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Both penicillamine and tiopronin have significant side effects, but trying the alternative drug can be beneficial if the first is not tolerated.

Penicillamine can cause taste problems due to copper loss, which can be fixed with copper or zinc supplements.

Some drugs can cause serious side effects, like hypoglycemia from mix-ups, skin reactions, or depression, and while penicillamine may help rheumatoid arthritis more than auranofin, it has more severe side effects.

Avoiding certain nutrients and drugs may help manage pemphigus.

Hair damage shows as fragility, dullness, and discoloration, varies by ethnicity, and is worsened by cosmetic procedures and diseases.