Dosing and uses of NutreStore (glutamine)
Adult dosage forms and strengths
powder for oral solution
- 5g/packet (as L-glutamine)
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
Pediatric dosage forms and strengths
Safety and efficacy not established
NutreStore (glutamine) adverse (side) 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%)
Warnings
Contraindications
None
Cautions
Metabolized to glutamate and ammonia; levels of these metabolites may increase with hepatic impairment
Monitor renal and hepatic function
Pregnancy and 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.
Pharmacology of NutreStore (glutamine)
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
