Cuvrior Dosage

Generic name: TRIENTINE TETRAHYDROCHLORIDE 300mg
Dosage form: tablet, film coated
Drug class: Chelating agents

Medically reviewed by Drugs.com. Last updated on Jan 31, 2024.

Recommended Dosage and Administration

The recommended starting total daily dosage of CUVRIOR in adult patients is 300 mg up to 3,000 mg taken orally in divided doses (two times daily). Table 1 provides the recommended starting total daily dosage of CUVRIOR in adult patients switching from penicillamine to CUVRIOR [see Clinical Studies (14)]. Discontinue penicillamine before starting CUVRIOR.

Table 1: Recommended Starting Total Daily Dosage of CUVRIOR when Switching from Penicillamine to CUVRIOR
Penicillamine Total Daily Dosage	CUVRIOR Starting Total Daily Dosage
125 mg	300 mg
250 mg	600 mg
375 mg	900 mg
500 mg	900 mg
625 mg	1,200 mg
750 mg	1,500 mg
875 mg	1,800 mg
1,000 mg	2,100 mg
1,125 mg	2,400 mg
1,250 mg	2,400 mg
1,375 mg	2,700 mg
1,500 mg or greater	3,000 mg

Adjust the total daily dosage of CUVRIOR according to clinical assessment and laboratory monitoring of copper [see Dosage and Administration (2.4)]. The total daily dosage of CUVRIOR should not exceed 3,000 mg.

If the number of CUVRIOR tablets prescribed per day cannot be equally divided among doses, then divide the total daily dosage such that the higher number of tablets is administered with the first daily dose. Table 2 provides the recommended approach to administration of CUVRIOR tablets to achieve the total daily dosage.

Table 2: Recommended Administration Schedule of CUVRIOR Tablets to Achieve Total Daily Dosage
CUVRIOR	Number of CUVRIOR Tablets to Administer
Total Daily Dosage	Morning	Evening
300 mg	1	0
600 mg	1	1
900 mg	2	1
1,200 mg	2	2
1,500 mg	3	2
1,800 mg	3	3
2,100 mg	4	3
2,400 mg	4	4
2,700 mg	5	4
3,000 mg	5	5

Important Administration Instructions

Discontinue penicillamine before starting CUVRIOR [see Dosage and Administration (2.1)].
Administer CUVRIOR on an empty stomach, at least 1 hour before meals or 2 hours after meals and at least 1 hour apart from any other food or milk.
Avoid concomitant use of mineral supplements (e.g. iron, zinc, calcium, magnesium). If concomitant use of mineral supplements is unavoidable [see Drug Interactions (7.1)]:
- Iron supplements: Administer CUVRIOR at least 2 hours before or 2 hours after administration of an iron supplement.
- Other mineral supplements: Administer CUVRIOR at least 1 hour before or 2 hours after administration of other mineral supplements.
Administer CUVRIOR at least 1 hour apart from any other oral drug.
Do not remove tablets from the blister pack until just before dosing.
Swallow tablets of CUVRIOR without crushing, chewing, or dissolving tablets. For patients who have difficulty swallowing the tablet whole, the scored tablet can be divided into two equal halves. Do not store the tablet for future use after the blister has been opened.
Avoid the use of CUVRIOR in patients who are unable to swallow tablets.

Switching to CUVRIOR from Other Trientine Products

CUVRIOR is not substitutable on a milligram-per-milligram basis with other trientine products.

If switching a patient from a trientine hydrochloride formulation to CUVRIOR, note that the content of the active moiety (trientine base) is not the same as CUVRIOR. A 250 mg capsule of trientine hydrochloride contains 167 mg of trientine base; in contrast, each 300 mg tablet of CUVRIOR contains 150 mg of trientine base [see Clinical Pharmacology (12.3)].

Clinical Monitoring and Laboratory Monitoring of Copper

Adjust the total daily dosage of CUVRIOR according to clinical assessment and serum non-ceruloplasmin copper (NCC) levels. Evaluate serum NCC levels when initiating CUVRIOR treatment, after 3 months of treatment and approximately every 6 months thereafter. Therapy may also be monitored periodically (every 6 to 12 months) with measurement of 24-hour urinary copper excretion (UCE) [see Warnings and Precautions (5.1, 5.2)].