Adult Dosing

Wilson's Disease

• Start 750-1250 mg/day PO divided bid-qid
• Max: 2,000 mg/day
• Note: Give on empty stomach, atleast 1 hr before meal or 2 hrs after meals

Pediatric Dosing

• Note: Controlled studies of safety and efficacy not conducted; however, trientine has been used clinically in children as young as 6 yr of age without reported adverse reactions

Wilson's Disease

Child <12 yrs

• Start 500-750 mg/day PO divided bid-qid
• Max: 1,500 mg/day
• Note: Give on empty stomach, atleast 1 hr before meal or 2 hrs after meals

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of Wilson's disease in patients intolerant of penicillamine

• Hypersensitivity to trientine or any of the ingredients of the product
• Not indicated in cystinuria, rheumatoid arthritis, or biliary cirrhosis

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

See Supplemental Patient Information

• Limited clinical experience with trientine; monitor closely for evidence of iron-deficiency anemia
• Trientine and penicillamine are not interchangeable. Trientine is not recommended in rheumatoid arthritis or cystinuria
• Although hypersensitivity was not reported; asthma, bronchitis and dermatitis occurring after prolonged environmental exposure in workers using trientine as a hardener of epoxy resins, have occured. Observe closely for signs of possible hypersensitivity
• Controlled studies of safety and efficacy in pediatric population not conducted; however, it has been used clinically in children as young as 6 yr of age without reported adverse reactions
• Monitor CBC and serum ferritin closely, especially in women

Cautions: Use cautiously in

• Elderly population
• Pregnancy (teratogenic in animal studies; monitor maternal and neonatal serum copper concentrations)

Supplemental Patient Information

• Take on an empty stomach with whole glass of water
• Patient should take temperature nightly for 1st month of treatment and report any symptom such as fever or skin eruption

Pregnancy Category:C

Breastfeeding: Safety unknown; copper bound to trientine is detected in human breastmilk. Limited information indicates that trientine may be preferred to penicillamine for the treatment of wilson's disease in nursing mothers. It does not decrease the concentrations of copper or zinc in the milk or in the serum of the breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 06 August 2010). Manufacturer advises caution.

• METABOLIC: Iron deficiency
• CNS: Malaise, weakness, dystonia
• DERM: Thickening, fissuring, and flaking of the skin
• GI: Heartburn, epigastric pain and tenderness, acute gastritis, abdominal pain/cramps, aphthoid ulcer, anorexia
• HEMA: Hypochromic microcytic anemia
• MUSC: Dystonia, muscular spasm/pain, myasthenia gravis, rhabdomylosis
• MISC: System lupus erythematosus, melena

• Chelating agent; forms chelate with copper, facilitating removal from the body
• Metabolism: Unknown
• Excretion: Unknown
• Half-life: Unknown

US Trade Name(s)

• Syprine

US Availability

Syprine

• CAPS: 250 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• Only generic available

UK Availability

trientine (generic)

• CAPS: 300 mg

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Emergency/Critical Care

Chelating Agents

Pricing data from www.DrugStore.com in U.S.A.

• Syprine 250 MG CAPS [Bottle] (VALEANT)
  100 mg = $1218.02
  300 mg = $3528.09

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

Drug Name: Syprine 250 MG Oral Capsule

Ingredient(s): Trientine

Imprint: Aton;710;Syprine

Color(s): Brown

Shape: Capsule

Size (mm): 19.00

Score: 1

Inactive Ingredient(s): gelatin / stearic acid / titanium dioxide

Drug Label Author:
Aton Pharma, Inc.

DEA Schedule:
Non-Scheduled

Drug Name: Syprine 250 MG Oral Capsule

Ingredient(s): Trientine

Imprint: SYPRINE;MSD;661

Color(s): Brown

Shape: Capsule

Size (mm): 18.00

Score: 1

Inactive Ingredient(s): gelatin / yellow iron oxide / stearic acid / titanium dioxide / black iron oxide / red iron oxide

Drug Label Author:
Merck & Co., Inc.

DEA Schedule:
Non-Scheduled