Drug & supplement interaction

Fish Therapy + Penicillamine

Penicillamine brand names: Cuprimine, Depen Titratable.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Fish Therapy and Penicillamine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Fish Therapy and Penicillamine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Penicillamine and Fish Therapy in our sources. This does not guarantee that the combination is completely free of risk — research on Fish Therapy alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Fish Therapy at all — not against Penicillamine, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

Fish Therapy is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Fish Therapy safety at a glance

Fish Therapy overall Use caution Hygiene and infection risks make this a cautious choice, especially with shared water.
Pregnancy Use caution Not studied in pregnancy; avoid due to infection risk unless cleared by your doctor.
Breastfeeding Use caution No safety data; infection risk makes caution reasonable while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Penicillamine and Fish Therapy? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Fish Therapy and Penicillamine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so having Fish Therapy while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    Fish Therapy

    “Multiple case reports suggest that fish therapy can increase the risk for bacterial infection. Studies of fish therapy water have identified multiple bacteria capable of causing disease. It is currently not possible to adequately sterilize the water without killing the fish. Additionally, when performed in a spa or salon setting, pedicure tubs cannot be adequately cleaned when fish are present.”

    Fish Therapy · Natural Medicines adverse-effect record, reported in dermatitis.

    6 sources cited
    1. 103109. Vanhooteghem O, Anseeuw D, Michel C, et al. Fish Pedicure-induced Aeromonas sobria Superficial Necrotic Bullous Dermatitis in a Previously Undiagnosed Diabetes Patient. What are the Risks of Fish Pedicure for Public Health? BJMMR. 2015;10(12):1-10. DOI
    2. 103110. Veraldi S, Nazzaro G, Çuka E. Staphylococcus aureus infection of the feet following fish pedicure. Infection. 2014 Oct;42(5):925-6. PubMed
    3. 103111. Sugimoto K, Frei R, Graber P. Methicillin-resistant Staphylococcus aureus foot infection after fish pedicure. Infection. 2013 Oct;41(5):1013-5. PubMed
    4. 103112. Vanhooteghem O, Theate I. Fish pedicure-induced foot mycobacteriosis infection due to Mycobacterium marinum: a first case report. Eur J Dermatol. 2017 Jun 1;27(3):299-300. PubMed
    5. 103108. Lipner SR. Onychomadesis Following a Fish Pedicure. JAMA Dermatol. 2018 Sep 1;154(9):1091-1092. PubMed
    6. 103113. US Centers for Disease Control (CDC). Fish Pedicures and Fish Spas. August 2, 2016. Available at: https://www.cdc.gov/healthywater/hygiene/body/fish_pedicures.html. Accessed on June 15, 2020.

    Penicillamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Penicillamine. Read the label on DailyMed ›

  • A skin rash Additional detail

    Fish Therapy

    Recorded for Fish Therapy in the same Natural Medicines adverse-effect record shown under Liver problems above.

    Penicillamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Penicillamine. Read the label on DailyMed ›

Reported for Fish Therapy but not commonly for Penicillamine: a higher chance of infection and swelling.

Effects for Penicillamine come from the ADVERSE REACTIONS section of its FDA label; effects for Fish Therapy come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 917 voluntary FDA FAERS reports for Penicillamine that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Penicillamine

This page covers Fish Therapy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Penicillamine page lists 26 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Siberian Cocklebur (major), Aristolochia (moderate) and Coffee Charcoal (moderate).

By severity: 3 major · 13 moderate · 10 minor.

From our pharmacist’s overview on the Penicillamine page

“People take penicillamine (Cuprimine, Depen) for demanding conditions, Wilson's disease, rheumatoid arthritis, cystinuria, and its 26 supplement interactions are not a list to skim, three of them rated major. Seventeen ingredients can keep an oral dose from being fully absorbed, activated charcoal chief among them, and six more can str…”

Reviewed by 2 · Jul 18, 2026

Open the Penicillamine interaction page

How much people look this up

Where Fish Therapy and Penicillamine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Fish Therapy
Steady interest

#1,021 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Penicillamine
Steady interest

#2,288 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Fish Therapy reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Fish Therapy and Penicillamine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Treatment approach

About Fish Therapy

What is Fish Therapy?

  • Psoriasis
  • Skin exfoliation and smoothing
  • Eczema and dry skin
  • Cosmetic foot care (pedicure)
  • General relaxation

Fish therapy (also called ichthyotherapy or a 'fish pedicure') uses small Garra rufa fish to nibble away dead skin, and it is mostly used cosmetically or for skin conditions like psoriasis. Evidence that it treats any medical condition is very limited, and there are real infection and hygiene concerns. If you have a skin condition, talk with a dermatologist before trying it.

Live fish (commonly Garra rufa); the whole animal used in skin-immersion baths · Spa fish baths (foot or full-body immersion with Garra rufa fish)

An interaction check asks whether these two react with each other — it does not ask whether Fish Therapy is a good idea for someone in your situation. Here is what our Fish Therapy record says about it on its own.

Fish Therapy: dosing

There is no standard 'dose' for fish therapy, since it is a spa procedure rather than a supplement you take. Sessions are usually a set number of minutes in a spa setting.If you choose to try it, only use a reputable, licensed facility that follows strict hygiene rules, and never share water with someone who has a skin infection.

From our Fish Therapy monograph — the full record covers uses, side effects and every documented interaction.

Read the full Fish Therapy monograph & all interactions
Medication

About Penicillamine

What Is Penicillamine Used For?

Brand names: Cuprimine, Depen Titratable

Penicillamine is used for three distinct conditions. It treats Wilson's disease — a rare genetic disorder in which the body accumulates dangerous levels of copper — by binding to the excess copper and helping the body remove it. It also treats cystinuria, a condition where the amino acid cystine builds up and forms painful kidney stones, by converting cystine into a more soluble form that the body can excrete more easily.

For patients with severe, active rheumatoid arthritis who have not responded adequately to conventional therapies, penicillamine (available as Aagylur, Cuprimine, Depen, and other products) may be used to help suppress disease activity and reduce joint pain, tenderness, and swelling.

See full Penicillamine drug information
Keep checking

Other Drugs & Fish Therapy

Browse every other medication we’ve checked against Fish Therapy — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Fish Therapy against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Fish Therapy list.

See the full Fish Therapy interactions page
See every supplement checked against Penicillamine, ranked by severity
Evidence & sources

Fish Therapy References

The 8 references that drive our Fish Therapy monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Grassberger M, Hoch W. Ichthyotherapy as alternative treatment for patients with psoriasis: a pilot study. Evid Based Complement Alternat Med. 2006 Dec;3(4):483-8. PubMed
  2. Lipner SR. Onychomadesis Following a Fish Pedicure. JAMA Dermatol. 2018 Sep 1;154(9):1091-1092. PubMed
  3. Vanhooteghem O, Anseeuw D, Michel C, et al. Fish Pedicure-induced Aeromonas sobria Superficial Necrotic Bullous Dermatitis in a Previously Undiagnosed Diabetes Patient. What are the Risks of Fish Pedicure for Public Health? BJMMR. 2015;10(12):1-10. DOI
  4. Veraldi S, Nazzaro G, Çuka E. Staphylococcus aureus infection of the feet following fish pedicure. Infection. 2014 Oct;42(5):925-6. PubMed
  5. Sugimoto K, Frei R, Graber P. Methicillin-resistant Staphylococcus aureus foot infection after fish pedicure. Infection. 2013 Oct;41(5):1013-5. PubMed
  6. Vanhooteghem O, Theate I. Fish pedicure-induced foot mycobacteriosis infection due to Mycobacterium marinum: a first case report. Eur J Dermatol. 2017 Jun 1;27(3):299-300. PubMed
  7. US Centers for Disease Control (CDC). Fish Pedicures and Fish Spas. August 2, 2016. Available at: https://www.cdc.gov/healthywater/hygiene/body/fish_pedicures.html. Accessed on June 15, 2020.
  8. Vanhooteghem O, Theate I, De Schaetzen V. Periungual Mycobacterium marinum Infection following a Fish Manicure. Skin Appendage Disord. 2021 Aug;7(5):393-396.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Having Fish Therapy While Taking Penicillamine: Common Questions

Is it safe to have Fish Therapy while taking Penicillamine?
We do not list a known interaction between Fish Therapy and Penicillamine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Fish Therapy and Penicillamine have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Penicillamine interact with any supplements?
Yes. Penicillamine has documented interactions with 26 supplements in our database — Fish Therapy is not one of them. The Penicillamine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Fish Therapy monograph Uses, safety profile, and every drug interaction in one place Penicillamine drug information The full plain-English guide to this medication Penicillamine supplement interactions Every supplement checked against Penicillamine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 8 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Penicillamine and Fish Therapy?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.