Interactions : אינטראקציות

4.5    Interaction with other medicinal products and other forms of interaction

No interaction studies have been performed.
Zinc
There are insufficient data to support the concomitant use of zinc and trientine. The combination of trientine with zinc is not recommended as interaction of zinc with trientine is likely, thereby reducing the effect of both active substances.

Other anti-copper agents
No interaction studies have been performed on the concomitant administration of trientine with D- Penicillamine.

Food

Trientine is poorly absorbed following oral intake and food further inhibits trientine absorption. Specific food interaction studies have been performed with trientine in healthy subjects, showing a reduction of the extent of absorption of trientine up to 45%. Systemic exposure is critical for its principal mechanism of action, copper chelation (see section 5.1). Therefore, it is recommended that trientine is taken at least 1 hour before meals or 2 hours after meals and at least one hour apart from any other medicinal product, food, or milk to allow for maximum absorption and reduce the likelihood of the formation of complexes by metal binding in the gastrointestinal tract (see section 4.2).
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Other products
Trientine has been found to reduce serum iron levels. Therefore, iron supplementation may be necessary in some cases. Concomitant oral iron or other heavy metals should be administred at a different time than trientine to prevent the formation of complexes (see section 4.4).

Although there is no evidence that calcium and magnesium antacids alter the efficacy of trientine, it is good practice to separate their administration (see section 4.4).