Trientine Dihydrochloride

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Generic Name: Trientine Dihydrochloride Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: C

Uses

What is Trientine Dihydrochloride used for?

Trientine Dihydrochloride is a chelating agent. A chelating agent works by removing a heavy metal (such as lead, mercury, or copper) from the blood. Wilson’s disease is a genetic metabolic defect that causes excess copper to build up in the body. Trientine is used to treat this inherited condition in people who cannot take penicillamine. Trientine may also be used for purposes not listed in this medication guide.

How should I take Trientine Dihydrochloride?

Follow all directions on your prescription label. Do not take trientine in larger or smaller amounts or for longer than recommended.

Take trientine on an empty stomach, at least 1 hour before or 2 hours after a meal.

Do not drink milk, eat food, or take any other medications for at least 1 hour after you take trientine.

Do not chew, break, or open a trientine capsule. Swallow it whole.

The medicine from a broken pill can be irritating if it gets on your skin. If this occurs, wash your skin with water right away. Ask your doctor or pharmacist how to safely handle and dispose of a broken capsule.

Your doctor may have you take extra iron while you are taking trientine. Take only the amount of iron that your doctor has prescribed.

Call your doctor if you have a fever or a skin rash while taking this medicine. You may need to take your temperature every night for the first month of treatment with trientine.

While using trientine, you may need frequent blood and urine tests. You should remain under the care of a doctor during treatment.

How do I store Trientine Dihydrochloride?

Trientine Dihydrochloride is best stored in the refrigerator. To prevent drug damage, do not freeze. There may be different brands of Trientine Dihydrochloride that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Trientine Dihydrochloride down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Trientine Dihydrochloride?

There are no reports of hypersensitivity in patients who have been administered trientine hydrochloride for Wilson’s disease. However, there have been reports of asthma, bronchitis and dermatitis occurring after prolonged environmental exposure in workers who use trientine hydrochloride as a hardener of epoxy resins. Patients should be observed closely for signs of possible hypersensitivity.

You should not use this medication if you are allergic to trientine.

To make sure trientine is safe for you, tell your doctor if you have:

  • Anemia (low red blood cells); or
  • A liver condition called biliary cirrhosis.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Trientine Dihydrochloride during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Trientine Dihydrochloride. Trientine Dihydrochloride is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Trientine Dihydrochloride?

Clinical experience with Trientine has been limited. The following adverse reactions have been reported in a clinical study in patients with Wilson’s disease who were on therapy with trientine hydrochloride: iron deficiency, systemic lupus erythematosus. In addition, the following adverse reactions have been reported in marketed use: dystonia, muscular spasm, myasthenia gravis.

Trientine is not indicated for treatment of biliary cirrhosis, but in one study of 4 patients treated with trientine hydrochloride for primary biliary cirrhosis, the following adverse reactions were reported: heartburn; epigastric pain and tenderness; thickening, fissuring and flaking of the skin; hypochromic microcytic anemia; acute gastritis; aphthoid ulcers; abdominal pain; melena; anorexia; malaise; cramps; muscle pain; weakness; rhabdomyolysis. A causal relationship of these reactions to drug therapy could not be rejected or established.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Trientine Dihydrochloride?

In general, mineral supplements should not be given since they may block the absorption of Trientine. However, iron deficiency may develop, especially in children and menstruating or pregnant women, or as a result of the low copper diet recommended for Wilson’s disease. If necessary, iron may be given in short courses, but since iron and Trientine each inhibit absorption of the other, two hours should elapse between administration of Trientine and iron.

It is important that Trientine be taken on an empty stomach, at least one hour before meals or two hours after meals and at least one hour apart from any other drug, food, or milk. This permits maximum absorption and reduces the likelihood of inactivation of the drug by metal binding in the gastrointestinal tract.

Trientine Dihydrochloride may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Trientine Dihydrochloride?

Trientine Dihydrochloride may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Trientine Dihydrochloride?

Trientine Dihydrochloride may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Trientine Dihydrochloride.

What is the dose of Trientine Dihydrochloride for an adult?

Usual Adult Dose for Wilson’s Disease

750 to 1250 mg, orally, in divided doses given 2, 3, or 4 times daily

Maximum dose: 2000 mg daily

Comments:

-Increase dose for inadequate clinical response or free serum copper persistently above 20 mcg/dL.

-Re-evaluate dose every 6 to 12 months.

-Clinical experience with this drug is limited and alternate dosing regimens have not been well characterized.

-All dosing endpoints are not well defined.

-This drug is not interchangeable with penicillamine.

-Use this drug when penicillamine treatment is not possible because of intolerable or life threatening side effects.

-This drug is not recommended for cystinuria or rheumatoid arthritis.

-It is incapable of binding cystine, so it is of no use in cystinuria.

-In a small study, it was ineffective for rheumatoid arthritis.

-This drug is not indicated for treatment of biliary cirrhosis.

Use: Treatment of Wilson’s disease in patients who are intolerant of penicillamine.

What is the dose of Trientine Dihydrochloride for a child?

Usual Pediatric Dose for Wilson’s Disease

13 and older:

750 to 1250 mg, orally, in divided doses given 2, 3, or 4 times daily

Maximum dose: 2000 mg daily

12 and under:

500 to 750 mg, orally, in divided doses given 2, 3, or 4 times daily

Maximum dose: 1500 mg daily

Comments:

-Increase dose for inadequate clinical response or free serum copper persistently above 20 mcg/dL.

-Re-evaluate dose every 6 to 12 months.

-Clinical experience with this drug is limited and alternate dosing regimens have not been well characterized.

-All dosing endpoints are not well defined.

-This drug is not interchangeable with penicillamine.

-Use this drug when penicillamine treatment is not possible because of intolerable or life threatening side effects.

-This drug is not recommended for cystinuria or rheumatoid arthritis.

-It is incapable of binding cystine, so it is of no use in cystinuria.

-In a small study, it was ineffective for rheumatoid arthritis.

-This drug is not indicated for treatment of biliary cirrhosis.

Use: Treatment of Wilson’s disease in patients who are intolerant of penicillamine.

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Trientine Dihydrochloride available?

Trientine Dihydrochloride is available in the following dosage forms and strengths:

  • Oral capsules.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Trientine Dihydrochloride, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 9, 2018 | Last Modified: August 9, 2018

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