Copper sequestrant
- Chelates copper → mobilizes it for urinary excretion
- Treats Wilson disease copper overload
- Initial neurologic worsening can occur as copper is mobilized
Drugs with this mechanism (2)
- Penicillamine — Copper chelator for Wilson disease, also used for cystinuria; serious renal, marrow, and autoimmune toxicities limit tolerability.
- Trientine — Copper chelator for Wilson disease, often better tolerated than penicillamine; can cause copper or iron deficiency.
Self-check
- Where is chelated copper excreted?
Urine. - What paradoxical early effect can copper mobilization cause?
Neurologic worsening.
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