Dosing and uses of Syprine (trientine)
Adult dosage forms and strengths
capsule
- 250mg
Wilson Disease
For patients intolerant of penicillamine
750-1250 mg/day PO divided q6-12hr; not to exceed 2 g/day
Manganism (Orphan)
Indicated for the treatment of manganism
Orphan indication sponsor
- Biovail Technologies, Ltd; 700 Route 202/206 North; Bridgewater, NJ 08807
Wilson Disease (Orphan)
New salt form: trientine tetrahydrochloride
Orphan designation for treatment of Wilson Disease
Sponsor
- GMP-Orphan SAS; Voisin Consulting, Inc; 222 Third Street, Suite 3121; Cambridge, Massachusetts 02142
Pediatric dosage forms and strengths
capsule
- 250mg
Wilson Disease
<12 years
- 500-750 mg/day PO divided q6-12hr; not to exceed 1.5 g/day
≥12 years
- For patients intolerant of penicillamine: 750-1250 mg/day PO divided q6-12hr; not to exceed 2 g/day
Syprine (trientine) adverse (side) effects
Frequency not defined
Dystonia
Iron deficiency
Rash; thickening and fissuring of skin
Muscular spasm
Myasthenia gravis
SLe
Abdominal pain
Gastritis
Aphthoid ulcer
Anorexia
Colitis
Heartburn
Loss of taste
Aplastic anemia
Sideroblastic anemia
Lupus like eruption
Myasthenia gravis
Warnings
Contraindications
Hypersensitivity to product or components
Cautions
Not indicated for cystinuria, RA (cf penicillamine) or biliary cirrhosis
May cause iron deficiency anemia
Hepatic iron oveload may result from copper deficiency induced by therapy
Monitor urinary copper and for signs of hypersensitivity (eg, elevated body temperature)
Pregnancy and lactation
Pregnancy category: C
Lactation: Excretioin in breast milk unknown; use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Syprine (trientine)
Mechanism of action
Oral chelating agent used to induce adequate cupriuresis
Pharmacokinetics
Absorption: Poor
Excretion: Urine (9%)
Metabolite: Acetyltrien
Administration
Oral Administration
Take on empty stomach 1 hr before or 2 hr after meals