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Indications and Dosage
Intravenous
Part of parenteral nutrition regimen Adult: Dosage is individualised according to severity of the catabolic state and amino acid/protein requirements. In a hypercatabolic state: As 200 mg/mL solution for infusion: 300-500 mg/kg daily. The proportion of the amino acids supplied should not exceed approx 30% of the total amino acid supply. Max: 500 mg L-alanyl-L-glutamine/kg daily; 2,000 mg amino acids/kg daily. Max duration of treatment: 3 weeks.
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Contraindications
Severe metabolic acidosis. Severe hepatic and renal impairment (CrCl <25 mL/min).
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Special Precautions
Mild to moderate hepatic impairment. Pregnancy and lactation.
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Monitoring Parameters
Monitor serum electrolytes, osmolarity and bilirubin, water balance, acid-base status and LFTs (e.g. alkaline phosphatase, ALT/AST); signs and symptoms of hyperammonaemia.
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Action
Description:
Mechanism of Action: L-alanyl-L-glutamine is used as a part of parenteral nutrition. In the body, it endogenously split into two amino acids, alanine and glutamine. The released amino acid flow as nutrients into their respective body pools and are metabolised according to the needs of the organism. Synonym: N(2)-L-alanyl-L-glutamine, alanylglutamine. Pharmacokinetics: Excretion: Elimination half-life: 2.4-3.8 minutes. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. l-Alanyl-l-glutamine, CID=123935, https://pubchem.ncbi.nlm.nih.gov/compound/l-Alanyl-l-glutamine (accessed on Jan. 22, 2020) |
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Storage
Store below 25°C.
Any unused portions should be disposed of in accordance with local requirements. |
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MIMS Class
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References
Buckingham R (ed). Glutamic Acid. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/08/2018. Fresenius Kabi New Zealand Limited. Dipeptiven Concentrate for Solution for Infusion data sheet 19 March 2012. Medsafe. http://www.medsafe.govt.nz/. Accessed 06/08/2018. Joint Formulary Committee. Parenteral Nutrition Supplements. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/08/2018.
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