トリエンチン
トリエンチンは、主に犬の銅関連性肝疾患の治療に使用される経口銅キレート剤です。ペニシラミンの副作用（重度の嘔吐など）に耐えられない患者にとって、重要な代替治療薬となります。
作用機序: Trientine acts as a polyamine chelating agent. It binds to systemic copper to form a stable, water-soluble complex (a chelate) that is subsequently eliminated from the body via **urinary excretion**. * **Affinity Profile:** Trientine has a greater affinity for **plasma copper** compared to penicillamine. * Conversely, penicillamine has a higher affinity for **tissue copper**. * By binding circulating copper, trientine creates a concentration gradient that gradually pulls stored copper out of hepatic tissues for elimination.
動物種別の用量
- As a chelator for copper hepatotoxicity · 10-15 mg/kg · PO · q12h · 1-2 hours before a meal
- As a chelator for copper hepatotoxicity · 10-15 mg/kg · PO · q12h · Give one hour before meals
- As a chelator for copper hepatotoxicity · 15-30 mg/kg · PO · q12h · Give prior to meals
- Copper hepatotoxicosis · 10-15 mg/kg · PO · q12h · Long-term as needed · Vomiting may be reduced by giving in divided doses with food.
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Hypersensitivity to trientine
- Cystinuria
- Rheumatoid arthritis
- Biliary cirrhosis
- No specific contraindications available in the monograph, but should be used with caution in patients without confirmed copper storage disease.
有害事象
- Acute renal failure (rare but reported in dogs)
- Iron deficiency anemia (with long-term use)
- Topical contact dermatitis (if powder contacts skin)
- Nausea
- Vomiting
- Abdominal pain
- Melaena (dark, tarry stools)
- Weakness
- Copper deficiency (with chronic therapy)
薬物相互作用
- Iron · Iron and trientine mutually inhibit the absorption of one another. Separate doses by at least 2 hours.
- Zinc · Trientine may chelate zinc and other essential minerals, reducing their absorption. Separate doses by at least 2 hours.
- Iron supplements · Inhibits absorption of iron; separate doses by a minimum of 2 hours · moderate
- Zinc supplements · Inhibits absorption of zinc; separate doses by a minimum of 2 hours · moderate
- Other mineral supplements · Inhibits absorption of minerals; separate doses by a minimum of 2 hours · moderate
モニタリング
- Periodic quantitative hepatic copper levels (via liver biopsy)
- Renal function parameters (BUN, Creatinine, SDMA, Urinalysis) due to the risk of acute renal failure
- Complete Blood Count (CBC) to monitor for iron deficiency anemia
- Hepatic copper concentrations (via biopsy)
- Liver enzymes (ALT, AST, ALP)
- Clinical signs of copper deficiency (e.g., anemia, weakness)
- Gastrointestinal tolerance
過量投与
Little information is available regarding acute toxicity in veterinary species. In human medicine, a case of a patient ingesting 30 grams of trientine without significant morbidity has been reported. If a massive overdose occurs in a pet, standard gastrointestinal decontamination and supportive care are recommended.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。