoid arthritis and Wilson’s disease. It is essential to follow your healthcare provider’s instructions closely, as the dosage and duration of treatment can vary depending on the specific condition being treated.
Names of Medication
US Brand Name: Thiola EC (Tiopronin)
Medications often have both a brand name and a generic name. The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, Tiopronin is the generic name.
Pharmacologic Category
Thiola EC (Tiopronin) belongs to a class of medications known as Thiol-containing compounds.
Other medications in this category include D-penicillamine and Dimercaprol.
Tiopronin Dosage
Tiopronin is prescribed for various conditions, and the dosage will differ based on the specific condition being treated. Always consult your healthcare provider before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.
Tiopronin for Cystinuria Treatment
Initial dose: 800 mg to 1,000 mg per day, divided into three doses.
Maintenance dose: Adjusted based on urinary cystine levels, typically between 400 mg and 1,000 mg per day.
Tiopronin for Wilson’s Disease
Initial dose: 100 mg to 300 mg per day, divided into two or three doses.
Maintenance dose: Adjusted based on copper levels, typically between 300 mg and 600 mg per day.
Tiopronin for Rheumatoid Arthritis
Initial dose: 250 mg per day, taken once daily.
Maintenance dose: Gradually increased to 500 mg to 1,000 mg per day, depending on response and tolerance.
Tiopronin for Systemic Lupus Erythematosus (SLE)
Initial dose: 250 mg per day, taken once daily.
Maintenance dose: Gradually increased to 500 mg to 1,000 mg per day, based on response and tolerance.
Tiopronin for Cystinosis
Initial dose: 100 mg to 300 mg per day, divided into two or three doses.
Maintenance dose: Adjusted based on cystine levels, typically between 300 mg and 600 mg per day.
Tiopronin for Nephrolithiasis (Kidney Stones)
Initial dose: 800 mg to 1,000 mg per day, divided into three doses.
Maintenance dose: Adjusted based on urinary cystine levels, typically between 400 mg and 1,000 mg per day.
Tiopronin for Liver Disease
Initial dose: 100 mg to 300 mg per day, divided into two or three doses.
Maintenance dose: Adjusted based on liver function tests, typically between 300 mg and 600 mg per day.
Tiopronin for Hyperuricemia and Gout
Initial dose: 100 mg to 300 mg per day, divided into two or three doses.
Maintenance dose: Adjusted based on uric acid levels, typically between 300 mg and 600 mg per day.
Tiopronin for Kidney Stones
Initial dose: 800 mg to 1,000 mg per day, divided into three doses.
Maintenance dose: Adjusted based on urinary cystine levels, typically between 400 mg and 1,000 mg per day.
Dosage Forms and Strengths
Tablets: 100 mg, 300 mg
Extended-release tablets: 100 mg, 300 mg
Administration Instructions for Tiopronin
Take Tiopronin exactly as prescribed by your healthcare provider. It can be taken with or without food, but it’s important to take it at the same time each day to maintain consistent levels in your body. If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. Do not double up on doses. Be sure to drink plenty of water while taking Tiopronin to help prevent kidney stones.
Tiopronin Side Effects and Adverse Reactions
Like all medications, Tiopronin may cause side effects. Some are more common, while others are rare but potentially serious. If you experience any side effects, contact your healthcare provider promptly. You can also schedule a telemedicine visit with one of our providers for further evaluation.
Common side effects: Nausea, vomiting, loss of appetite, and diarrhea. These are usually mild and tend to resolve on their own.
Less common side effects: Skin rash, itching, or hives. These may indicate an allergic reaction and should be reported to your doctor.
Serious side effects: Fever, sore throat, unusual bleeding or bruising, and signs of infection. These require immediate medical attention.
Contraindications for Tiopronin
A contraindication is a specific condition where a treatment or medication should not be used due to potential harm. If you have any of the following conditions, you should not take Tiopronin or should discuss the risks with your healthcare provider before starting the medication.
Hypersensitivity to Tiopronin: If you have a known allergy to Tiopronin or any of its components, taking this medication could trigger a severe allergic reaction, including rash, itching, swelling, or difficulty breathing.
Severe Renal Impairment: Tiopronin is processed through the kidneys. If your kidneys are not functioning properly, the drug may accumulate in your body, leading to toxicity or worsening kidney function.
Pregnancy: Tiopronin may pose risks to the developing fetus, especially in the first trimester. It is generally not recommended during pregnancy unless the benefits outweigh the risks. (See more details in the “Tiopronin in Pregnancy” section below.)
Breastfeeding: The safety of Tiopronin during breastfeeding is not well established. It is recommended to avoid use during breastfeeding unless absolutely necessary. (See more details in the “Tiopronin while Breastfeeding” section below.)
Drug Interactions with Tiopronin
Tiopronin can interact with other medications, potentially altering its effectiveness or increasing the likelihood of side effects. It is important to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs, supplements, and herbal products. Some known interactions with Tiopronin include:
- Penicillamine (Cuprimine, Depen): Both Tiopronin and penicillamine are used to treat conditions like cystinuria and Wilson’s disease. Taking them together may heighten the risk of side effects such as bone marrow suppression or kidney damage.
- Gold compounds (Auranofin, Ridaura): These medications, often prescribed for rheumatoid arthritis, can increase the risk of kidney damage when combined with Tiopronin.
- Immunosuppressants (Azathioprine, Methotrexate): These drugs suppress the immune system and may raise the risk of infections or other complications when taken with Tiopronin.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) (Ibuprofen, Advil, Naproxen, Aleve): NSAIDs can elevate the risk of kidney damage when used alongside Tiopronin, particularly in patients with pre-existing kidney conditions.
Tiopronin and Pregnancy: Is It Safe?
Is it safe to take Tiopronin during pregnancy?
Tiopronin is generally not recommended during pregnancy, especially in the first trimester, as it may pose risks to the developing fetus. Animal studies have shown potential harm, and while human data is limited, the risks may outweigh the benefits. If you are pregnant or planning to become pregnant, it is essential to discuss your treatment options with your healthcare provider. In some cases, the benefits of continuing Tiopronin may outweigh the risks, but this decision should be made with careful consideration. If you have concerns about taking Tiopronin during pregnancy, you can consult one of our providers through telemedicine for personalized advice.
Tiopronin while Breastfeeding: What You Need to Know
Is it safe to take Tiopronin while breastfeeding?
The safety of Tiopronin during breastfeeding is not well established. There is limited information on whether Tiopronin passes into breast milk or what effects it may have on a nursing infant. Due to the potential for adverse effects, it is generally recommended to avoid Tiopronin while breastfeeding unless absolutely necessary. If you are breastfeeding and need to take Tiopronin, consult with your healthcare provider to carefully weigh the risks and benefits. You can also speak with one of our telemedicine providers for guidance on managing your condition while breastfeeding.
Estimated Cost of Tiopronin Medication
The cost of a 30-day supply of Tiopronin without insurance can vary depending on the pharmacy and location. Using a GoodRx coupon, the price typically ranges from $1,200 to $1,500 for a 30-day supply. Prices may fluctuate, so it is advisable to check with your pharmacy or use a prescription discount service like GoodRx for the most up-to-date pricing.
Possible Alternatives to Tiopronin
Depending on the condition being treated, there may be alternative medications or lifestyle changes that can help manage your symptoms. Always discuss any potential changes to your treatment plan with your healthcare provider before making adjustments. You can also schedule a telemedicine appointment with one of our providers to explore your options.
- Cystinuria: In addition to Tiopronin, medications like Penicillamine (Cuprimine) may be used. Increasing water intake and reducing salt and animal protein in your diet can also help reduce cystine stone formation.
- Wilson’s Disease: Alternatives include Zinc acetate (Galzin) or Trientine (Syprine). Dietary changes, such as reducing copper intake, can also be beneficial.
- Rheumatoid Arthritis: Other treatments include Methotrexate, biologics like Adalimumab (Humira), and lifestyle changes such as regular exercise and a balanced diet to reduce inflammation.
- Systemic Lupus Erythematosus: Hydroxychloroquine (Plaquenil) and corticosteroids are common alternatives. Managing stress and avoiding sun exposure can also help control symptoms.
- Cystinosis: Cysteamine (Cystagon) is the primary alternative treatment. Maintaining proper hydration and following a low-sodium diet can also help manage this condition.
- Nephrolithiasis (Kidney Stones): Increasing fluid intake, reducing dietary oxalate, and medications like potassium citrate can help prevent stone formation.
- Liver Disease: Depending on the type of liver disease, alternatives may include medications like Ursodiol (Actigall) or lifestyle changes such as reducing alcohol intake and following a liver-friendly diet.
- Hyperuricemia and Gout: Allopurinol (Zyloprim) or Febuxostat (Uloric) are common alternatives. Dietary changes, such as reducing purine-rich foods, can also help manage symptoms.
- Kidney Stones: Besides Tiopronin, medications like Thiazide diuretics or allopurinol may be used. Increasing water intake and reducing sodium and oxalate in your diet can also help prevent stones.
Recent Updates on Tiopronin Research
Recent research on Tiopronin has focused on improving its formulation to reduce side effects and enhance patient adherence. Studies are also exploring its use in combination with other treatments for cystinuria to improve outcomes. Additionally, ongoing clinical trials are investigating the long-term safety of Tiopronin in pediatric patients with cystinuria. While Tiopronin remains a key treatment for cystinuria, researchers are continually looking for ways to optimize its effectiveness and minimize potential risks. If you are interested in learning more about the latest research or clinical trials, please consult with your healthcare provider or schedule a telemedicine appointment with one of our specialists.
