Glutamine
 Mechanism : 
Glutamine regulates GI cell growth, function, and regeneration in short bowel syndrome. Glutamine is considered a "conditionally essential" amino acid during metabolic stress and injury. Glutamine is a precursor for nicotinamide adenine dinucleotide (NAD).
 Indication : 
- Short bowel syndrome
 - Sickle cell disease
 - Nutritional supplement
 
 Contraindications : 
Renal or liver impairment; Reye syndrome; shock; multi-organ failure.
Dosing : 
Sickle cell disease:
Oral:
Children ≥5 years and Adolescents:
<30 kg: 5 g twice daily.
30 to 65 kg: 10 g twice daily.
>65 kg: 15 g twice daily.
Supplement (nutritional):
Oral:
0.25 to 0.5 g/kg/day given in 3 divided doses.
 Adverse Effect : 
Chest pain, headache, constipation, nausea, abdominal pain, limb pain, cough.
 Interaction : 
Lactulose: Glutamine may diminish the therapeutic effect of Lactulose. Specifically, glutamine may diminish the ammonia-lowering effects of lactulose.
 Hepatic Dose : 
No dosage adjustments are needed.