Trientine Hydrochloride

This prescription is used for the treatment of a certain inherited disorder called Wilson’s disease. The Food and Drug Administration (FDA) has already approved this medication

Wilson’s disease causes copper to accumulate in your brain, liver, and other vital organs. Copper plays a key role in the development of healthy bones, nerves, collagen, and the skin pigment melanin. Usually, copper is absorbed from your food and excess is excreted by a substance that is made in your life. This is a rare inherited disorder. Most people with this kind of condition are diagnosed between the ages of 5-35. But, it can affect younger and older people as well. Wilson’s disease exists at natal but signs and symptoms do not appear until the copper forms up in the liver, brain, or other organs. Signs and symptoms of this disease may include:

  • Jaundice or a yellowing of the skin and the whites of the eye
  • Lack of appetite
  • Abdominal pain
  • Fatigue
  • Golden-brown eye discoloration
  • Fluid build-up in the legs or abdomen 
  • Uncontrolled movements or muscle stiffness 

Wilson’s disease is inherited as an autosomal recessive trait. It means that to develop the condition you must inherit one copy of the defective gene from each parent. If you receive only one abnormal gene, you won’t become ill yourself, but you’re a carrier and can pass the gene to your children. Untreated Wilson’s disease can be fatal. Serious complications may include:

  • Liver failure
  • Scarring of the liver
  • Kidney problems 
  • Persistent neurological problems 
  • Blood problems
  • Psychological problems 

Trientine Hydrochloride is a chelating agent. A chelating agent works by binding to copper which helps your body get rid of extra copper. This helps lessen the symptoms of the disease. Trientine Hydrochloride comes as a capsule for oral administration. Each capsule has a dosage form of 250 mg. The capsule of Trientine Hydrochloride contains iron oxides, gelatin, titanium dioxide, and stearic acid as inactive ingredients.  

How does Trientine Hydrochloride work?

Trientine Hydrochloride is the hydrochloride salt form of a metal chelating agent with potential anti-angiogenic activity. This drug chelates excess copper in the body. Through the kidneys, the extra copper is then detached from the body. 

An additional copper accrues perhaps because the liver wants the mechanism to defecate free copper into the bile. Hepatocytes supply extra copper but then when their capacity is exceeded copper is released into the blood and is taken up into extrahepatic sites. Wilson’s disease is treated with a low copper diet and the use of chelating agents that bind copper to facilitate its excretion from the body.  

How to use Trientine Hydrochloride?

Trientine Hydrochloride is given on an empty stomach. It can be an hour before meals or two hours after meals. This can be taken ay least one hour apart from any other medications, milk, or food. The capsules should be swallowed whole with water and should not be opened or chewed. It is because of the potential for contact dermatitis, any site of exposure to the capsule contents should be washed with water quickly. 

The dosage is based on your medical condition and response to the treatment. Follow a low-copper diet as directed by your doctor for the best effect. Take this medication regularly as well. Take it at the same time and in the same way each day. For the first month of treatment, check your temperature every night and let your doctor know of any fever or rash. If your doctor directs you to also take an iron supplement, take it at least 2 hours before or after Trientine Hydrochloride. Tell your doctor if your condition does not get better or if it gets worse. If you accidentally come in contact with the capsule contents, wash the area promptly with water to avoid an allergic reaction. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up for the missed dose.

What are the possible side effects of Trientine Hydrochloride?

Common side effects:

  • Loss of appetite
  • Stomach pain
  • Heartburn
  • Mouth sores
  • General ill feeling
  • Skin flaking, thickening, or cracking 

Call your doctor right away if you have these side effects:

  • Skin rash or fever
  • Muscle pain or stiffness
  • Problem with speech, walking, balance, chewing, swallowing, or lifting 
  • Muscle weakness
  • Drooping eyelids or double vision 
  • Symptoms of lupus (headaches, chest pain, joint pain, cold feeling, skin sores, or pale appearance of your fingers or toes)

If any side effects occur, inform your doctor right away. 

Warnings and Precautions

  • This drug is contraindicated in patients’ hypersensitivity to it or any components of the formulation. Patients should be observed closely for signs of possible hypersensitivity.
  • Those who are taking this medication should remain under regular medical supervision throughout drug administration. Patients especially women should be closely monitored for evidence of iron deficiency anemia. 
  • In general, mineral supplements should not be given since they may block the absorption of Trientine Hydrochloride.
  • It is not known yet if this drug is excreted in human milk. Several medications are emitted in human milk. Cautiousness must be applied when Trientine Hydrochloride is given to a nursing mother. 
  • While having this medication, you may need frequent blood and urine tests. You should remain under the care of a doctor during treatment. 
  • To make sure that this drug is safe for you, let your doctor know if you have a liver condition called biliary cirrhosis or anemia. 
  • Ask your doctor before using a vitamin or mineral supplement and use only the type your doctor recommends. Some minerals can make it harder for your body to absorb Trientine Hydrochloride.
  • Get emergency medical help if you have any of these signs of an allergic reaction; difficulty breathing, hives, or swelling of your tongue, face, lips, and throat. 
  • During pregnancy, this medication should only be used when needed. Discuss the risks and benefits with your doctor. 
  • If there are any signs of an overdose, call for medical assistance right away.