Formulary
Trientine: Indications, Dosing, Side Effects and Interactions
Trientine is a chelating agent that binds to copper, forming a complex that is readily excreted by the kidneys; it may also inhibit the absorption of copper...
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Trientine: Indications, Dosing, Side Effects and Interactions
Trientine is a chelating agent that binds to copper, forming a complex that is readily excreted by the kidneys; it may also inhibit the absorption of copper...
Drug action
Trientine is a chelating agent that binds to copper, forming a complex that is readily excreted by the kidneys; it may also inhibit the absorption of copper from the gastro-intestinal tract.
Indications and dose
**Wilson's disease in patients intolerant of penicillamine [using Tillomed generic capsules] (initiated by a specialist)**
- **Adult** (By Mouth): Initially 1000-2000 mg daily in 2-4 divided doses, dose should then be adjusted according to response and serum-copper concentrations.
**Wilson's disease in patients intolerant of penicillamine (initiated by a specialist)**
- **Adult** (By Mouth): Initially 450-975 mg daily in 2-4 divided doses, dose should then be adjusted according to response and serum-copper concentrations.
**Wilson's disease in patients intolerant of penicillamine [using Tillomed generic capsules] (initiated by a specialist) for trientine**
- **Child 5-17 years** (By mouth): Initially 20 mg/kg daily in 2-3 divided doses, each dose should be rounded to the nearest 250 mg; usual initial dose 500-1250 mg daily. Dose should then be adjusted according to response and serum-copper concentrations.
**Wilson's disease in patients intolerant of penicillamine (initiated by a specialist) for Cufence**
- **Child 5-17 years** (By mouth): Initially 400-1000 mg daily in 2-4 divided doses, dose should then be adjusted according to response and serum-copper concentrations.
**Wilson's disease in patients intolerant of penicillamine (initiated by a specialist) for Cuprior**
- **Child 5-17 years** (By mouth): Initially 225-600 mg daily in 2-4 divided doses, dose should then be adjusted according to response and serum-copper concentrations.
Side effects
Common or very common Nausea Uncommon Anaemia; aplastic anaemia; skin reactions Frequency not known Gastrointestinal disorders; neurological deterioration in Wilson's Disease
Interactions
**Other interactions (4):**
- Absorption of oral iron is reduced by calcium salts, Magnesium salts (as magnesium trisilicate), Trientine.
- Trientine: the absorption of oral iron preparations is reduced by trientine.
- Trientine: The absorption of zinc may be reduced by trientine, also the absorption of trientine may be reduced by zinc.
- Absorption of iron is reduced with entacapone, proton pump inhibitors, bicarbonates, carbonates, calcium, zinc, magnesium and other mineral supplements, trientine, antacids, cholestyramine, tea,...
Pregnancy
Teratogenic in animal studies-use only if benefit outweighs risk. M Monitor maternal and neonatal serum-copper concentrations. M
Breast feeding
Specialist sources indicate caution-limited information available; effect on copper levels in milk conflicting and impact on infant unknown. D
Medicinal forms
Tablet,Capsule
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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