Cuvrior (trientine tetrahydrochloride) is a newly approved medication that's used to treat a rare genetic condition called Wilson's disease in adults. It can only be used in people with stable Wilson's disease who are able to take penicillamine (Depen).
Wilson's disease in people with copper levels that are under control and who can take penicillamine (Depen)
Cuvrior (trientine tetrahydrochloride) is a chelating agent. People with Wilson's disease have high amounts of copper which can cause organ damage. Cuvrior (trientine tetrahydrochloride) works by attaching to copper in your body, preventing it from getting absorbed from your gut, and allows your body to remove it through your urine. This helps to keep your copper levels low.
Source: FDA
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Works just as well as penicillamine (Depen) to lower copper levels in people with Wilson's disease
Scored tablets can be broken in half for people who have difficulty swallowing whole pills
Can be stored at room temperature
Must be taken on an empty stomach
Can't be used in people who aren't able to take penicillamine (Depen)
Has many interactions with foods, drinks, medications, and supplements
Your dose of Cuvrior (trientine tetrahydrochloride) will depend on your previous dose of penicillamine (Depen). Stop taking penicillamine (Depen) before starting Cuvrior (trientine tetrahydrochloride).
Take Cuvrior (trientine tetrahydrochloride) on an empty stomach, at least 1 hour before or 2 hours after meals. You should also take it 1 hour away from any other food or milk. This is because it can attach to certain foods and drinks which might prevent the medication from getting absorbed and working properly.
Make sure to keep the Cuvrior (trientine tetrahydrochloride) tablet inside of the blister pack until you're ready to take it so moisture from the air doesn't damage the medication. Don't use a pill box to store the medication.
Don't crush, chew, or dissolve Cuvrior (trientine tetrahydrochloride) tablets since this can damage the medication and cause it to work less well.
If you have trouble swallowing whole pills, you can divide the tablet into two equal halves on the line in the middle of the tablet. Tell your provider if you have trouble swallowing tablets since this might not be the best option for you if you do.
Keep up with your scheduled lab work so your provider can monitor your copper levels properly and see if Cuvrior (trientine tetrahydrochloride) is working for you. They might need to adjust your dose based on your lab results.
Cuvrior (trientine tetrahydrochloride) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
When you first start taking Cuvrior (trientine tetrahydrochloride), the copper in your body moves around until your levels are stable. This can cause worsening of your symptoms, including brain problems. Let your provider know if you start to feel worse when beginning treatment with Cuvrior (trientine tetrahydrochloride) and they might adjust your dose or even stop the medication. Your provider will monitor your copper levels when you first start taking Cuvrior (trientine tetrahydrochloride), after 3 months, and then every 6 months.
Risk factors: Pregnancy | Menstruation | Low copper diet
Cuvrior (trientine tetrahydrochloride) can sometimes cause copper and iron levels to get too low. Pregnant women are at a higher risk since the amount of copper they need is often greater. Women who are on their period are at a higher risk of having low iron levels. A low copper diet that's commonly recommended in people with Wilson's disease can also lead to low iron levels. Let your provider know if you experience symptoms of low copper or iron levels including muscle weakness, dizziness, feeling tired, confusion, or tingling in your feet or hands. Your provider might recommend that you take an iron supplement, but take it at least 2 hours away from Cuvrior (trientine tetrahydrochloride) to prevent any interaction.
Rash was a commonly reported side effect of Cuvrior (trientine tetrahydrochloride) in the clinical studies. If you develop a rash or other allergic reaction during treatment with Cuvrior (trientine tetrahydrochloride), contact your provider to discuss whether you should continue taking it or switch to a different medication.
Your dose will depend on the dose of penicillamine (Depen) you were taking.
The typical dose ranges from 300 mg to 3,000 mg by mouth on an empty stomach per day, split into two doses throughout the day.
Wilson's disease in people with copper levels that are under control and who can take penicillamine (Depen)
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