Drug Interaction:
Drug interactions- summary-
Mineral supplements - in general do not give mineral supplements , they may block the absortion of
trientine.
If necessary iron may be given in short because iron an trientine each inhibit absorption of the
other, allow 2 hours to elapse between administration of trientine and iron.
Drug/food interaction- it is important that trientine be taken on an empty stomach at least 1 hour
before or 2 hours after meals and at least 1 hour apart from other drug , food or milk.
Indication:
Wilsons Disease
Adverse Reaction:
Iron deficiency, systemic lupus erythematosus ,
dystonia, muscular spasm, and myasthenia gravis,
occurred in patients with Wilsons disease who have been treated with trientine
Contra-Indications:
Hypersensitivity to the drug
Special Precautions-
Not indicated for the following- cysturia, rhemumatoid arthiritis, biliary cirrhosis.
Patient supervision- patients should remain under medical suervision throughout the period of
drug administration.
Iron deficiency anemia- closely monitor patients ( especially women) for evidence of iron
deficiency anemia
Hypersensitivity - There no reports of hypersensitivity in patients given trientine for Wilsons Disease.
However there have been reports of asthma, bronchitis, and dermatitis ocurring after prolonged
environmental exposure in workers who use trietine as a hardener for epoxy resins.
Observe patients closely for possible hypersensitivity .
Pregnancy- use during pregnancy only when potential benefits outweigh the potential hazards
to the fetus.
Lactation- excercise caution when administering to breast-feeding woman.
Children- safety and efficacy for use in children have not been established. Trientine has
been used clinically in children as young as 6 years of age with no adverse effects.
Elderly- Dose selection should be cautious usually starting at the low end of the dosing range,
reflecting the greater frequency of decreased hepatic, renal or cardiac function and the concomittant
disease or other drug therapy.
Monitoring- the most reliable index for monitoring treatment is the determination of free copper
in the serum which equals the difference bteween quantitivelty determined total copper and
ceruloplasmin-copper . Adequately treated patients will usually have less than 10mcg free
copper/dL of serum
Dosages/ Overdosage Etc:
Indication-
Wilsons Disease
Dosage -
Take on an empty stomach 1 hour before or 2 hours after meals and at least 1 hour apart from
any other drug, food, or milk.
Swallow the capsules whole and do not open or chew.
Adults- initially 750 to 1250mg/day in divided doses 2,3, or 4 times /day.
May increase to a maximum of 2000mg/day
Children- 12 years ofage or younger - initially 500 to 750mg/day in diivided doses 2, 3,4, or 4 times
a day . May increase to a maximum of 1500mg/day
Increase the daily dose only when the clinical experience is not adequate
Patient Information:
1. Take on an empty stomach 1 hour before or 2 hours after meals and at least 1 hour
apart from any other drug, food, or milk.
2. Swallow capsules whole with water . Do not open or chew.
3. Because of the potential for contact dermatitis, promptly wash any site of exposure
to the capsule contents with water.
4. Take temperature nightly for the first month of treatment and report any symptoms
such as fever, or skin eruption
Ref - USP PDI Vol II 17th Edition (1997)
TRIENTINE - SYSTEMIC
1.Pregnancy-
Treientine has not shown to cause birth defects or other problems in humans.
However, it has shown to cause birth defects in rats.
3. Breast-feeding-
It is not known whether trientine passes into breast milk.This medicine has not
been reported to cause problems in nursing babies.
4.Children-
Anemia is likely to occur in children during treatment with trientine
5.Older adults-
There is no specific information comparing use of trientine in the elderly
with use in other age groups.
6. Other medicines-
When you are taking trientine it is especially important that your doctor
know if you are taking -
Copper supplements or
Iron supplements or other medicines containing minerals-
use of these medicines with trientine may decrease the effect of trientine.
Iron supplements or other medicines containing minerals should not
be given 2 hours before or after trientine.
7. Other medical problems-
The presence of other medical problems may affect the use of trientine.
Make sure you tell your doctor if you have any other medical problems
especially-
Iron deficiency - trientine may make the condition worse.
Pharmacology/ Pharmacokinetics:
Pharmacology-
Wilsons disease hepatolenticular degeneration ) is an inherited metabolic defect resulting in
excess copper accumulation, possibly because the liver lacks the mechanism to extract free
copper into the bile.
Hepatocytes store excess copper , but when their capacity is exceeded , copper is released
into the blood and taken into extrahepatic sites.
Treat this condition with a low copper diet and chelating agents that bind copper to facilitate
its excretion from the body. Trientine is a chelating compound for removal of excess copper
from the body.
Interaction with Food:
Take on an empty stomach 1 hour before or 2 hours after meals and at least 1 hour apart from
any other drug, food, or milk.
Pregnancy and lactation:
Pregnancy-
Use during pregnancy only when potential benefits outweigh the potential hazards
to the fetus.
Lactation-
Excercise caution when administering to breast-feeding woman.
Children-
Safety and efficacy for use in children have not been established. Trientine has
been used clinically in children as young as 6 years of age with no adverse effects.
Manufacturer Details