Drug information of Trientine

Trientine

Drug group:

Triethylenetatramine (TETA) is a highly selective divalent Cu(II) chelator that revereses copper overload in tissues. Its salt form, trientine was introduced in 1969 as an alternative to D-penicillamine. It consists of a polyamine-like structure different from D-penicillamine, as it lack sulfhydryl groups.

Trientine

Mechanism of effect

Oral chelating agent used to induce adequate cupriuresis

Pharmacodynamic

Not available

Pharmacokinetics

Absorption: Poor

Excretion: Urine (9%)

Metabolite: Acetyltrien

Drug indications

Wilson's disease

Dosage

Adult

Wilson Disease

For patients intolerant of penicillamine

750-1250 mg/day PO divided q6-12hr; not to exceed 2 g/day

Pediatric

Wilson Disease

<12 years

  • 500-750 mg/day PO divided q6-12hr; not to exceed 1.5 g/day

≥12 years

  • For patients intolerant of penicillamine: 750-1250 mg/day PO divided q6-12hr; not to exceed 2 g/day

Drug contraindications

Hypersensitivity to product or components

Side effects

Heartburn , anorexia , aplastic anemia, , Abdominal pain , Rash , Systemic Lupus Erythematosus , Myasthenia gravis

Iron deficiency, Aphthoid ulcer, Sideroblastic anemia, Lupus like eruption

Interactions

Selenium , Sucralfate , Ferrous Gluconate , Biolectra Magnesium , dichlorphenamide
There is no major interactions.

Alerts

Not indicated for cystinuria, RA or biliary cirrhosis

May cause iron deficiency anemia

Hepatic iron oveload may result from copper deficiency induced by therapy

Monitor urinary copper and for signs of hypersensitivity (eg, elevated body temperature)

Points of recommendation

  • Tell all of your health care providers that you take trientine. This includes your doctors, nurses, pharmacists, and dentists.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • Have your urine checked as you have been told by your doctor.
  • During the first month you take trientine, take your temperature every night. Call your doctor if you have a fever or skin irritation.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using trientine while you are pregnant.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.
  • Take on an empty stomach. Take at least 1 hour before or 2 hours after meals. Take at least 1 hour before or after any other drug, food, or milk.
  • Do not take iron products within 2 hours before or 2 hours after taking trientine.
  • If you take other products with minerals in them (like aluminum, calcium, magnesium, or zinc), talk with your doctor. You may need to avoid these products while taking trientine.
  • Swallow whole. Do not chew, open, or crush.
  • Take with a full glass of water.
  • If the capsule is opened or broken, do not touch the contents. If the contents are touched or they get in the eyes, wash hands or eyes right away.
  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

Pregnancy level

Group c - Not adequate studies in pregnant women

Related drugs

Penicillamine , Succimer


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