Endari (l-glutamine)
An approved treatment for Sickle Cell Disease.
The same compound appears under different names depending on the context. Here is how to identify L-glutamine wherever you encounter it, plus the key facts at a glance.
- Generic name
- L-glutamine
- Brand name
- Endari
- Drug class
- Amino acid therapy
- Manufacturer
- Emmaus Medical
- How it's taken
- Taken as an oral powder mixed with food or drink twice daily.
A medical-grade amino acid powder that reduces the frequency of sickle cell pain crises by decreasing oxidative damage to red blood cells.
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Where L-glutamine fits
Oral supplement approved to reduce acute complications of sickle cell disease. Can be used as add-on therapy alongside hydroxyurea and other SCD treatments.
How L-glutamine works
Sickle red blood cells are under constant oxidative stress, which makes them more rigid and likely to sickle. L-glutamine is thought to improve the balance of NAD, a molecule red blood cells use to fight oxidative damage, though the label says the exact way it works is not fully understood. By reducing oxidative stress, it helps sickle red blood cells maintain better function and reduces the likelihood of pain crises.
Mechanism: Amino acid supplement that reduces oxidative stress in sickle red blood cells
Side effects and safety
Generally well-tolerated. Common side effects include constipation, nausea, headache, abdominal pain, cough, pain in extremities, back pain, and chest pain.
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking L-glutamine
Taken as an oral powder mixed with food or drink twice daily. Dose is based on body weight. Approved for patients age 5 and older. Can be used alongside hydroxyurea.
Availability and cost
Generic versions may be available at a lower cost. Ask your pharmacist.
Pharmaceutical-grade amino acid supplement with orphan drug designation. The prescription formulation requires specific purity and manufacturing standards beyond dietary supplement grade.
Help paying for Endari
Pick your insurance to see which help fits. Drugmaker copay cards can't be used with Medicare, Medicaid or TRICARE; charity funds are the usual route there.
- Copay help
Eligible commercially insured patients pay the first $10 of their monthly ENDARI co-payment. Must apply and attest to financial need.
For: private insurance · source - Free medicine program
ENDARI at no or minimal cost for US residents under income limits who are uninsured or whose commercial plan does not cover ENDARI.
For: no insurance, underinsured · source
Good to know: Sponsor is Emmaus Medical. Copay program excludes Medicare, Medicaid, Part D, TRICARE, VA, DoD and other government coverage and must be used at network pharmacies. Endari Support Program help line (on the official application page): 1-855-723-5646, esp@endarirx.com. General line: 1-877-420-6493.
- From a charity · The Assistance FundSickle Cell Disease fundWaitlist
Pays for: Copays, coinsurance, deductibles and other health-related expenses.
The foundation says: “WAITLIST — Accepting Waitlist Patients. TAF is currently accepting requests to join the enrollment waitlist for this program. Waitlists a…”
Clinical trial results
Phase 3 trial showed 25% fewer pain crises versus placebo over 48 weeks (3.0 vs 4.0 median crises per year), and 33% fewer hospitalizations.
Development history
Approved by FDA in July 2017, making it the first new SCD treatment in nearly two decades at the time. It was the second FDA-approved drug for SCD after hydroxyurea.
Explore Sickle Cell Disease trials
Other Sickle Cell Disease treatments
L-glutamine in Trial Friend News and Guides
Common questions about L-glutamine
▸What is L-glutamine (Endari)?
A medical-grade amino acid powder that reduces the frequency of sickle cell pain crises by decreasing oxidative damage to red blood cells.
▸How does L-glutamine work?
Sickle red blood cells are under constant oxidative stress, which makes them more rigid and likely to sickle. L-glutamine is thought to improve the balance of NAD, a molecule red blood cells use to fight oxidative damage, though the label says the exact way it works is not fully understood. By reducing oxidative stress, it helps sickle red blood cells maintain better function and reduces the likelihood of pain crises.
▸What are the side effects of L-glutamine?
Generally well-tolerated. Common side effects include constipation, nausea, headache, abdominal pain, cough, pain in extremities, back pain, and chest pain.
▸How is L-glutamine taken?
Taken as an oral powder mixed with food or drink twice daily. Dose is based on body weight. Approved for patients age 5 and older. Can be used alongside hydroxyurea.
▸Is L-glutamine FDA approved?
Yes, L-glutamine (Endari) is FDA approved (2017) for the treatment of Sickle Cell Disease.
▸How is prescription L-glutamine different from dietary supplements?
Endari is a pharmaceutical-grade L-glutamine that meets specific purity and manufacturing standards required by the FDA. Over-the-counter glutamine supplements do not meet these standards and should not be substituted for the prescription formulation.
▸Can L-glutamine be used alongside hydroxyurea?
Yes. L-glutamine (Endari) is approved for use alongside hydroxyurea and other sickle cell disease treatments. It works through a different mechanism (reducing oxidative stress) and can provide additional benefit when added to existing therapy.
▸How is Endari taken?
Endari is taken as an oral powder mixed with food or drink twice daily. The dose is based on body weight. It is approved for patients aged 5 and older.
▸What were the clinical trial results for L-glutamine?
The Phase 3 trial showed 25% fewer pain crises versus placebo over 48 weeks (3.0 vs 4.0 median crises per year) and 33% fewer hospitalizations. While the effect size is modest, it provides additional benefit as part of a treatment regimen.
▸Why was Endari's approval significant?
When approved in July 2017, Endari was the first new sickle cell disease treatment in nearly two decades, breaking a long period without new FDA-approved options. It was the second drug ever approved for SCD after hydroxyurea.
▸Is generic L-glutamine available as a prescription?
Yes, generic pharmaceutical-grade L-glutamine is available for sickle cell disease. However, patients should use the prescription formulation rather than dietary supplement versions, which lack the required purity standards.