Uses of medication: Trientine (TriLaWil) is a chelating agent used for the treatment of Wilson’s disease (hepatolenticular degeneration) in patients intolerant to Penicillamine. Use of this drug when continued treatment with Penicillamine is no longer considerable because of intolerable or severe side effects.
Limitation(s) of use: Unlike penicillamine, treatment with Trientine (TriLaWil 333 mg Capsule) is not recommended in patients with cystinuria or rheumatoid arthritis. Do not use this medicine for biliary cirrhosis.
Dosage: The recommended initial dosage is 500-750 mg daily for pediatric patients and 750-1,250 mg daily for adults taken on an empty stomach, at least 60 minutes prior to a meal or 120 minutes after a meal, and at least 60 minutes apart from any kind of other drugs, food, or milk, in divided doses 2, 3, or 4 times daily. The capsules should be swallowed whole with water and must not be opened or chewed.
The dosage of Trientine can be increased to a maximum of 2,000 mg/daily for adult individuals or 1,500 mg/daily for pediatric patients who are aged 12 or less.
Enhance the daily dosage only in case the clinical response is not adequate or the free serum copper concentration is constantly greater than 20 mcg/dL.
Treatment Reactions: The most commonly reported side effects of Trientine 333 mg capsules (TriLaWil) are:
- stomach pain
- loss of appetite
- general ill feeling
- black/tarry stools
- skin rash
Warnings and Precautions:
- Avoid using Trientine if patients are allergic to it. Regular medical supervision is recommended throughout the treatment. Patients must be checked for iron deficiency anemia (particularly women). Free copper in the blood needs to be also checked.
- As trientine dihydrochloride 333 mg capsule is a chelating agent, it may likely reduce serum iron levels. Doctors can prescribe iron supplementation in a few cases. Use concomitant oral iron at a different time than trientine.
- The use of trientine in conjunction with zinc is not recommended. Limited data are available on the use of both these medicines concomitantly. No specific dosages are recommended.
- In patients who took treatment with D-Penicillamine, lupus-like reactions may occur throughout subsequent treatment with trientine capsules, although it is not possible to define in case there is a formal bond with trientine.
- Individuals taking treatment with trientine generic and with renal or hepatic impairment should remain under persistent and precise medical supervision for adequate control of symptoms and copper levels. Renal or liver function monitoring is also needed in these populations.