What Are My Treatment Options?

Medications approved for the treatment of WD include chelating agents and zinc. Chelating agents such as SYPRINE® (trientine hydrochloride) Capsules remove copper from the organs where it has built up and pull it into the bloodstream. The kidneys then filter the copper out of the blood and into the urine. Zinc blocks absorption of copper from food in the digestive tract, but it does not help remove excess copper if it has already been absorbed.2
Treatment thus occurs in 2 phases:

Diet and Nutrition

Food choices. Copper enters our bodies through the food we eat and the water we drink, which is a good thing because our bodies need copper to function.3 However, when you have WD and your body can’t rid itself of excess copper, it’s important to limit your copper intake by avoiding foods with a high copper content, especially for the first year after diagnosis. Foods you should avoid (or limit) include4:
  • Shellfish
  • Nuts
  • Chocolate
  • Mushrooms
  • Organ meat (eg, liver paté, tripe, sweetbreads)

Water

  • People with WD should avoid using copper containers for cooking, serving, or storing food2
  • If your tap water runs through copper pipes or comes from a well, be sure to run the water for a while before using, as this should reduce any copper residues to acceptable levels2

Vitamins and Dietary Supplements

  • Talk to your doctor before taking a multivitamin, and if he or she approves, ask your pharmacist to recommend one that does not contain copper5
  • If you are a woman who is pregnant or is planning to become pregnant, you should ask your obstetrician to consult with your WD specialist before prescribing prenatal vitamins5
  • Many prenatal vitamins contain a lot of copper and it’s important to find a brand that does not5
You and your doctor should also discuss any other dietary supplements or herbal preparations you are taking, or would like to take, to make sure they will not interact with your medications or worsen problems in your liver.5
Mineral supplements in particular can block absorption of SYPRINE® and should not be taken unless your doctor prescribes 1 for a specific problem, such as anemia due to low iron.6 It is essential to follow your healthcare professional’s advice when it comes to any potential sources of copper or drug interactions that could be harmful to you.
INDICATIONS AND USAGE
Syprine® (trientine hydrochloride) is used to treat Wilson's disease in patients who cannot take the medication known as penicillamine. Wilson's disease is a condition where the body stores too much copper. Syprine is not recommended to treat cystinuria (a condition where a protein known as cystine is excreted into the urine), rheumatoid arthritis, or a disease affecting the bile ducts in the liver known as biliary cirrhosis.
IMPORTANT SAFETY INFORMATION
  • Do not take Syprine if you are allergic to it or any parts of the formulation.
  • You should remain under regular medical supervision the entire time you are taking Syprine. Your doctor should regularly check to see if you have iron deficiency anemia. This is particularly important for women.
  • Take Syprine on an empty stomach, at least one hour before a meal or two hours after a meal and at least one hour apart from any other drug, food, or milk. The capsules should be swallowed whole with water and should not be opened or chewed. For the first month of treatment, take your temperature every night, and report any symptom such as fever or skin rash to your doctor.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are nursing.
  • The following adverse reactions have been reported from a clinical study: iron deficiency and a condition affecting the immune system known as systemic lupus erythematosus. In addition, the following adverse reactions have been reported in marketed use: abnormal or uncontrolled muscle contractions, muscle spasm and an immune disease affecting muscles known as myasthenia gravis.
  • Do not take mineral supplements because they may block the absorption of Syprine.
Please click here to see full Prescribing Information for Syprine Capsules.
You are encouraged to report negative side effects of prescription drugs to FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.
References
  1. Rodriguez-Castro KI, Hevia-Urrutia FJ, Sturniolo GC. Wilson's disease: a review of what we have learned. World J Hepatol. 2015;7(29):2859-2870.
  2. National Institute of Diabetes and Digestive and Kidney Diseases. Wilson Disease. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/wilson-disease/Pages/facts.aspx#sec10. Accessed May 25, 2016.
  3. Desai V, Kaler SG. Role of copper in human neurological disorders. Am J Clin Nutr. 2008;88(suppl):855S-858S.
  4. Roberts EA, Schilsky ML. AASLD Practice Guidelines. Diagnosis and treatment of Wilson disease: an update. Hepatology. 2008;47(6):2089-2111.
  5. Wilson Disease Association. Diet and nutrition. http://www.wilsonsdisease.org/wilson-disease/wilsondisease-diet.php. Accessed July 1, 2016.
  6. Syprine [package insert]. Bridgewater, NJ: Valeant Pharmaceuticals North America LLC; 2014.

©2016 Valeant Pharmaceuticals North America LLC. All Rights Reserved. SYP.0024.USA.16

 

Indications and Usage

Syprine® (trientine hydrochloride) is used to treat Wilson's disease in patients who cannot take the medication known as penicillamine. Wilson's disease is a condition where the body stores too much copper. Syprine is not recommended to treat cystinuria (a condition where a protein known as cystine is excreted into the urine), rheumatoid arthritis, or a disease affecting the bile ducts in the liver known as biliary cirrhosis.

Important Safety Information

  • Do not take Syprine if you are allergic to it or any parts of the formulation.
  • You should remain under regular medical supervision the entire time you are taking Syprine. Your doctor should regularly check to see if you have iron deficiency anemia. This is particularly important for women.
  • Take Syprine on an empty stomach, at least one hour before a meal or two hours after a meal and at least one hour apart from any other drug, food, or milk. The capsules should be swallowed whole with water and should not be opened or chewed. For the first month of treatment, take your temperature every night, and report any symptom such as fever or skin rash to your doctor.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are nursing.
  • The following adverse reactions have been reported from a clinical study: iron deficiency and a condition affecting the immune system known as systemic lupus erythematosus. In addition, the following adverse reactions have been reported in marketed use: abnormal or uncontrolled muscle contractions, muscle spasm and an immune disease affecting muscles known as myasthenia gravis.
  • Do not take mineral supplements because they may block the absorption of Syprine.
Please click here to see full Prescribing Information for Syprine Capsules.
 

INDICATIONS AND USAGE

Syprine® (trientine hydrochloride) is used to treat Wilson's disease in patients who cannot take the medication known as penicillamine. Wilson's disease is a condition where the body stores too much copper. SYPRINE® is not recommended to treat cystinuria (a condition where a protein known as cystine is excreted into the urine), rheumatoid arthritis, or a disease affecting the bile ducts in the liver known as biliary cirrhosis.

IMPORTANT SAFETY INFORMATION

  • Do not take Syprine if you are allergic to it or any parts of the formulation.
  • You should remain under regular medical supervision the entire time you are taking Syprine. Your doctor should regularly check to see if you have iron deficiency anemia. This is particularly important for women.
  • Take Syprine on an empty stomach, at least one hour before a meal or two hours after a meal and at least one hour apart from any other drug, food, or milk. The capsules should be swallowed whole with water and should not be opened or chewed. For the first month of treatment, take your temperature every night, and report any symptom such as fever or skin rash to your doctor.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are nursing.
  • The following adverse reactions have been reported from a clinical study: iron deficiency and a condition affecting the immune system known as systemic lupus erythematosus. In addition, the following adverse reactions have been reported in marketed use: abnormal or uncontrolled muscle contractions, muscle spasm and an immune disease affecting muscles known as myasthenia gravis.
  • Do not take mineral supplements because they may block the absorption of Syprine.
Please click here to see full Prescribing Information for Syprine Capsules.