曲恩汀
Trientine
Trientine hydrochloride
別名: Syprine · Metalite · Cufence · MK-0681 · 2,2,2-tetramine · trien hydrochloride · triethylenetetramine dihydrochloride · trientine hydrochloride · TETA
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| As a chelator for copper hepatotoxicity | 10-15 mg/kg | PO | q12h | — | 🌎 NA |
| As a chelator for copper hepatotoxicity | 10-15 mg/kg | PO | q12h | — | 🌎 NA |
| As a chelator for copper hepatotoxicity | 15-30 mg/kg | PO | q12h | — | 🌎 NA |
| Copper hepatotoxicosis | 10-15 mg/kg | PO | q12h | Long-term as needed | 🌍 EU |
- As a chelator for copper hepatotoxicity: 1-2 hours before a meal
- As a chelator for copper hepatotoxicity: Give one hour before meals
- As a chelator for copper hepatotoxicity: Give prior to meals
- Copper hepatotoxicosis: Vomiting may be reduced by giving in divided doses with food.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
曲恩汀是一種口服銅螯合劑，主要用於治療犬隻的銅相關性肝病（例如貝林登㹴、拉布拉多犬等易發品種）。當病患無法耐受青黴胺（Penicillamine）的胃腸道副作用（如嚴重嘔吐）時，曲恩汀是極佳的替代選擇。
作用機制
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.
安全性與警告
禁忌症
- 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.
不良反應
- 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)
注意事項
Teratogenicity: Trientine is a potential teratogen (FDA Category C). It should only be used in pregnant animals when the benefits to the mother clearly outweigh the risks to the offspring. Exercise caution in nursing patients.
Handling Warning: The drug can cause topical dermatitis. It must be given in an intact capsule and should never be opened or sprinkled on food. If the powder accidentally contacts human or animal skin, wash the area immediately with water.
藥物相互作用
Iron and trientine mutually inhibit the absorption of one another. Separate doses by at least 2 hours.
Trientine may chelate zinc and other essential minerals, reducing their absorption. Separate doses by at least 2 hours.
Inhibits absorption of iron; separate doses by a minimum of 2 hours
Inhibits absorption of zinc; separate doses by a minimum of 2 hours
Inhibits absorption of minerals; separate doses by a minimum of 2 hours
監測
- 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
藥物動力學
吸收
Poorly absorbed from the gastrointestinal tract.
分佈
Widely distributed, but has greater affinity for plasma copper than tissue copper.
代謝
Metabolized via acetylation.
排除
Excreted primarily in the urine as a copper-trientine complex.
過量
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.
可用產品
劑型
- Capsules
- 250 mg capsule
- 300 mg capsule
人用標示
- Trientine HCl Oral Capsules: 250 mg
- 250 mg capsule
- 300 mg capsule
各地核准狀態
POM (Prescription Only Medicine). Human orphan drug used off-label under the cascade.
POM (Prescription Only Medicine).
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store trientine capsules in the refrigerator (2-8°C) in tightly closed containers. The powder is highly hygroscopic (absorbs moisture from the air).
飼主須知
請盡量在空腹時（飯前1-2小時）給藥以達到最佳吸收效果。如果空腹給藥引發嘔吐或食慾不振，可與極少量食物一起餵食。請勿打開膠囊將藥粉撒在食物上，因藥粉可能引起接觸性皮膚炎。若藥粉不慎接觸到皮膚，請立即用清水洗淨。藥物請保存在冰箱內並保持容器密閉。
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