Cuvrior

— THERAPEUTIC CATEGORIES —
  • Inborn errors of metabolism

Cuvrior Generic Name & Formulations

General Description

Trientine tetrahydrochloride 300mg; tabs; functionally scored.

Pharmacological Class

Chelating agent.

How Supplied

Tabs—8, 72

Manufacturer

Generic Availability

NO

Mechanism of Action

Trientine eliminates absorbed copper from the body by forming a stable complex that is then eliminated through urinary excretion. Trientine also chelates copper in the intestinal tract, reducing copper absorption.

Cuvrior Indications

Indications

Wilson’s disease, in patients who are de-coppered and tolerant to penicillamine.

Cuvrior Dosage and Administration

Adult

Swallow whole. Take on an empty stomach. Discontinue penicillamine prior to initiation. Start at 300–3000mg/day in 2 equally divided doses; max 3000mg/day. Adjust total daily dose based on clinical response and serum non-ceruloplasmin copper (NCC) levels. If the number of tabs per day cannot be equally divided, then divide the total daily dose such that the higher number of tabs is given with the first daily dose. Switching from other trientine products: see full labeling.

Children

Not established.

Cuvrior Contraindications

Not Applicable

Cuvrior Boxed Warnings

Not Applicable

Cuvrior Warnings/Precautions

Warnings/Precautions

Not substitutable on a mg-per-mg basis with other trientine products. Potential worsening of clinical symptoms (including neurological deterioration) at therapy initiation; adjust dose or discontinue if condition worsens. Assess serum NCC levels at initiation, after 3 months, and every 6 months thereafter; may also monitor periodically (every 6–12 months) with 24-hour urinary copper analysis. Monitor for iron deficiency (esp. menstruating or pregnant women) or copper deficiency (eg, in pregnancy). Evaluate and consider discontinuing if rash or other hypersensitivity reactions develop. Elderly. Pregnancy. Nursing mothers.

Cuvrior Pharmacokinetics

Absorption

The median time to the peak concentration (Tmax): ranged from 1.25–2 hours.

Mean (± SD) maximum plasma concentrations (Cmax): 2030±981 ng/mL (after 900 mg dose), and 3430±1480 ng/mL (after 1500 mg dose).

Metabolism

Acetylation.

Elimination

Renal. Half-life: 13.8–16.5 hours.

Cuvrior Interactions

Interactions

Avoid concomitant mineral supplements (eg, iron, zinc, calcium, magnesium); if unavoidable, give Cuvrior at least 2hrs before or after an iron supplement, and at least 1hr before or 2hrs after other mineral supplements. Separate dosing of any other drug, food, or milk by at least 1 hour.

Cuvrior Adverse Reactions

Adverse Reactions

Abdominal pain, change of bowel habits, rash, alopecia, mood swings; copper deficiency, iron deficiency, lupus, hypersensitivity reactions.

Cuvrior Clinical Trials

See Literature

Cuvrior Note

Not Applicable

Cuvrior Patient Counseling

See Literature