The drug transfers into breast milk. There is no evidence that its use during pregnancy is harmful to the developing fetus and its use is not contraindicated in pregnancy. The concurrent use of<unk>  and the antibiotic azithromycin appears to increase the risk for certain serious side effects with short-term use, such as an increased risk of chest pain, congestive heart failure, and mortality from cardiovascular causes. Care should be taken if combined with medication altering liver function as well as aurothioglucose (Solganal), cimetidine (Tagamet) or digoxin (Lanoxin).<unk> can increase plasma concentrations of penicillamine which may contribute to the development of severe side effects. It enhances hypoglycemic effects of insulin and oral hypoglycemic agents. Dose altering is recommended to prevent profound hypoglycemia. Antacids may decrease the absorption of<unk> . Both neostigmine and pyridostigmine antagonize the action of<unk> . While there may be a link between<unk>  and hemolytic anemia in those with glucose-6-phosphate dehydrogenase deficiency, this risk may be low in those of African descent. Specifically, the US Food and Drug Administration's (FDA) drug label for<unk>  lists the following drug interactions: * Digoxin (wherein it may result in increased serum digoxin levels) * Insulin or anti-diabetic medication (wherein it may enhance the effects of a hypoglycemic treatment) * Drugs that prolong QT interval and other arrhythmogenic drugs (as<unk>  prolongs the QT interval and may increase the risk of inducing serious abnormal heart rhythms (ventricular arrhythmias) if used concurrently) * Mefloquine and other drugs known to lower the seizure threshold (co-administration with other antimalarials known to lower the convulsion threshold may increase risk of convulsions) * Antiepileptics (concurrent use may impair the antiepileptic activity) * Methotrexate (combined use is unstudied and may increase the frequency of side effects) * Cyclosporin (wherein an increased plasma cyclosporin level was reported when used together).
Hydroxychloroquine
Azathioprine
Teriflunomide
Leflunomide
Tofacitinib
Etanercept
Cyclizine
Prednisolone