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copper sulfate
V03AB20
Forms & Strengths
- Intravenous injection: 0.4 mg/mL copper (as copper sulfate pentahydrate)
- Oral solution: various concentrations (historical/adjunctive)
Adult Dosing
- Total parenteral nutrition (TPN) additive: 0.5 to 1.5 mg elemental copper daily for stable adult patients with additional requirements
- Wilson's disease (historical oral use): 20 to 35 mg elemental copper daily with meals to block intestinal absorption of copper
Pediatric Dosing
- Neonates and infants on TPN: 20 mcg/kg/day elemental copper
- Pediatric patients (> 10 kg) on TPN: 20 mcg/kg/day elemental copper, up to a maximum of 300 to 500 mcg daily
Indications
- Adjunct to intravenous nutrition (TPN) to prevent copper deficiency in patients requiring long-term parenteral support
- Treatment of copper deficiency syndromes
Mechanism of Action
- Copper is an essential trace element functioning as an essential cofactor for numerous cuproenzymes, including cytochrome c oxidase, dopamine beta-hydroxylase, superoxide dismutase, and lysyl oxidase, involved in energy production, iron metabolism, connective tissue formation, and neurotransmission
Contraindications
- Wilson's disease (hepatolenticular degeneration) when considering parenteral administration or excessive dosing
- Biliary obstruction or severe cholestasis (due to risk of hepatic copper accumulation and toxicity)
- Known hypersensitivity to copper sulfate or any component of the formulation
Adverse Reactions
- Acute copper toxicity manifested as nausea, vomiting, abdominal pain, and diarrhea (upon oral overdose)
- Hepatic damage, jaundice, and cirrhosis with chronic overload
- Hemolytic anemia in acute poisoning
- Injection site reactions or thrombophlebitis with intravenous administration
Drug Interactions
- Chelating agents (e.g., penicillamine, trientine): decrease copper absorption and increase excretion
- Zinc and iron supplements: competitively inhibit intestinal absorption of copper
- Ascorbic acid (high doses): may reduce copper absorption and alter its bioavailability
Curated Content: Needs Vetting Before Put to Clinical Use