Section 18 · Monograph
Trientine hydrochloride
Reviewed Nov 2026FDA label
SyprineCopper chelator
- Forms
- Cap: 250mg
- Dose
- Wilson's disease (penicillamine-intolerant): adults 750-1250mg/day in divided doses (max 2000mg/day); children 500-750mg/day divided
- MOA
- Chelates copper, promotes urinary excretion
Indications
- Wilson's disease in patients who are intolerant of penicillamineFDA-labeled
Mechanism of Action
- Copper chelator that promotes urinary excretion of copper
Full Dosing
Adult / usual
- Adults: 750-1250mg/day in divided doses (2-4 times daily); maximum 2000mg/day
- Take on an empty stomach, 1 hour before or 2 hours after meals; not interchangeable mg-for-mg with trientine tetrahydrochloride (Cuvrior)
Pediatric
- Children 12 years and younger: 500-750mg/day in divided doses; maximum 1500mg/day
Contraindications
- Known hypersensitivity to trientine
Drug Interactions
- Iron and other mineral supplements: avoid or separate by at least 2 hours (trientine reduces iron absorption)
Adverse Effects
- Iron deficiency anemia
- Rash and contact dermatitis
- Neurologic deterioration early in therapy
- Lupus-like reactions (rare)
Monitoring Parameters
- 24-hour urinary copper and non-ceruloplasmin copper
- CBC and iron studies
- Neurologic status
Pregnancy & Lactation
- Published experience has not identified major risks; untreated Wilson's disease is dangerous in pregnancy — continue treatment with specialist guidance