Glutamine

Pronunciation

U.S. Brand Names

Enterex® Glutapak-10® [OTC]; NutreStore™; Resource® GlutaSolve® [OTC]; Sympt-X [OTC]; Sympt-X G.I. [OTC]

Synonyms

Gln; L-Glutamine

Use

Treatment of short bowel syndrome when used in combination with nutritional support and growth hormone therapy; a medical food used to promote GI tract healing and nutritional supplementation with GI disorders, HIV/AIDS, cancer, and other critical illnesses

Pregnancy Risk Factor

Pregnancy Implications

Reproduction studies have not been conducted.

Lactation

Excretion in breast milk unknown/use caution

Warnings/Precautions

Use caution with hepatic or renal impairment. NutreStore™ should be used with nutritional support based on individual patient requirements. Medical foods are intended to be used under the direction of a healthcare provider.

Adverse Reactions

Frequency not defined.

Cardiovascular: Facial edema, peripheral edema

Central nervous system: Dizziness, fever, headache, pain

Dermatologic: Pruritus, rash

Gastrointestinal: Abdominal pain, flatulence, nausea, pancreatitis, tenesmus, vomiting

Neuromuscular & skeletal: Arthralgia, back pain, hypoesthesia

Otic: Ear or hearing symptoms

Respiratory: Rhinitis

Miscellaneous: Flu-like syndrome, infection, sepsis

Stability

Store at controlled room temperature.

Mechanism of Action

Glutamine regulates gastrointestinal cell growth, function, and regeneration. Considered a "conditionally essential" amino acid during metabolic stress and injury.

Pharmacodynamics/Kinetics

As reported in healthy adults; parameters may vary following oral administration in patients with short bowel syndrome.

Distribution: I.V.: Vd: 200 mL/kg

Metabolism: Via splanchnic tissue, lymphocytes, kidney, and liver to glutamate and ammonia

Half-life elimination: I.V.: 1 hour

Dosage

Oral: Adults:

Nutritional supplement (Enterex® Glutapak-10®, Resource® GlutaSolve®, Sympt-X, Sympt-X G.I.): Average dose: 10 g 3 times/day; dosing range: 5-30 g/day

Short bowel syndrome (NutreStore™): 30 g/day administered as 5 g 6 times/day (every 2-3 hours while awake) for up to 16 weeks; to be used in combination with growth hormone and nutritional support

Administration

Enterex® Glutapak-10®: Prior to use, mix with clear liquids or semi-solid food. If administering via feeding tube, mix each 10 g packet with 60 mL water. Use immediately after preparation. May also be added directly to enteral formula if used within 24 hours.

Resource® GlutaSolve®: Mix each 15 g packet with 120-240 mL of water. May also be mixed in hot or cold beverages, applesauce, or pudding. If administering via feeding tube, mix with 60-120 mL water. Use immediately after preparation.

NutreStore™: Mix each packet (5 g) with ~240 mL of water prior to administration. May be given with meals or snacks

Sympt-X, Sympt-X G.I.: Mix dose with 6-8 ounces of juice or another beverage, may also be mixed with applesauce or pudding. Administer with meals. If administering via feeding tube, mix with 60 mL water; do not add directly to feeding bag. Use immediately after preparation.

Monitoring Parameters

BUN; body weight, nutritional status

Dietary Considerations

NutreStore™: To be used in combination with a specialized diet. May be taken with food or a snack.

Patient Education

Prepare, store, and use exactly as directed. Do not exceed recommended dosage. May cause increased flatulence, nausea or vomiting, or abdominal pain; if persistent or severe contact prescriber. Report facial or peripheral swelling, rash; unusual back pain; or other persistent adverse reactions. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant or breast-feed.

Dental Health: Effects on Dental Treatment

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions

Mental Health: Effects on Mental Status

May cause dizziness

Mental Health: Effects on Psychiatric Treatment

None reported

Dosage Forms

Powder for oral solution:

Enterex® Glutapak-10®: 10 g/packet (50s)

NutreStore™: 5 g/packet

Resource® GlutaSolve®: 15 g/packet (56s)

Sympt-X, Sympt-X G.I.: 10 g/packet (60s)

International Brand Names

Glumin® (JP); Glutacerebro® (IT); Glutaven® (IT); Levoglutamina CH® (AR); Memoril® (IT)

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