Syprine (trientine hydrochloride)
An approved treatment for Wilson Disease.
The same compound appears under different names depending on the context. Here is how to identify Trientine hydrochloride wherever you encounter it, plus the key facts at a glance.
- Generic name
- Trientine hydrochloride
- Brand name
- Syprine
- Drug class
- Copper chelator (oral)
- Manufacturer
- Bausch Health (Syprine); generic available
- How it's taken
- Capsules taken by mouth and swallowed whole.
An older oral copper chelator long used as second-line treatment for Wilson disease in patients who cannot tolerate penicillamine. Generic versions are widely available and remain a workhorse of long-term Wilson disease management. Requires refrigeration in its hydrochloride formulation.
Where Trientine hydrochloride fits
Standard alternative for people with Wilson disease who cannot tolerate penicillamine, which is the group its FDA label covers. It cannot be swapped dose for dose with Cuvrior (trientine tetrahydrochloride): Cuvrior's label says it is not substitutable milligram for milligram with other trientine products. Cuvrior is also approved for a different group: adults with stable Wilson disease who are already de-coppered and tolerate penicillamine. Refrigeration and dosing schedule are other practical differences.
How Trientine hydrochloride works
Oral copper chelator that binds excess copper in the body so it can be excreted in the urine, reducing toxic copper accumulation in Wilson disease
Side effects and safety
Iron deficiency anemia (trientine also chelates iron), gastrointestinal upset, rash, and lupus-like syndrome (systemic lupus erythematosus) has been reported. Paradoxical neurologic worsening can occur in patients with neurologic Wilson disease during early treatment. Capsules require refrigeration.
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking Trientine hydrochloride
Capsules taken by mouth and swallowed whole. The usual starting dose is 750 to 1,250 mg a day for adults and 500 to 750 mg a day for children, divided into 2 to 4 doses, up to a maximum of 2,000 mg a day for adults and 1,500 mg a day for children 12 and under. Take on an empty stomach, at least 1 hour before or 2 hours after meals and at least 1 hour apart from other drugs, food, or milk.
Availability and cost
Generic versions may be available at a lower cost. Ask your pharmacist.
Help paying for Syprine
Pick your insurance to see which help fits. Drugmaker copay cards can't be used with Medicare, Medicaid or TRICARE; charity funds are the usual route there.
- Free medicine program
Brand SYPRINE is on the Bausch Health PAP list. Free medicine for eligible patients with limited or no coverage, shipped home for up to 1 year.
For: no insurance, underinsured, Medicaid · source
Good to know: Applies to brand SYPRINE only; generic trientine is made by many companies and is not covered. Bausch left certain federal Medicaid programs on Oct 1, 2025, so Medicaid may not cover Bausch brands; Medicaid patients may get them free through the PAP. A WD Rx Access copay form exists, but its posted terms expired, so current copay help is unconfirmed.
- From a charity · Wilson Disease AssociationWDA Patient Assistance fundApply directly
Pays for: Travel and lodging (up to 7 days) for testing or treatment, for the patient and one companion, up to $2,000 per year.
The foundation says: “Status not shown on page”
How Wilson disease treatments compare
Four FDA-approved medications are available for Wilson disease, plus several investigational programs in late-stage trials. Treatment choice depends on your stage (active de-coppering versus stable maintenance), your tolerance to penicillamine, whether you have neurologic or hepatic features, and your age. This chart summarizes the practical differences between the approved options.
4 FDA-approved wilson disease treatments are available: Cuprimine / Depen (penicillamine, approved 1956); Syprine (trientine hydrochloride, approved 1985); Galzin (zinc acetate, approved 1997); Cuvrior (trientine tetrahydrochloride, approved 2022). Cuprimine / Depen is typically used as historical first-line for active de-coppering. many centers now switch patients off due to side effect burden once stable..
| Drug | How it works | How it’s given | How often | Where you take it | Typical use | FDA approved |
|---|---|---|---|---|---|---|
Cuprimine / Depen penicillamine | Copper chelator — binds copper in the body so it can be flushed out through the urine. The original Wilson disease drug. | Oral capsule or tablet, taken on an empty stomach | 3–4 times daily during de-coppering, lower doses for maintenance | Home (oral) | Historical first-line for active de-coppering. Many centers now switch patients off due to side effect burden once stable. | 1956 |
Syprine trientine hydrochloride You are here | Copper chelator — binds copper for urinary excretion. Generally better tolerated than penicillamine but similar efficacy. | Oral capsule, taken on an empty stomach (capsules require refrigeration) | 2–4 times daily | Home (oral) | Alternative chelator for patients who cannot tolerate penicillamine. Generic versions widely available. | 1985 |
Galzin zinc acetate | Copper absorption blocker — induces a protein in the gut (metallothionein) that traps dietary copper before it can be absorbed. | Oral capsule, taken on an empty stomach (separated from chelators) | 3 times daily | Home (oral) | First-line maintenance therapy in many centers, particularly for presymptomatic patients identified through family screening. | 1997 |
Cuvrior trientine tetrahydrochloride | Copper chelator — same chelating action as Syprine, with a more chemically stable salt formulation that allows simpler storage and twice-daily dosing. | Oral tablet, taken on an empty stomach | Twice daily | Home (oral) | Approved for adults with stable Wilson disease who are de-coppered and tolerant to penicillamine; designed as a maintenance switch option. | 2022 |
This chart summarizes approved Wilson disease treatments to help you understand the landscape. It is not medical advice. Treatment decisions depend on your individual disease stage, prior therapies, tolerability, and lab values for copper control. Investigational programs (ALXN1840, VTX-801, UX701) are not included because they are not yet FDA-approved. Always discuss options with your hepatologist or metabolic specialist.
Development history
Trientine hydrochloride was approved in the U.S. in 1985 as Syprine for patients intolerant to penicillamine. Generic trientine hydrochloride became available in 2018, dramatically reducing prices that had previously become controversial when Valeant raised the cost of Syprine. The newer Cuvrior (trientine tetrahydrochloride) was approved in 2022 as a more stable salt formulation.
Explore Wilson Disease trials
Other Wilson Disease treatments
Common questions about Trientine hydrochloride
▸What is Trientine hydrochloride (Syprine)?
An older oral copper chelator long used as second-line treatment for Wilson disease in patients who cannot tolerate penicillamine. Generic versions are widely available and remain a workhorse of long-term Wilson disease management. Requires refrigeration in its hydrochloride formulation.
▸What is the mechanism of action of Trientine hydrochloride?
Oral copper chelator that binds excess copper in the body so it can be excreted in the urine, reducing toxic copper accumulation in Wilson disease
▸What are the side effects of Trientine hydrochloride?
Iron deficiency anemia (trientine also chelates iron), gastrointestinal upset, rash, and lupus-like syndrome (systemic lupus erythematosus) has been reported. Paradoxical neurologic worsening can occur in patients with neurologic Wilson disease during early treatment. Capsules require refrigeration.
▸How is Trientine hydrochloride taken?
Capsules taken by mouth and swallowed whole. The usual starting dose is 750 to 1,250 mg a day for adults and 500 to 750 mg a day for children, divided into 2 to 4 doses, up to a maximum of 2,000 mg a day for adults and 1,500 mg a day for children 12 and under. Take on an empty stomach, at least 1 hour before or 2 hours after meals and at least 1 hour apart from other drugs, food, or milk.
▸Is Trientine hydrochloride FDA approved?
Yes, Trientine hydrochloride (Syprine) is FDA approved (1985) for the treatment of Wilson Disease.