Glutamine
/api/v1/drug/glutamineMechanism of action
Sourced from openFDAThe mechanism of action of the amino acid L-glutamine in treating sickle cell disease (SCD) is not fully understood. Oxidative stress phenomena are involved in the pathophysiology of SCD.
Indications
Sourced from openFDA- Endari is indicated to reduce the acute complications of sickle cell disease in adult and pediatric patients 5 years of age and older. ENDARI is an amino acid indicated to reduce the acute complications of sickle cell disease in adult and pediatric patients 5 years of age and older.
Contraindications
Sourced from openFDA- None None ( 4 )contraindicated
Dosage & administration
Sourced from openFDA5 grams to 15 grams orally, twice daily based on body weight. ( 2 ) Each dose of Endari should be mixed in 8 oz. (240 mL) of cold or room temperature beverage or 4 oz. to 6 oz. of food before ingestion. ( 2 ) 2.1 Dosage Administer Endari orally, twice per day at the dose based on body weight according to Table 1. Table 1. Recommended Dosing Weight in kilograms Weight in pounds Per dose in grams Per day in grams Packets per dose Packets per day less than 30 less than 66 5 10 1 2 30 to 65 66 to 143 10 20 2 4 greater than 65 greater than 143 15 30 3 6 2.2 Preparation of Product Mix Endari immediately before ingestion with 8 oz. (240 mL) of cold or room temperature beverage, such as water, milk or apple juice, or 4 oz. to 6 oz. of food such as applesauce or yogurt. Complete dissolution is not required prior to administration.
Adverse reactions
Sourced from openFDAMost common adverse reactions (incidence > 10%) are constipation, nausea, headache, abdominal pain, cough, pain in extremity, back pain, and chest pain. ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Emmaus Medical, Inc. at 1-877-420-6493 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The data described below reflect exposure to Endari in 187 patients, including 136 exposed for 6 months and 109 exposed for ≥1 year. Endari was studied in 2 placebo-controlled clinical trials (a phase 3 study, n=230 and a phase 2 study, n=70). In these trials, patients with sickle cell anemia or sickle β 0 -thalassemia were randomized to receive Endari (n=187) or placebo (n=111) orally twice daily for 48 weeks followed by 3 weeks of tapering. Both studies included pediatric and adult patients (5-58 years of age) and 54% were female. The majority of patients were black (97.3%), had a diagnosis of sickle cell anemia (89.9%) and were receiving hydroxyurea at baseline (63.4%). Treatment discontinuation due to adverse reactions was reported in 2.7% (n=5) of patients receiving Endari. These adverse reactions included one case each of hypersplenism, abdominal pain, dyspepsia, burning sensation, and hot flash.
Use in specific populations
Sourced from openFDA8.1 Pregnancy Risk Summary There are no available data on Endari use in pregnant women to inform a drug-associated risk of major birth defects and miscarriage. Animal reproduction studies were not conducted with Endari. Adverse outcomes in pregnancy occur regardless of the health of the mother or the use of medications. The background risk of major birth defects and miscarriage for the indicated population are unknown. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. 8.2 Lactation Risk Summary There are no data on the presence of Endari in human milk, the effect on the breastfed infant or the effect on milk production. The developmental and health benefits from breastfeeding should be considered along with the mother's clinical need for Endari and any potential adverse effects on the breastfed child from Endari or from the underlying maternal condition. 8.4 Pediatric Use The safety and effectiveness of Endari have been established in pediatric patients 5 years and older. Use of Endari is supported by evidence from 2 placebo-controlled studies in adult and pediatric patients with sickle cell disease.
Pharmacokinetics
Sourced from openFDA- Metabolism
- The pharmacokinetics of L-glutamine has been studied in healthy subjects and a variety of disease states. Relevant results from published literature are summarized below.
Overdosage
Sourced from openFDASingle oral doses of L-glutamine at about 20 g/kg to 22 g/kg, 8 g/kg to 11 g/kg, and 19 g/kg were lethal in mice, rats, and rabbits, respectively. Supportive measures should be undertaken in the event of overdose of Endari.
Approval history
Sourced from openFDA- Jul 7, 2017NDANDA208587Emmaus Medcl
- Jul 8, 2024ANDAANDA215647Novitium Pharma
- May 14, 2026ANDAANDA219750Stira
FAERS reports
- 1Sickle Cell Anaemia With Crisis1,64332%
- 2Product Dose Omission Issue67713%
- 3Pain3236.2%
- 4Nausea3045.9%
- 5Product Dose Omission2805.4%
- 6Headache2605.0%
- 7Diarrhoea2424.7%
- 8Fatigue2023.9%
- 9Hospitalisation1933.7%
- 10Abdominal Pain Upper1853.6%
- 11Constipation1753.4%
- 12Pain In Extremity1553.0%
- 13Arthralgia1502.9%
- 14Drug Ineffective1452.8%
- 15Drug Dose Omission1442.8%
Literature
Recent PubMed references pinned to Glutamine as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.
- Dissecting mechanisms of ligand binding and conformational changes in the glutamine-binding protein.eLife · 2026 · Han Z, Panhans S, Brameyer S, et al.PMID 42227972DOI 10.7554/eLife.95304
- Impaired redox adaptation through SLC38A5-dependent glutamine metabolism contributes to melatonin-mediated anoikis sensitivity and metastasis suppression in bone cancer.International journal of biological sciences · 2026 · Nguyen BT, Chen WC, Fong YC, et al.PMID 42212332DOI 10.7150/ijbs.133256
- Glutamine Starvation Induces Ferroptosis in NSCLC via AMPK/PDZD8-Mediated Ferritinophagy.Nutrients · 2026 · Chen H, Wu X, Zhu M, et al.PMID 42197056DOI 10.3390/nu18101596
- Mycobacterium tuberculosis reinforces M2 polarization of macrophages by activating glutamine metabolism.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2026 · Yu Y, Lai L, Yu S, et al.PMID 42149367DOI 10.1007/s42770-026-01960-6
- Glutamine Metabolism: Role in Cancer Cell Proliferation and Survival.Cancer treatment and research · 2026 · Chakraborty A, Pramanik S, Mullick S, et al.PMID 42144519DOI 10.1007/978-3-032-21861-2_3
- Glutamine-driven reductive TCA cycle metabolism supports aged muscle stem cell function via de novo lipogenesis.Nature aging · 2026 · Lee DE, McKay LK, Bareja A, et al.PMID 42135577DOI 10.1038/s43587-026-01120-3
- Senescent Stroma-Derived Glutamine: A Driver of Aggressiveness in Prostate and Ovarian Cancer Cells.Cells · 2026 · Lori G, Mancini C, Paffetti C, et al.PMID 42121871DOI 10.3390/cells15090770
- A Novel Glutamine Riboswitch, LRN, Regulates the Expression of a Nucleoside Permease in Bacillus thuringiensis.Environmental microbiology · 2026 · Qin J, Zhang Y, Qian C, et al.PMID 42087385DOI 10.1111/1462-2920.70318
Clinical trials
The 10 most recently updated of 294 ClinicalTrials.gov registrations naming Glutamine as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- Proglumide and Chemotherapy for Metastatic Pancreatic CancerActive not recruiting · Phase 2 · Interventional · 30 enrolled · Georgetown UniversityNCT05827055updated 2026-06-10
- DRP-104 in Patients With NFE2L2/KEAP1-altered Non-Small Cell Lung CancerRecruiting · Phase 2 · Interventional · 37 enrolled · NYU Langone HealthNCT07249372updated 2026-05-26
- EAT-ING: Enhancing Anticancer Treatment Safety Via Immunomodulatory Nutritional Support in Advanced Gastrointestinal CancersNot yet recruiting · Interventional · 88 enrolled · IRCCS San RaffaeleNCT07590622updated 2026-05-15
- L-Theanine to Support Relaxation and Mood for Cancer Patients in SurveillanceRecruiting · Early phase 1 · Interventional · 50 enrolled · City of Hope Medical CenterNCT07220447updated 2026-05-08
- A DNAJB1-PRKACA Fusion Kinase Peptide Vaccine Combined With Glutamine Antagonist DRP-104, Nivolumab, and Ipilimumab in Patients With Advanced Stage Fibrolamellar Carcinoma (FLC)Not yet recruiting · Phase 1 · Interventional · 27 enrolled · Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsNCT07430202updated 2026-05-06
- Long-term Follow-up of Diabetic Patients From the GLUTADIAB StudyNot yet recruiting · Observational · 450 enrolled · Assistance Publique - Hôpitaux de ParisNCT07347613updated 2026-04-17
- Essential Amino Acid Supplementation for Femoral Fragility FracturesRecruiting · Phase 2 · Interventional · 60 enrolled · Michael C WilleyNCT06050668updated 2026-04-15
- Glutamine Plus L. Reuteri Prevents TKI Therapy-diarrhea in Patients With NSCLCRecruiting · Phase 3 · Interventional · 28 enrolled · Instituto Nacional de Cancerologia de MexicoNCT05852990updated 2026-04-09
- Beverage Hydration Index of Different SolutionsRecruiting · Interventional · 30 enrolled · University of MemphisNCT07507344updated 2026-04-07
- Effect of Glutamine on Gastric Emptying and Length of Parenteral Nutrition in Premature NeonatesCompleted · Phase 4 · Interventional · University Hospital, RouenNCT00213668updated 2026-03-30
Frequently asked questions
- How does Glutamine work?
- The mechanism of action of the amino acid L-glutamine in treating sickle cell disease (SCD) is not fully understood. Oxidative stress phenomena are involved in the pathophysiology of SCD.
- What is Glutamine used for?
- According to FDA labeling, Glutamine carries indications including: Endari is indicated to reduce the acute complications of sickle cell disease in adult and pediatric patients 5 years of age and older. ENDARI is an amino acid indicated to reduce the acute complications of sickle cell disease in adult and pediatric patients 5 years of age and older.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
- What class of drug is Glutamine?
- Glutamine is classified as Amino acids and derivatives, Amino Acid, Biological Macromolecular Activity, Metabolic Activity Alteration.
- What are the brand names for Glutamine?
- Glutamine is marketed under brand names including Endari.
- What are the contraindications for Glutamine?
- Glutamine labeling lists contraindications including: None None ( 4 ). Always consult the full prescribing information and a clinician.
glutamine is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.