Trientine Hydrochloride

Mechanism :

Trientine hydrochloride is a chelating compound for removal of excess copper from the body. The effects of trientine hydrochloride on urinary copper excretion are similar to those of equimolar doses of penicillamine, although in one study they were significantly smaller.

Indication :

• Wilson disease-when Penicillamine is not tolerated or in patients with Neuro-Wilson’s.

Contraindications :

Not indicated as an alternative to penicillamine treatment for rheumatoid arthritis or cystinuria. It should not be used in the treatment of conditions where free copper levels are not elevated. Reduces serum iron levels, possibly by reducing absorption. Iron supplementation may be required.

Dosing :

Adverse Effect :

Iron deficiency, systemic lupus erythematosus, dystonia, muscular spasm, myasthenia gravis, heartburn; epigastric pain and tenderness; thickening, fissuring and flaking of the skin; hypochromic microcytic anemia; aphthoid ulcers; melena; anorexia; malaise; cramps; muscle pain; weakness; rhabdomyolysis.

Interaction :

Although there is no evidence that calcium or magnesium containing antacids affects the efficacy of trientine, it is desirable to separate administration if the two therapies are administered concurrently. Do not administer iron preparations at the same time of day.

Hepatic Dose :