l-glutamine
L-glutamine (Endari) is used to reduce complications of sickle cell disease, such as painful sickle cell crises. It's an amino acid that comes as a powder in individual packets. The powder needs to be mixed with food or liquid before it's taken by mouth. The typical dosage for people 5 years and older is 5 to 15 grams of l-glutamine (Endari) twice a day. Potential side effects include constipation, nausea, and headache.
What is L-glutamine (Endari)?
What is L-glutamine (Endari) used for?
- Reducing complications of sickle cell disease in people 5 years and older
How L-glutamine (Endari) works
L-glutamine (Endari) is a type of amino acid. This medication is thought to work by balancing the natural antioxidants in your body. This is important for preventing damage to red blood cells in people with sickle cell disease.
Drug facts
Side effects of L-glutamine (Endari)
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
- Constipation (21%)
- Nausea (19%)
- Headache (18%)
- Stomach pain (17%)
- Cough (16%)
- Pain in arm or leg (13%)
- Back pain (12%)
- Chest pain (12%)
The following L-glutamine (Endari) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Back pain
- Constipation
- Cough
- Headache
- Nausea
- Stomach pain
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Pros and cons of L-glutamine (Endari)
Pros
- Helps lessen the number of hospitalizations and pain crises in people with SCD
- Approved for people 5 years and older
- Easy to swallow once mixed with liquid or soft food
- Can mix powder with a variety of cold or room-temperature foods and liquids
Cons
- Taken twice a day
- Must be ready to take the medication before you prepare each dose
- Doesn't come in child-resistant packaging
- Not known if it's safe to take during pregnancy
Pharmacist tips for L-glutamine (Endari)
- Take l-glutamine (Endari) twice a day. Choose times during the day that's easy for you to remember and convenient for you to prepare the medication.
- You must mix the l-glutamine (Endari) powder with a beverage or soft food before you take the medication. Follow the instructions to prepare your dose before each time you take the medication.
- Store unopened packets of l-glutamine (Endari) at room temperature. Keep them away from direct sunlight.
Tips for how to prepare l-glutamine (Endari):
- Fill a cup with 8 ounces (1 cup) of cold or room-temperature liquid (e.g., water, milk, apple juice). Alternatively, you can fill a small bowl with 4 to 6 ounces of cold or room-temperature soft food (e.g., applesauce, yogurt). Don't use hot food or liquid because this might damage the medication and make it not work as well for you.
- Tear open the number of l-glutamine (Endari) packets you need for your dose. Pour the powder into the cup of liquid or bowl of food. Mix together with a spoon. Then, drink or eat it right away. It's okay if the powder doesn't completely dissolve.
- Always prepare your dose right before you're going to take l-glutamine (Endari). You shouldn't prepare the medication ahead of time or save it for a later time. This might make the medication not work as well.
Common questions about L-glutamine (Endari)
Follow your prescriber's instructions on when to take l-glutamine (Endari). You'll need to take this medication twice a day. Try to take your two doses 12 hours apart as best as you can to keep the amount of medication in your body stable. Keep in mind that l-glutamine (Endari) comes as a powder that you need to mix with cold or room-temperature food or a drink before you can take it. Choose two times during the day when it's convenient for you to prepare the medication and easy for you to remember.
The amount of l-glutamine (Endari) you need to take typically depends on your body weight. Your prescriber will tell you how much of the medication you need to take each day. They might talk about how much medication to take in terms of the number of packets of l-glutamine (Endari) to use. Contact your prescriber if you have questions about how many packets of l-glutamine (Endari) you need to take per dose or per day.
No. Don't prepare your dose of l-glutamine (Endari) and then save it for a later time. You should be ready to take the medication right after you mix the powder with cold or room-temperature food or drink. If you mix the packet of l-glutamine (Endari) and you can't take it right away, throw it away.
Yes, l-glutamine (Endari) can cause constipation as a side effect. In clinical studies, about 1 in 5 people who took this medication reported having constipation. Prevent constipation by making sure to eat enough fiber-rich foods and drink plenty of water. Talk to a healthcare professional if you get constipated while you're taking l-glutamine (Endari). They can recommend ways to treat constipation.
Diarrhea isn't a common side effect of l-glutamine (Endari). Be sure to drink plenty of fluids if you have diarrhea while you're taking this medication. Talk to a healthcare professional about options to treat diarrhea that are appropriate for you.
Over a span of 11 months, people who took l-glutamine (Endari) during a clinical study had 25% fewer sickle cell crises than people who took a placebo (no active medication). People who took the medication also had fewer hospital visits for pain and fewer days in the hospital than those who took placebo. Ask your prescriber if you have questions about how well l-glutamine (Endari) might work for you.
Yes. There's a generic version of l-glutamine (Endari) available.
L-glutamine (Endari) and hydroxyurea (Droxia, Siklos) are both approved for adults and children with sickle cell disease (SCD). But they have slightly different purposes and they're taken differently. L-glutamine (Endari) is FDA approved to reduce complications from SCD. It comes in a powder that's mixed with food or a drink and the medication is taken twice a day. On the other hand, hydroxyurea (Droxia, Siklos) is approved to lessen the number of painful crises and the need for blood transfusions in people with SCD. It comes in tablets and capsules that are taken once a day. Some people might take l-glutamine (Endari) and hydroxyurea (Droxia, Siklos) together. Talk to your prescriber about comparing between the two medications.
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L-glutamine (Endari) dosage
Packet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5g | 180 packets | $1,003.18 | $5.57 |
Typical dosage for L-glutamine (Endari)
Dosing for l-glutamine (Endari) depends on your weight.
- Weigh less than 66 lbs: The typical dose is 5 grams (1 packet) twice per day. Mix the powder with a beverage or soft food before you take the medication by mouth.
- Weigh 66 lbs to 143 lbs: The typical dose is 10 grams (2 packets) twice per day. Mix the powder in the packets with a beverage or soft food before you take the medication by mouth.
- Weigh more than 143 lbs: The typical dose is 15 grams (3 packets) twice per day. Mix the powder from the packets with a beverage or soft food before you take the medication by mouth.
How much does L-glutamine (Endari) cost?
$1,003.18
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