Yes, some patients experience delayed onset if starting at a low dose (0.25 mg) or if gastrointestinal absorption is slower
This includes D-penicillamine (distributed under the brand named including Cuprimine, a capsule, and Depen, a tablet), which was the first oral therapy developed for Wilson disease
Mutat Res 679:1316 Sitta A, Vanzin CS, Biancini GB, Manfredini V, de Oliveira AB, Wayhs CA, Ribas GO, Giugliani L, Schwartz IV, Bohrer D, Garcia SC, Wajner M, Vargas CR (2011) Evidence that L-carnitine and selenium supplementation reduces oxidative stress in phenylketonuric patients
More approvals for additional health conditions
Many people stop taking them because of those side effects and, perhaps even more so, cost and insurance barriers
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