d-penicillamine + sulphasalazine

This is a combination of two disease-modifying antirheumatic drugs (DMARDs): d-penicillamine and sulphasalazine. Both are small molecule agents used primarily in the management of rheumatoid arthritis. D-penicillamine acts as a chelating agent and immunomodulator, reducing immune-mediated joint damage. Sulphasalazine is metabolized to 5-aminosalicylic acid and sulfapyridine; it exerts anti-inflammatory effects by inhibiting prostaglandin synthesis and modulating immune responses. The combination has been shown to provide greater clinical improvement in rheumatoid arthritis compared to monotherapy but with increased risk of adverse effects such as nausea, dyspepsia, dysgeusia, thrombocytopenia, and higher withdrawal rates due to intolerance[1][2]. Both drugs have also been associated with rare cases of drug-induced systemic lupus erythematosus when used together[2].

Other names

d-penicillamine + sulfasalazineDPA + SASPpenicillamine + sulfasalazine