glutamine

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Used with human growth hormone in the treatment of short bowel syndrome (orphan drug designation).
Treatment of sickle cell disease (orphan drug designation).
Critical illness (trauma)
HIV/AIDS—related wasting.
Oral mucositis.
Surgery.

Action ⬆ ⬇

Glutamine is a conditionally essential amino acid necessary for maintaining intestinal function, immune response, and amino acid homeostasis during times of severe stress. It enhances the function of stimulated immune cells. After surgery or trauma, one third of the nitrogen mobilized for wound repair and vital organ function comes from glutamine. During stress, glutamine requirements increase and progressive muscle breakdown can occur. Muscle breakdown is metabolized to ammonia which may cause adverse neurological and psychiatric effects.

Therapeutic effects:

Improved nutritional and immunologic status.

Pharmacokinetics ⬆ ⬇

Absorption: Unknown

Distribution: Unknown

Metabolism/Excretion: Unknown

Half-Life: Unknown

Time/Action Profile ⬆ ⬇

	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity.
Pregnancy and lactation.

Use Cautiously in:

Hepatic encephalopathy (may worsen symptoms).
Mania.
Seizure disorders (may lower seizure threshold).

Adv. Reactions/Side Effects ⬆ ⬇

GI: gritty taste

Interactions ⬆ ⬇

Natural-Drug Products:

May antagonize effects of anticonvulsants,lactuloseand chemotherapy.

Natural-Natural Products:

None.

Route/Dosage ⬆ ⬇

PO (Adults ): 500–4000 mg three times a day.

Availability ⬆ ⬇

Capsules: Powder

Assessment ⬆ ⬇

Monitor for signs and symptoms of allergic reaction (itching, hives, swelling of face or hands, swelling or tingling in mouth or throat, chest tightness, trouble breathing). Keep epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction.

Lab Test Considerations:

Monitor serum ammonia and glutamate levels periodically during therapy.
- Monitor liver and renal function periodically during therapy.

Implementation ⬆ ⬇

PO: Administer by mixing 1 packet with at least 8 ounces of water every 2 to 3 hr while awake with a meal or snack. Mix with water just before using. Make sure all of the mixture is consumed.

Patient/Family Teaching ⬆ ⬇

Instruct patient to take as directed and not to take more or more frequently than directed. Take missed doses as soon as remembered unless close to time for next dose; do not double doses.
Advise patient to notify health care professional immediately if signs and symptoms of allergic reaction occur or if fever, chills, cough, sore throat, body aches, swelling of face, hands, ankles, or feet occur.
Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes ⬆ ⬇

Reduction in intravenous parenteral nutrition requirements in patients with short bowel syndrome.
Increased body weight and lean muscle mass and decreased body fat in patients with short bowel syndrome.

US Brand Names ⬆ ⬇

L-2–aminoglutaramic acid, glutamate, glutamic acid

Code ⬆

NDC Code

42457- Emmaus Medical, Inc.
- 42457-420- Endari
  - 42457-420-60- 60 PACKET in 1 CARTON (42457-420-60) > 1 POWDER, FOR SOLUTION in 1 PACKET (42457-420-01)

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇