Drug Interaction Report

GENERALLY AVOID: Concurrent oral administration of mineral supplements or mineral-containing products may block the absorption of trientine, and vice versa. The mechanism is trientine chelation of polyvalent metal ions resulting in a nonabsorbable complex.

MANAGEMENT: In general, mineral supplements or mineral-containing products (e.g., antacids) should not be used in patients treated with trientine. If concomitant use is unavoidable, separation of administration times by at least two hours is advisable.

ADJUST DOSING INTERVAL: The gastrointestinal absorption of trientine may be decreased in the presence of food, resulting in reduced therapeutic effects.

MANAGEMENT: Trientine should be administered on an empty stomach, at least one hour before or two hours after meals and at least one hour apart from any other food, drug, or milk.

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

GENERALLY AVOID: Concurrent oral administration of mineral supplements or mineral-containing products may block the absorption of trientine, and vice versa. The mechanism is trientine chelation of polyvalent metal ions resulting in a nonabsorbable complex.

MANAGEMENT: In general, mineral supplements or mineral-containing products (e.g., antacids) should not be used in patients treated with trientine. If concomitant use is unavoidable, separation of administration times by at least two hours is advisable.