[Lotus]

Hi CM, D-penicillamine looks too risky, I'd pass on the approach. 


Fatal cholestatic hepatitis caused by D-penicillamine
J W Jacobs et al. Br J Rheumatol. 1994 Aug.
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Abstract
A 37-yr-old woman with RF-positive RA developed cholestatic hepatitis after 10 days of D-penicillamine therapy. This was discontinued immediately. The cholestasis persisted for the remaining 14 months of her life. Severe hypercholesterolemia developed with xanthelasmata and eventually pancytopenia, which was caused by a massive infiltration of the bone marrow by lipid-containing foam cells. The patient died of sepsis. Review of the literature shows intrahepatic cholestasis to be a rare and idiosyncratic complication of D-penicillamine therapy. To our knowledge, ours is the first documented case of persistent cholestatic icterus.
https://pubmed.ncbi.nlm.nih.gov/8055207/

[Liver complications caused by D-penicillamine. Apropos of a case]
[Article in French]
H Roux et al. Rev Rhum Mal Osteoartic. 1986 Jan.
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Abstract
The complications of D-penicillamine are rare. It generally consists of reversible cholestatic hepatitis which may, however, be fatal. The authors report a typical case with a benign outcome and with concomitant signs of cutaneous intolerance with eosinophilia. The definite role of D-penicillamine was confirmed by the re-introduction of the drug.


Similar articles for PMID: 3704507 D-penicillamine
https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=3704507

Think this would be a good one for lotus.

Lotus? Who's lotus?

That's okay CM, I know a Drew reincarnation when I see it.