(trientine dihydrochloride)

Brand name:

Generic name:
Trientine dihydrochloride

Product Class:
Chelating agent

Each hard capsule contains 250 mg
of trientine dihydrochloride

Therapeutic indication1

The treatment of Wilson’s disease in patients intolerant to D-Penicillamine therapy, in adults, adolescents and children aged 5 years or older


  • The starting dose would usually correspond to the lowest recommended dose and the dose should subsequently be adapted according to the patient’s clinical response
  • Dose adjustments should be considered in case of signs of reduced efficacy such as (persistent) increase in liver enzymes, and worsening of tremor. When doses are adjusted this should be done in small steps
  • The dose may also be reduced in case of side effects, such as gastrointestinal complaints and haematological changes. Doses should be reduced to a more tolerable dose and may be increased again, once side effects have been resolved

For more information about dosage, consult the Summary of Product Characteristics

Trientine benefits2

  • From a retrospective analysis of data on 134 monotherapy treatments (103 trientine and 31 penicillamine), Trientine was as effective as penicillamine for reducing hepatic and neurological signs and symptoms when used second line
  • Hepatic signs and symptoms were reduced in 70.5% of symptomatic patients taking second line therapy with either drug
  • The proportion of patients experiencing improvement in neurological symptoms was lower, with more than a third of patients not improving or becoming worse in both treatment groups
  • The study suggested that cerebral damage caused by copper toxicity may be at least partly irreversible

How Wilson’s Disease affects the body3

In Wilson’s Disease the symptoms are highly variable and can affect the liver, brain, kidney, eyes, heart, bone, blood system, and many other organs or tissues.3

Adapted from Stremmel and Weiskirchen, 20213

Trientine tolerability profile2

Undesirable Effects

Undesirable effects have been observed and reported during treatment with Trientine, with the following frequencies:

Common (≥1/100 to <1/10); Uncommon (≥1/1,000 to <1/100). ‘Not known’ undesirable effects cannot be estimated from the available data.1

There have been reports of neurological deterioration at the start of treatment in Wilson’s disease patients treated with copper chelators including Trientine, with symptoms of, for example, dystonia, rigidity, tremor and dysarthria

System organ class
Adverse reaction
Blood and lymphatic system disorders
Uncommon: Anaemia
Uncommon: Aplastic anaemia
Uncommon: Sideroblastic anaemia
Nervous system disorders
Uncommon: Dystonia
Uncommon: Tremor
Not known: Dysarthria
Not known: Muscle rigidity
Not known: Neurological deterioration
Immune system disorders
Not known: Lupus-like syndrome
Not known: Lupus nephritis
Gastrointestinal disorders Common
Common: Nausea
Not known: Colitis
Not known: Duodenitis
Skin and subcutaneous tissue
Uncommon: Rash


Hypersensitivity to the active substance(s) or to any of the following excipients:

Titanium dioxide (E171)
Shellac (E904)

Stearic acid

Black Iron Oxide (E172)
Potassium Hydroxide (E525)


Contact Us

Side effects should be reported.
Healthcare professionals are requested to report any suspected side effects to 1 800 970 8841 or by email to: Waymade@veristat.com
Side effects should also be reported to Waymade PLC at:
+44 (0)1279 406759 or by email to: WaymadePV@diamondpharmaservices.com
    1. Trientine 250 mg hard capsules. Product Monograph.
    2. Weiss KH, et al. Efficacy and safety of oral chelators in treatment of patients with Wilson disease. Clin Gastroenterol Hepatol. 2013 Aug;11(8):1028-35.
    3. Stremmel W, Weiskirchen R. Therapeutic strategies in Wilson disease: pathophysiology and mode of action. Ann Transl Med. 2021 Apr;9(8):732.

    Importer of Record for Canada:
  1. Waymade Canada, 4150 Sainte-Catherine O 6th floor, Westmount, QC H3Z 2Y5