Is Trientine Safe in Breastfeeding
Question
I am a breastfeeding mother and i want to know if it is safe to use Trientine? Is Trientine safe for nursing mother and child? Does Trientine extracts into breast milk? Does Trientine has any long term or short term side effects on infants? Can Trientine influence milk supply or can Trientine decrease milk supply in lactating mothers?
Trientine lactation summary
- DrLact safety Score for Trientine is 3 out of 8 which is considered Low Risk as per our analyses.
- A safety Score of 3 indicates that usage of Trientine may cause some minor side effects in breastfed baby.
- Our study of different scientific research indicates that Trientine may cause moderate to no side effects in lactating mother.
- Most of scientific studies and research papers declaring usage of Trientine low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
- While using Trientine We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
- Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.
Answer by Dr. Ru: About Trientine usage in lactation
Copper chelator used in the treatment of Wilson's disease. It is excreted in breast milk in clinically insignificant amounts (undetectable levels: Izumi 2012). Copper and zinc levels in breastmilk of mothers treated with penicillamine, trientine or zinc are normal (Izumi 2012). Oral bioavailability, which is very low during periods of fasting, is practically non-existent in the presence of food, especially milk, so it would be very difficult to pass into the infant plasma from the ingested breast milk (PDR 2016).
Answer by DrLact: About Trientine usage in lactation
Limited information indicates that trientine is not detectable in breastmilk. The effect of trientine on breastmilk copper and zinc concentrations in milk is conflicting,[1][2][3] but breastfed infants appear to have normal serum copper and zinc plasma levels. Based on available data, it appears that trientine is acceptable to use during breastfeeding.
Trientine Side Effects in Breastfeeding
Three infants were breastfed during maternal treatment of Wilson's disease with trientine. Serum zinc and copper concentrations were normal in these infants.[3] A center in Turkey reported 23 infants born to mothers with Wilson's disease over a 20-year period. One patient was treated with 600 mg of trientine plus 100 mg of zinc daily. All of the infants were breastfed (extent and duration not specified). One premature infant died at 3 weeks of age (maternal drug not specified), but the other infants had no apparent complications over a median of 51 months (range 13 to 105 months) of follow-up.[4]
Trientine Possible Effects in Breastfeeding
Conflicting data exist on breastmilk concentrations of zinc and copper during therapy of Wilson's disease with trientine. One abstract reported that breastmilk concentrations were normal during therapy,[2] but another abstract from the same authors reported lower milk concentrations of zinc and copper.[1]