Copper

Trace Element·Vitamins & Minerals

Prevention and treatment of copper deficiency (often secondary to massive zinc supplementation, bariatric surgery, or long-term TPN)

MINERALVarious OTCTabletsUNSCHEDULEDTGA

Max Dose

10 mg/day

Wilson's Dis.

FATAL

Anemia

COFACTOR

Zinc Tox

CAUSES DEFICIENCY

Rapid Summary

Overview

Trace mineral required for iron absorption, nerve myelination, and collagen cross-linking. Highly toxic in excess.

Maximum Dose

Max 10 mg/day (Tolerable Upper Limit).

Clinical Focus

Strictly contraindicated in Wilson's Disease. Deficiency perfectly mimics B12 deficiency (severe spinal cord degeneration).

Bottom Line

Copper is an essential trace element for haematopoiesis and connective tissue, but supplementation is rarely needed and excess causes hepatotoxicity (Wilson's disease phenocopy).

Formulation & Access

Brand Names

Various OTC

Oral Routes

Tablets.

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Prevention and treatment of copper deficiency (often secondary to massive zinc supplementation, bariatric surgery, or long-term TPN).

Quick reference

Class & Role

Trace Element — Trace mineral required for iron absorption, nerve myelination, and collagen cross-linking.

Route / Formulation

Tablets. (Various OTC)

Usual Dose & Max

PO 2-4 mg OD until replenished. Max 10 mg/day (Tolerable Upper Limit).

Key Indication Doses

Copper Deficiency: PO 2-4 mg OD until replenished. TPN Additive: IV Included in standard trace element vials.

Best Uses

Copper is an essential trace element for haematopoiesis and connective tissue, but supplementation is rarely needed and excess causes hepatotoxicity (Wilson's disease phenocopy).

Avoid / Cautions

Wilson's Disease, severe biliary cirrhosis/cholestasis (cannot excrete it).

Key Risks

Hepatic: Severe hepatotoxicity, cirrhosis, and massive hemolysis (seen in Wilson's disease where copper cannot be excreted). Gastrointestinal: Nausea, vomiting, blue-green vomit (in acute toxicity).

Key Interactions

Zinc. Massive doses of oral Zinc induce proteins in the gut that trap Copper and poop it out. The #1 cause of Copper deficiency on the ward is a doctor prescribing high-dose Zinc for a bed-sore for 6 months.

Monitoring

If a patient has unexplained anemia and severe peripheral neuropathy, but their B12 is normal, check a Serum Copper level.

Clinical Pearl

You cannot fix iron deficiency if the patient is copper deficient. Copper (via ceruloplasmin) is the 'forklift' that loads iron into the blood. Without copper, the iron just sits uselessly in the liver.

Access

Various OTCTablets

Brand: Various OTC
Formulation: Tablets

Copper

Trace Element·Vitamins & Minerals

Prevention and treatment of copper deficiency (often secondary to massive zinc supplementation, bariatric surgery, or long-term TPN)

MINERALVarious OTCTabletsUNSCHEDULEDTGA

Max Dose

10 mg/day

Wilson's Dis.

FATAL

Anemia

COFACTOR

Zinc Tox

CAUSES DEFICIENCY

Rapid Summary

Overview

Trace mineral required for iron absorption, nerve myelination, and collagen cross-linking. Highly toxic in excess.

Maximum Dose

Max 10 mg/day (Tolerable Upper Limit).

Clinical Focus

Strictly contraindicated in Wilson's Disease. Deficiency perfectly mimics B12 deficiency (severe spinal cord degeneration).

Bottom Line

Copper is an essential trace element for haematopoiesis and connective tissue, but supplementation is rarely needed and excess causes hepatotoxicity (Wilson's disease phenocopy).

Formulation & Access

Brand Names

Various OTC

Oral Routes

Tablets.

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Prevention and treatment of copper deficiency (often secondary to massive zinc supplementation, bariatric surgery, or long-term TPN).

Quick reference

Class & Role

Trace Element — Trace mineral required for iron absorption, nerve myelination, and collagen cross-linking.

Route / Formulation

Tablets. (Various OTC)

Usual Dose & Max

PO 2-4 mg OD until replenished. Max 10 mg/day (Tolerable Upper Limit).

Key Indication Doses

Copper Deficiency: PO 2-4 mg OD until replenished. TPN Additive: IV Included in standard trace element vials.

Best Uses

Copper is an essential trace element for haematopoiesis and connective tissue, but supplementation is rarely needed and excess causes hepatotoxicity (Wilson's disease phenocopy).

Avoid / Cautions

Wilson's Disease, severe biliary cirrhosis/cholestasis (cannot excrete it).

Key Risks

Hepatic: Severe hepatotoxicity, cirrhosis, and massive hemolysis (seen in Wilson's disease where copper cannot be excreted). Gastrointestinal: Nausea, vomiting, blue-green vomit (in acute toxicity).

Key Interactions

Monitoring

If a patient has unexplained anemia and severe peripheral neuropathy, but their B12 is normal, check a Serum Copper level.

Clinical Pearl

Access

Various OTCTablets

Brand: Various OTC
Formulation: Tablets