Does L-glutamine interact with medications?

1. Why the answers differ: different databases, different thresholds

Some clinical summaries explicitly say there are “no known interactions” with L‑glutamine for most medicines, a conclusion reflected on WebMD, RxList and some review articles ^{[1] [2] [3]}. By contrast, Drugs.com’s interaction checker lists two drug interactions and a disease interaction—Databases use different evidence thresholds, include different product formulations (prescription Endari vs. supplements), and update on different schedules; that explains the divergent statements ^{[4] [7]}.

2. What the flagged interactions are — limited but present in some databases

Drugs.com reports two drugs interacting with glutamine and one disease interaction, though the publicly visible summary does not list those drugs in the provided snippets; Drugs.com recommends using its interaction checker for details ^{[4] [7]}. The site also shows that pairwise checks (for example Adderall + glutamine) can return “no interactions found,” underscoring that the flagged interactions are specific rather than universal ^[8].

3. Prescription product (Endari) vs. over‑the‑counter supplements — different labels, different claims

An FDA‑approved oral L‑glutamine product for sickle cell disease (Endari) is described in product and patient guides; some manufacturer and drug‑info pages for Endari state there are no known medicine interactions but still advise telling clinicians about all other medicines ^{[9] [1]}. Over‑the‑counter glutamine supplement listings and older labels (e.g., nutreStore) also vary; some sources emphasize that absence of reported interactions does not guarantee none exist ^{[9] [10]}.

4. Disease interactions and physiologic concerns — liver, ammonia, seizures, chemotherapy

Several sources raise disease‑specific cautions rather than blanket drug conflicts: Mayo Clinic warns liver disease may be worsened and to disclose medical problems when using glutamine ^[5]. A review article notes “physiological antagonism” may occur with lactulose in treating high ammonia levels in liver failure, and cautions that glutamine/glutamate metabolism can affect brain excitation and seizure control in some contexts ^[3]. Some summaries and secondary sources suggest glutamine could affect efficacy of anti‑seizure drugs or chemotherapy, but these claims appear in less authoritative summaries and are not consistently documented in primary interaction databases ^{[11] [3]}.

5. Reported adverse effects and when interactions matter clinically

Drug pages note glutamine can cause side effects (nausea, constipation, headache, possible liver problems, and rare psychiatric effects) and recommend stopping and seeking care for signs such as jaundice or manic episodes—these adverse events can change how other drugs are used or metabolized and thus influence interaction risk ^{[6] [1]}. Mayo Clinic guidance similarly links other medical problems (notably liver disease) to altered safety ^[5].

6. Practical guidance for patients and clinicians

Given the mixed database statements, the practical course is to: ^[12] tell your clinician or pharmacist if you take L‑glutamine (prescription or supplement); ^[13] flag liver disease, seizure disorders, chemotherapy or lactulose use because some sources raise specific physiologic concerns ^{[5] [3]}; and ^[14] if using multiple prescription drugs, run a formal interaction check (Drugs.com or your pharmacist) because Drugs.com lists two interactions even while other sources say none ^{[4] [1]}.

7. Limitations, disagreements, and what’s not found in current reporting

Sources disagree: major consumer drug references sometimes state “no known interactions” ^{[1] [2]} while Drugs.com reports specific interactions ^[4]. Available sources do not mention the exact two interacting drugs in the provided snippets, so I cannot list them here—users should run the interaction checker or consult a pharmacist for the precise pairs ^{[4] [7]}. Also, claims that glutamine definitively alters chemotherapy or anti‑seizure drug efficacy are variably reported and not consistently documented across the clinical references provided ^{[11] [3]}.

Bottom line: authoritative summaries often report no widespread drug interactions, but at least one interaction database flags specific drug and disease interactions; disclose glutamine use to health providers, especially with liver disease, seizure disorders, chemotherapy, or when taking multiple prescription medicines ^{[1] [4] [5] [3]}.