Can Zinc and Trientine be used in combination?
The combination of zinc and trientine can be used for the first four months of therapy in patients with significant liver or neurologic disease. How often you check lab values depends on the extent of disease, the range can be from weekly checks of urine copper and zinc to every three months after initiating treatment. Subsequently, the urine copper and zinc could be checked every six months for two years, then annually with more frequent checks if compliance is in doubt. Urine copper levels should be in the range expected for treatment with trientine alone, in other words 1-2 mg /24 hours initially and then reducing to 0.5-1.0 mg after several months of treatment. We look at the trend in urine values over time as much as the absolute numbers at any one time to gauge compliance and treatment effectiveness at reducing copper. You also can monitor the non-ceruloplasmin copper. This frequently falls to less than 10 micrograms/dl on the combination therapy. Monitoring for compliance: The u
