Levacetylleucine

The distinct molecular target for levacetylleucine in the treatment of NPC is unknown.

• AQNEURSA™ is indicated for the treatment of neurological manifestations of Niemann-Pick disease type C (NPC) in adults and pediatric patients weighing ≥15 kg. AQNEURSA is indicated for the treatment of neurological manifestations of Niemann-Pick disease type C (NPC) in adults and pediatric patients weighing ≥15 kg.

• None. None.contraindicated

• For females of reproductive potential, verify that the patient is not pregnant prior to initiating treatment. ( 2.1 ) • Recommended dosage ( 2.2 ) Patient Body Weight Morning Dose Afternoon Dose Evening Dose 15 to <25 kg 1 g No Dose 1 g 25 to <35 kg 1 g 1 g 1 g 35 kg or more 2 g 1 g 1 g • See the full prescribing information for administration instructions. ( 2.3 ) 2.1 Important Recommendation Prior to AQNEURSA Treatment Initiation For females of reproductive potential, verify that the patient is not pregnant [see Use in Specific Populations ( 8.1 , 8.3 )]. 2.2 Recommended Dosage The recommended dosage of AQNEURSA is based on the patient’s actual body weight (kg) to be administered orally up to three times daily. See Table 1 . AQNEURSA can be taken with or without food [see Clinical Studies ( 14 )] . For 2 gram levacetylleucine doses, prepare two AQNEURSA packets individually [see Dosage and Administration ( 2.3 )] . Table 1 Recommended Dosage of Levacetylleucine Based on Body Weight (kg) Patient’s Body Weight Morning Dose Afternoon Dose Evening Dose 15 kg to less than 25 kg 1 gram No Dose 1 gram 25 kg to less than 35 kg 1 gram 1 gram 1 gram 35 kg or more 2 gram 1 gram 1 gram One AQNEURSA packet contains 1 gram levacetylleucine. Missed Dose If a dose of AQNEURSA is missed, skip the missed dose and take the next dose at the scheduled time. Do not take 2 doses at the same time to make up for a missed dose. 2.3 Preparation and Administration Instructions Oral Administration For oral administration, administer AQNEURSA as follows: 1.

Embryo-Fetal Toxicity : May cause fetal harm. Advise females of reproductive potential to use effective contraception during treatment and for 7 days after the last dose if AQNEURSA is discontinued. ( 5.1 ) 5.1 Embryo-Fetal Toxicity Based on findings from animal reproduction studies, AQNEURSA may cause embryo-fetal harm when administered during pregnancy. Administration of levacetylleucine to pregnant rats and rabbits during the period of organogenesis caused an increase in embryo-fetal death (post implantation loss/resorption) and skeletal malformations at a dose that was approximately 1.4-fold and 6-fold, respectively, the maximum recommended human dose (MRHD) of 4 g/day of levacetylleucine (based on body surface area). The decision to continue or discontinue AQNEURSA treatment during pregnancy should consider the female’s need for AQNEURSA, the potential drug-related risks to the fetus, and the potential adverse outcomes from untreated maternal disease. For females of reproductive potential, verify that the patient is not pregnant prior to initiating treatment with AQNEURSA. Advise females of reproductive potential to use effective contraception during treatment with AQNEURSA and for 7 days after the last dose if AQNEURSA is discontinued [see Use in Specific Populations ( 8.1 , 8.3 )].

Most common adverse reactions (incidence ≥5% and greater than placebo) are abdominal pain, dysphagia, upper respiratory tract infections, and vomiting. ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact IntraBio Inc. at 1-833-306-9677 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 safety of AQNEURSA was evaluated in Trial 1, which included a total of 60 patients with Niemann-Pick disease Type C (NPC), in a placebo-controlled, randomized, crossover trial [see Clinical Studies ( 14 )] . The mean (SD) treatment duration of AQNEURSA was 86.2 (4.7) days (69 min, 97 max); the mean (SD) treatment duration on placebo was 87.3 (4.8) days (78 min, 113 max). Table 2 summarizes adverse reactions that occurred in patients who were treated with AQNEURSA in Treatment Period I of Trial 1. Table 2 Adverse Reactions that Occurred in Adult and Pediatric Patients with NPC at an Incidence of ≥5% in Treatment Period I of Trial 1 Adverse Reaction AQNEURSA N=30 n (%) Placebo N=30 n (%) Upper respiratory tract infection 5 (17) 1 (3) Abdominal pain 2 (7) 0 (0) Dysphagia 2 (7) 0 (0) Vomiting 2 (7) 0 (0) Rosacea One patient experienced an exacerbation of rosacea during Trial 1 that responded to treatment. AQNEURSA was not discontinued.

8.1 Pregnancy Risk Summary Based on findings from animal reproduction studies, AQNEURSA may cause embryo-fetal harm when administered during pregnancy. In animal reproduction studies, an increase in embryo-fetal death (post implantation loss/resorption), decrease in fetal body weight, and increase in external and skeletal malformations were observed in rats and rabbits when levacetylleucine was administered in pregnant rats and rabbits during the period of organogenesis. These effects were observed in rats and rabbits at the doses that were approximately 1.4-fold and 6-fold, respectively, the maximum recommended human dose (MRHD) in patients taking 4 grams of AQNEURSA per day ( see Data ). There are no available data on AQNEURSA use in pregnant females to evaluate a drug-associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes. Advise a pregnant female of the potential risk to the fetus. The decision to continue or discontinue AQNEURSA treatment during pregnancy should consider the female’s need for AQNEURSA, the potential drug-related risks to the fetus, and the potential adverse outcomes from untreated maternal disease. The background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, miscarriage, or other adverse outcomes. In the U.S.

Metabolism

Levacetylleucine pharmacokinetic parameters at steady state are presented as mean (SD) unless otherwise specified. Levacetylleucine maximum concentration (C max ) and area under the curve from time 0 to 24 hours (AUC 0-24hrs ) were 8.3 (3.3) µg/mL and 33.2 (12.5) h*μg/mL.

• Sep 24, 2024NDANDA219132Intrabio

1. 1Off Label Use10556%
2. 2Dysphagia84.2%
3. 3Fall84.2%
4. 4Pneumonia84.2%
5. 5Seizure73.7%
6. 6Gait Disturbance63.2%
7. 7Insomnia52.6%
8. 8Product Prescribing Issue52.6%
9. 9Decreased Appetite42.1%
10. 10Interstitial Lung Disease42.1%
11. 11Pneumonia Aspiration42.1%
12. 12Product Use In Unapproved Indication42.1%
13. 13Sleep Disorder42.1%
14. 14Vomiting42.1%
15. 15Drooling31.6%

The 2 most recently updated of 2 ClinicalTrials.gov registrations naming Levacetylleucine as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.

• Expanded Access Program (EAP) of Levacetylleucine for Ataxia-Telangiectasia (A-T)
  Available · Expanded access · IntraBio Inc
  NCT07380165updated 2026-02-24
• A Pivotal Study of N-Acetyl-L-Leucine on Ataxia-Telangiectasia (A-T)
  Active not recruiting · Phase 3 · Interventional · 60 enrolled · IntraBio Inc
  NCT06673056updated 2025-07-03

Frequently asked questions

How does Levacetylleucine work?

The distinct molecular target for levacetylleucine in the treatment of NPC is unknown.

What is Levacetylleucine used for?

According to FDA labeling, Levacetylleucine carries indications including: AQNEURSA™ is indicated for the treatment of neurological manifestations of Niemann-Pick disease type C (NPC) in adults and pediatric patients weighing ≥15 kg. AQNEURSA is indicated for the treatment of neurological manifestations of Niemann-Pick disease type C (NPC) in adults and pediatric patients weighing ≥15 kg.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.

What class of drug is Levacetylleucine?

Levacetylleucine is classified as Other nervous system drugs, Bile Salt Export Pump Inhibitors, Breast Cancer Resistance Protein Inhibitors, Organic Anion Transporter 1 Inhibitors, Organic Anion Transporter 3 Inhibitors, P-Glycoprotein Inhibitors.

What are the brand names for Levacetylleucine?

Levacetylleucine is marketed under brand names including Aqneursa.

What are the contraindications for Levacetylleucine?

Levacetylleucine labeling lists contraindications including: None. None.. Always consult the full prescribing information and a clinician.