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Which common prescription drugs interact with L-glutamine and how serious are those interactions?
Executive summary
Available reporting shows that mainstream drug references generally list few or no established drug–drug interactions for prescription L‑glutamine (Endari); WebMD and RxList state “no known interactions” while Drugs.com reports two known drug interactions with glutamine, two of them rated major (contradiction among sources) [1] [2] [3]. Several authoritative pages also say formal interaction studies are limited or incomplete and advise clinicians to check product labeling and monitor patients [4] [5] [6].
1. Common references agree: interactions are uncommon or not well documented
Major patient-facing resources — WebMD and RxList — explicitly report no known or no significant interactions for oral L‑glutamine (Endari / glutamine) [1] [2]. MedlinePlus and the Mayo Clinic describe the drug, dosing and precautions but do not list routine interacting prescription drugs; both direct clinicians to product labeling for specifics [7] [6]. This convergence suggests that no large, well‑established list of common prescription drug interactions is widely recognized in public monographs [1] [2] [7].
2. But some drug‑interaction databases flag possible interactions — and disagreement exists
Drugs.com’ interaction checker reports two drugs that interact with glutamine and counts two major interactions, indicating that at least some databases identify specific concerns [3]. This directly conflicts with the “no known interactions” statements in other references, showing that databases use different evidence thresholds and inputs; thus, interaction risk cannot be declared uniformly absent [3] [1].
3. Key limitation: formal interaction studies are limited or incomplete
Several clinical and clinical‑reference sources state that formal drug–drug interaction studies for glutamine are lacking or incomplete and tell clinicians to consult product labeling and monitor patients if combining therapies [5] [4] [8]. Cleveland Clinic notes that "interactions have not been completed" for their entry on L‑glutamine powder [8]. This gap helps explain why sources disagree: absence of evidence is not evidence of absence [5] [4].
4. Potential interactions mentioned in secondary sources — anticonvulsants, chemotherapy, growth hormone, NSAIDs
Some secondary and specialty writeups raise hypothetical or limited‑evidence concerns. A synthesis article claims glutamine "can affect the efficacy of anti‑seizure drugs and some chemotherapy medications" but it does not cite a robust clinical database here — the claim appears in an aggregator piece rather than in the main drug monographs provided [9]. MedicalDialogue notes possible interactions or synergistic effects with human growth hormone in short‑bowel contexts and with indomethacin/NSAIDs for gut permeability — framed as potential beneficial interactions rather than safety conflicts [10]. These mentions are circumstantial and not standardized across references [9] [10].
5. Clinical consequences — what the sources say about seriousness
Where interactions are flagged, Drugs.com counts two major interactions [3], which implies potential for serious consequences, but the specific medications and clinical outcomes are not listed in the provided snippet — further review of that database entry would be needed. Other sources emphasize general adverse events (GI upset, rare seizures, hyperammonemia, liver issues) tied to glutamine itself rather than to interactions with specific prescription drugs [11] [5]. Product labeling and AHFS summaries urge provider oversight and monitoring rather than listing common, predictable interaction syndromes [4] [11].
6. Practical guidance for patients and clinicians based on available sources
Because authoritative sources disagree and formal interaction studies are incomplete, clinicians and patients should: (a) consult the product label and institutional drug‑interaction checkers before combining L‑glutamine with prescription drugs [4] [5]; (b) disclose all medications, supplements and herbal products to the prescriber and pharmacist [11] [6]; and (c) monitor liver, kidney function and neurologic status when appropriate, especially in vulnerable patients [11] [5]. If a patient believes they are experiencing an interaction, DrugBank and other references advise contacting a healthcare provider immediately [12].
7. Why sources disagree — hidden agendas and evidence thresholds
Discrepancies reflect different editorial policies: consumer sites that synthesize labeling and clinical trials (WebMD, RxList) may report “no known interactions” in absence of robust evidence, while interaction databases (Drugs.com) aggregate manufacturer reports, case reports and theoretical pharmacology, producing flagged interactions [1] [2] [3]. Some promotional or secondary health‑advice outlets may extrapolate mechanistic concerns (e.g., effects on chemotherapy or anticonvulsants) without primary clinical confirmation [9] [10].
8. Bottom line: cautious approach until stronger evidence emerges
Available sources do not present a consistent, detailed list of common prescription drugs that interact with L‑glutamine; some databases flag a small number of interactions while many mainstream monographs say none are known and emphasize limited interaction evidence [3] [1] [2] [5]. Clinicians should rely on product labeling, interaction‑checking tools and clinical monitoring for patients on complex regimens [4] [6].
If you want, I can: (a) pull the full Drugs.com interaction report to identify the two flagged drugs; (b) summarize the Endari product label interaction section; or (c) draft questions to ask your clinician or pharmacist about specific medications you take.