In the U.S.—

Another commonly used name is trien.

• Chelating agent

Trientine (TRYE-en-teen) is used to treat Wilson's disease, a disease in which there is too much copper in the body.

This medicine combines with excess copper in the body and may prevent your body from absorbing the copper in the foods you eat. Removing copper from the body prevents damage to the liver, brain, and other organs. The combination of copper and trientine is then easily removed by the kidneys and it passes from the body in urine.

Trientine is available only with your doctor's prescription, in the following dosage form:

Oral
• Capsules (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For trientine, the following should be considered:

Pregnancy—Trientine has not been shown to cause birth defects or other problems in humans. However, it has been shown to cause birth defects in rats.

Breast-feeding—It is not known whether trientine passes into the breast milk. This medicine has not been reported to cause problems in nursing babies.

Children—Anemia is especially likely to occur in children during treatment with trientine.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of trientine in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking trientine, it is especially important that your health care professional know if you are taking:

• Copper supplements or
• Iron supplements or other medicine containing minerals (contained in some vitamin combination products)—Use of these medicines with trientine may decrease the effects of trientine; iron supplements or other medicines containing minerals should be given 2 hours before or after trientine

• Iron-deficiency—Trientine may make this condition worse

Take trientine with water. The capsule should be swallowed whole. It must not be opened, crushed, or chewed.

Take this medicine on an empty stomach (at least 1 hour before or 2 hours after meals) and at least 1 hour before or after any other medicine, food, or milk. This will allow trientine to be better absorbed by your body.

Trientine will not cure Wilson's disease, but it will help remove the excess copper from your body. Therefore, you must continue to take this medicine regularly, as directed. You may have to take trientine for the rest of your life. If Wilson's disease is not treated continually, it can cause severe liver damage and can cause death. Do not stop taking this medicine without first checking with your doctor.

It is very important for you to follow any special instructions from your doctor, such as following a low-copper diet. You may need to avoid foods known to be high in copper, such as chocolate, mushrooms, liver, molasses, broccoli, cereals enriched with copper, shellfish, organ meats, and nuts. If you have any questions about this, check with your doctor.

Take this medicine only as directed by your doctor . Do not take more or less of it and do not take it more often than your doctor ordered. If too much is used, it may increase the chance of side effects.

Dosing—

The dose of trientine will be different for different patients. Follow your doctor's orders or the directions on the label.

• For oral dosage form (capsules):
  • For Wilson's disease:
    • Adults and teenagers—The usual dose is 750 milligrams (mg) to 1.25 grams a day. The dose may be divided into two to four smaller doses.
    • Children—The usual dose is 500 to 750 mg a day. The dose may be divided into two to four smaller doses.

Missed dose—

If you miss a dose of this medicine, double the next dose. Do not make up more than one missed dose at a time.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store sealed, unopened bottles of trientine in the refrigerator, but not in the freezer.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Your doctor should check your progress at regular visits to make sure trientine is working properly and to check for unwanted effects. Laboratory tests may be needed. This will allow your doctor to change your dose, if necessary.

During the first month of treatment, you may need to take your temperature each night. Tell your doctor if you develop a fever or skin rash.

Do not take copper or iron preparations or any other mineral supplements within 2 hours of taking trientine. This includes any vitamin preparation that contains minerals.

If a capsule breaks open and the contents touch your skin, wash the area right away with water. Trientine may cause a rash.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• More common--Symptoms of anemia
  • Unusually pale skin;  unusual tiredness 
  
  

  The above signs of anemia are more likely to occur in children, menstruating women, and pregnant women, who usually need more iron than other patients. If these signs appear during trientine treatment, your doctor will need to do some tests.

• Rare
  • Fever;  general feeling of discomfort, illness, or weakness;  joint pain;  skin rash, blisters, hives, or itching;  swollen glands  
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.