trientine
Trientine (Syprine) is a medication used in people with Wilson's disease to prevent blood copper levels from getting too high. It's only for people who can't take penicillamine (Depen). It's not commonly used, so there's little information about this medication.
What is Trientine (Syprine)?
What is Trientine (Syprine) used for?
- Wilson's disease in people who can't take penicillamine (Depen)
How Trientine (Syprine) works
Trientine (Syprine) is a chelating agent, which means that it attaches to certain metals to help remove them from the body.
In Wilson's disease, high amounts of copper get stored in different parts of your body, such as the liver and brain. By attaching to this extra copper, trientine (Syprine) prevents the copper from being absorbed into your body. This helps keep your blood copper levels low.
Drug facts
Side effects of Trientine (Syprine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Low iron levels (iron deficiency)
Less Common Side Effects
- Joint pain
- Muscle spasm
Trientine (Syprine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Myasthenia gravis: periods of muscle weakness, eyelid drooping, changes in vision or speech, difficulty swallowing
- Systemic lupus erythematosus (SLE): on-and-off fever, tiredness, skin rash across cheeks and nose (butterfly rash), joint pain
The following Trientine (Syprine) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Lupus-like syndrome—joint pain, swelling, or stiffness, butterfly-shaped rash on the face, rashes that get worse in the sun, fever, unusual weakness or fatigue
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
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Pros and cons of Trientine (Syprine)
Pros
- Can be used for short-term and long-term treatment of Wilson's disease
- Few reported side effects
- Available as a lower-cost generic medication
Cons
- Little known about this medication, since it hasn't been used or studied a lot
- Need to take 2 to 4 times per day and on an empty stomach
- Need to store in the refrigerator
Pharmacist tips for Trientine (Syprine)
- Store trientine (Syprine) capsules in the refrigerator, and keep them in their original container to protect it from light.
- Swallow the capsules whole with water only. Don't open or chew the capsules.
- Take trientine (Syprine) on an empty stomach at least 1 hour before or 2 hours after food or milk. This makes sure the medication can work properly to lower blood copper levels, instead of attaching to minerals found in the food or beverages.
- Take trientine (Syprine) at least 1 hour before or 1 hour after any other medications that you take by mouth. Avoid mineral supplements while taking trientine (Syprine). Doing so prevents trientine (Syprine) from attaching to minerals found in other medications or supplements, instead of the extra copper in your body.
- Your provider may recommend that you take an iron supplement for a short period of time if your iron levels get too low. If you need to take an iron supplement during treatment, take trientine (Syprine) at least 2 hours before or after the iron supplement.
Common questions about Trientine (Syprine)
Trientine (Syprine) is approved only for people who can't take penicillamine (Depen). Clinical practice guidelines support using trientine (Syprine) as a first-choice option for treating Wilson's disease. Talk to your provider to see if this medication is right for you.
There haven't been any strong studies looking at how safe or how well trientine (Syprine) works in children younger than 18 years old. But it has been safely used in children in practice. The medication has also been used in children as young as 6 years old without any reported serious side effects. Talk to your child's provider to see if trientine (Syprine) is right for your child.
There haven't been studies looking at how trientine (Syprine) affects pregnant women, so it's not completely known how safe it is for unborn babies. In animal studies, this medication caused harm to unborn babies at doses typically used in humans. But clinical practice guidelines still recommend trientine (Syprine) as an option for pregnant women when it's clearly needed and the benefits outweigh the risks of using it. If you're pregnant or thinking of getting pregnant, talk to your provider before starting trientine (Syprine).
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Risks and warnings for Trientine (Syprine)
Trientine (Syprine) 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.
Little known about the effects of the medication
There isn't a lot of clinical experience with trientine (Syprine), because it isn't commonly used. This means medical providers don't have a good understanding of how it works or the risks with it. However, it's still a recommended medication based on available clinical practice guidelines for the treatment of Wilson's disease. To make sure trientine (Syprine) is as safe for you as possible, your provider will follow up with you regularly and monitor for any side effects.
Trientine (Syprine) dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 250mg | 90 capsules | $396.90 | $4.41 |
| 500mg | 60 capsules | $899.14 | $14.99 |
Typical dosage for Trientine (Syprine)
- Adults and children older than 12 years: The typical starting dose is 750 mg to 1,250 mg by mouth per day. The maximum dose is 2,000 mg per day.
- Children age 12 years and younger: The typical starting dose is 500 mg to 750 mg by mouth per day. The maximum dose is 1,500 mg per day.
The total daily dose of trientine (Syprine) is typically separated into 2 to 4 doses throughout the day. Your provider will adjust the dose based on any side effects you experience with the medication, your Wilson's disease symptoms, and your blood copper levels.
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