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carglumic acid

Generic Carbaglu
Used for Hyperammonemia
Used for Hyperammonemia

Carbaglu (carglumic acid) lowers blood ammonia levels within 24 hours and helps keep it low, but it must be taken before every meal.

Reviewed by:
reviewer
Dalga Surofchy, PharmD, APh
reviewer
Allison Gourley, PharmD
Last reviewed on May 31, 2021
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostPricesMedicare
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What is Carbaglu (carglumic acid)?

What is Carbaglu (carglumic acid) used for?

  • High blood ammonia

How Carbaglu (carglumic acid) works

Carbaglu (carglumic acid) replaces a key chemical in people who don't have a specific liver enzyme, N-acetylglutamate synthase (NAGS). NAGS normally helps your body get rid of extra ammonia (a waste chemical produced by your body).

Drug Facts

Common BrandsCarbaglu
Drug ClassMetabolic alkalosis agent
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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What are the side effects of Carbaglu (carglumic acid)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Vomiting (26%)
  • Stomach pain (17%)
  • Fever (17%)
  • Swelling of tonsils (17%)
  • Diarrhea (13%)
  • Headache (13%)
  • Ear infection (13%)

Other Side Effects

  • Common cold
  • Fewer healthy red blood cells (anemia)
  • Lower hemoglobin levels
  • Infections

Source: FDA

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Carbaglu (carglumic acid)

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Pros

Lowers ammonia levels within 24 hours

Can be given as early as the first day of life

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Cons

Must be mixed with water and taken right before a meal

Tastes sour or acidic

pharmacist-tips

Pharmacist tips for Carbaglu (carglumic acid)

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  • Right before before you take Carbaglu (carglumic acid), put tablets in about half a teaspoon (2.5 milliliters) of water per tablet. Carefully stir and immediately swallow the mixture. If pieces of the tablet are still in the cup, repeat this step by adding water as needed until no more pieces remain.

    • Take Carbaglu (carglumic acid) in 2 to 4 divided doses throughout the day. Don't swallow tablets whole or crush them. Don't mix Carbaglu (carglumic acid) in liquids other than water.

      • Take Carbaglu (carglumic acid) immediately before meals.

        • Carbaglu (carglumic acid) may be started as early as the first day of life, depending on how severe (bad) the infant's condition is.

          • Store unopened containers in a refrigerator. After opening, store at room temperature in a tight container. Throw away 1 month after opening.

            • Don't breastfeed while taking Carbaglu (carglumic acid) unless your healthcare provider told you to do so.

              faqs

              Frequently asked questions about Carbaglu (carglumic acid)

              Does Carbaglu (carglumic acid) have a generic version?
              Unfortunately, Carbaglu (carglumic acid) is only available as a brand name drug and therefore is more expensive.
              Is Carbaglu (carglumic acid) supposed to taste sour or acidic?
              Yes, the medication has an acidic taste when it's mixed with water. This is normal.
              What is the most common side effect of Carbaglu (carglumic acid)?
              In clinical trials, the most common side effect was vomiting.
              Can I crush the tablets?
              No, Carbaglu (carglumic acid) must be mixed with water before drinking it. Each tablet must be mixed with 2.5 milliliters of water. You can't swallow the whole tablet like other medications. The medication may not fully dissolve in the water. If this happens, add more water and mix again until there are no remaining pieces of the tablet left in the cup or container you are using. It has to be taken right before a meal and no crushing is allowed.
              Which pharmacy can I pick up Carbaglu (carglumic acid) from?
              The medication is a specialty medication. This means it's not available from a regular pharmacy. Your healthcare provider will need to contact a special pharmacy who will then ship it to you.
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              What are the risks and warnings for Carbaglu (carglumic acid)?

              Carbaglu (carglumic acid) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              High blood ammonia levels

              Carbaglu (carglumic acid) lowers ammonia in the blood. If ammonia levels in the blood get too high and you aren't treated, brain damage and death may occur. Talk to your healthcare provider about which symptoms of high ammonia levels you should look out for. Your healthcare provider may suggest you eat less protein to help keep ammonia levels lower.

              dosage

              Carbaglu (carglumic acid) dosage forms

              Typical dosing for Carbaglu (carglumic acid)

              The typical dose of Carbaglu (carglumic acid) depends on whether the extra ammonia in your body is acute (started recently or suddenly) or chronic (long-lasting). Also, the dose is based on your weight. Your healthcare provider will monitor your blood levels of ammonia and make changes in the dose of the medication.

              • Acute hyperammonemia (too much ammonia): The dose is 100 to 250 mg for every kilogram of body weight per day. The dose is divided into 2 to 4 separate doses and given right before meals.

              • Chronic hyperammonemia (too much ammonia): The dose is 10 to 100 mg for every kilogram of body weight per day. The dose is divided into 2 to 4 separate doses and given right before meals.

              The tablets must be stirred and mixed in 2.5 milliliters of water (no other liquid or foods). Drink immediately after mixing. The medication may not dissolve completely in the water. Add more water to rinse the cup and drink it until no remaining pieces are left.

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              Carbaglu (carglumic acid) (generic)
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