glutamine (Rx)

Brand and Other Names:NutreStore
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for oral solution

  • 5g/packet (as L-glutamine)
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Short Bowel Syndrome

Indicated for short bowel syndrome in patients receiving specialized nutritional support when used in conjunction with recombinant human growth hormone

30 g/day PO in divided doses (ie, 5 g taken 6 times each day) for up to 16 weeks

Administration

Dissolve each 5 g packet in 8 oz water prior to drinking; volume of water may be varied according to the patient’s preference

Take with meals or snacks at 2-3 hr intervals while awake

If transiently intolerant to oral intake, a dose may be delayed for up to 2 hr

Safety and efficacy not established

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Adverse Effects

Adverse effects listed below are those reported that exceed growth hormone without glutamine supplementation

>10%

Peripheral edema (81%)

Nausea (31%)

Tenesmus (19%)

Rhinitis (19%)

Dizziness (13%)

Rash (13%)

Ear or hearing symptoms (13%)

1-10%

Pruritus (6%)

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Warnings

Contraindications

None

Cautions

Metabolized to glutamate and ammonia; levels of these metabolites may increase with hepatic impairment

Monitor renal and hepatic function

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Pregnancy & Lactation

Pregnancy Category: C

Lactation: Unknown whether distributed in breast milk

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Mechanism of Action

L-glutamine has important functions in regulation of gastrointestinal cell growth, function, and regeneration

When glutamine was administered in combination with growth hormone to rats, villous height, bowel growth, plasma insulin-like growth factor I, and body weight were significantly higher than in rats treated with either glutamine or rhGH alone

Absorption

Peak Plasma Time: 30 min

Peak Plasma Concentration: 150 mcg/mL

Distribution

Vd: 200 mL/kg

Metabolism

Glutamine participates in various metabolic activities, including the formation of glutamate, and synthesis of proteins, nucleotides, and amino sugars

Elimination

Metabolism is the major route of elimination for glutamine

Although glutamine is eliminated by glomerular filtration, it is almost completely reabsorbed by the renal tubules

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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