Section 18 · Monograph
Trientine tetrahydrochloride
Reviewed Nov 2026FDA label
CuvriorCopper chelator
- Forms
- Tab: 300mg (functionally scored)
- Dose
- Adults, stable de-coppered Wilson's disease tolerant of penicillamine: divided BID, max 3000mg/day; use label conversion table when switching; not mg-for-mg with other trientine products
- MOA
- Chelates copper, promotes urinary excretion
Indications
- Stable Wilson's disease in adult patients who are de-coppered and tolerant to penicillamineFDA-labeled
Mechanism of Action
- Copper chelator (trientine tetrahydrochloride salt) that promotes urinary excretion of copper
Full Dosing
Adult / usual
- Total daily dose divided twice daily, maximum 3000mg/day; use the label conversion table when switching from penicillamine (for example penicillamine 500mg/day to Cuvrior 900mg/day)
- Not substitutable mg-for-mg with other trientine products
- Take on an empty stomach at least 1 hour before or 2 hours after food, and 1 hour apart from other oral drugs; swallow tablets without crushing, chewing or dissolving; keep in blister until dosing
Contraindications
- Hypersensitivity to trientine or any excipient
Drug Interactions
- Avoid mineral supplements (iron, zinc, calcium, magnesium); if unavoidable separate per label (iron: at least 2 hours apart)
Adverse Effects
- Iron deficiency
- Neurologic worsening
- Hypersensitivity or rash
Monitoring Parameters
- Serum non-ceruloplasmin copper at initiation, after 3 months, then about every 6 months
- CBC for anemia and leukopenia
- Neurologic status
Pregnancy & Lactation
- Published experience has not identified major risks; untreated Wilson's disease increases miscarriage and disease-worsening risk — continue treatment with specialist guidance