Usage
L-Glutathione Reduced is primarily used as an antioxidant and is involved in various cellular functions, including detoxification, immune function, and tissue building and repair. It is prescribed as an adjunct treatment for nerve damage caused by the chemotherapy drug cisplatin. It is also used for liver diseases, but more research is needed to establish its effectiveness. It is not classified under a single pharmacological classification, as it plays multiple roles in the body.
Alternate Names
- GSH
- Gamma-L-Glutamyl-L-cysteinylglycine
- L-Glutathione
- N-(N-L-gamma-glutamyl-L-cysteinyl) glycine
Brand names vary depending on the manufacturer and formulation.
How It Works
Pharmacodynamics: L-Glutathione Reduced acts as a potent antioxidant, scavenging free radicals and reactive oxygen species that can damage cells. It is crucial for maintaining intracellular redox balance and protecting against oxidative stress. It also plays a role in detoxification by conjugating with toxins, making them more water-soluble and facilitating their excretion. It is involved in various cellular processes like DNA synthesis, immune function and enzyme activity.
Pharmacokinetics: Absorption of oral glutathione is limited. Liposomal and reduced forms are better absorbed than standard glutathione. It is produced naturally in the liver. Metabolism and elimination pathways are not fully understood. As it is a peptide it likely follows standard protein metabolic processes and renal excretion.
Mode of Action: Glutathione acts as a reducing agent, donating electrons to neutralize free radicals and other oxidizing agents. It is a cofactor for several enzymes, including glutathione peroxidase and glutathione S-transferase, which are involved in detoxification and antioxidant defense. It participates in the reduction of oxidized vitamin C and vitamin E, regenerating their antioxidant activity.
Dosage
Standard Dosage
Adults:
Limited scientific evidence exists to define a standard dose. Doses ranging from 50 mg to 1000 mg daily have been used in studies. 500 mg daily for up to 2 months is considered possibly safe. For specific conditions, like skin lightening or detoxification, higher doses (up to 1000 mg/day) may be considered under medical supervision.
Children:
65 mg/kg/day divided into three doses with meals has been studied in children with cystic fibrosis. Pediatric dosing should be determined by a healthcare professional.
Special Cases:
Dosage adjustments are needed for patients with renal or hepatic impairment. Consultation with a physician is essential to determine appropriate dosing based on individual patient characteristics and clinical condition.
Clinical Use Cases
Clinical use cases and dosages need further research.
- Cisplatin-induced neurotoxicity: 1.5-3 g/m^2 intravenously before chemotherapy; alternatively, 1.5 g/m^2 intravenously before chemotherapy plus 600 mg intramuscularly daily on days 2-5.
- Cystic fibrosis: 65 mg/kg/day orally, divided into three doses with meals, for up to 6 months.
- Parkinson’s disease: 1400 mg intravenously three times per week for 4 weeks.
- Male Infertility: 600mg intramuscularly every other day for two months
Dosage recommendations for other clinical settings (intubation, surgical procedures, mechanical ventilation, ICU use, emergency situations) haven’t been established through rigorous clinical trials.
Dosage Adjustments
Dose modifications should be considered based on individual patient factors, such as renal or hepatic dysfunction, and comorbid conditions.
Side Effects
Common Side Effects
Limited data is available on side effects. Abdominal cramps, bloating, and allergic reactions like rash have been reported. Inhaled glutathione may worsen asthma symptoms.
Rare but Serious Side Effects
Severe hepatic injury has been reported with IV glutathione.
Long-Term Effects
Long-term use may lower zinc levels. Skin lightening may also occur over time.
Adverse Drug Reactions (ADR)
Clinically significant ADRs are rare but may include severe allergic reactions and hepatotoxicity.
Contraindications
Asthma (inhaled form), hypersensitivity. Use cautiously in patients with liver or kidney disease. It is best avoided during pregnancy and breastfeeding due to a lack of sufficient safety data.
Drug Interactions
Glutathione may interact with certain medications, such as acetaminophen, chemotherapy drugs, and nitroglycerin. High doses of vitamin C might decrease the effectiveness of glutathione. It is always advisable to consult with a healthcare provider regarding potential drug interactions.
Pregnancy and Breastfeeding
Insufficient data exists for pregnant and breastfeeding women. Use is best avoided.
Drug Profile Summary
- Mechanism of Action: Antioxidant, detoxifying agent, involved in various cellular functions.
- Side Effects: Generally well-tolerated; potential side effects include abdominal discomfort, allergic reactions, and decreased zinc levels.
- Contraindications: Hypersensitivity, asthma (inhaled). Use cautiously in patients with liver or kidney disease. Avoid during pregnancy and breastfeeding due to a lack of sufficient safety data.
- Drug Interactions: Acetaminophen, chemotherapy drugs, nitroglycerin, high doses of Vitamin C
- Pregnancy & Breastfeeding: Insufficient data available; avoid use.
- Dosage: Varies depending on the condition and route of administration; consult a healthcare professional.
- Monitoring Parameters: Monitor liver function tests, zinc levels, and assess for allergic reactions.
Popular Combinations
Often combined with Vitamin C to enhance its antioxidant effects.
Precautions
- General Precautions: Obtain a complete medical history, including allergies, pre-existing conditions, and current medications.
- Specific Populations: Avoid or use cautiously in patients with asthma, liver or kidney disease, and during pregnancy and breastfeeding.
- Lifestyle Considerations: Avoid alcohol, tobacco, and exposure to toxins, as these may decrease glutathione levels or interfere with its effects.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for L Glutathione Reduced?
A: There is no established recommended dosage. Dosage varies widely based on the condition being treated and the individual patient. It’s crucial to consult with a healthcare professional to determine the appropriate dosage.
Q2: Is L-Glutathione Reduced effective for skin whitening?
A: While some studies suggest a potential skin-lightening effect, more robust research is needed to confirm this effect and its long-term safety.
Q3: Can I take L-Glutathione Reduced if I am pregnant or breastfeeding?
A: Due to insufficient safety data, it is recommended to avoid L-Glutathione Reduced during pregnancy and breastfeeding.
Q4: What are the potential long-term effects of L-Glutathione Reduced?
A: Long-term effects are not fully known. Studies suggest potential lowering of zinc levels with prolonged use.
Q5: How is L-Glutathione Reduced metabolized and eliminated from the body?
A: Metabolism and elimination pathways are not well-characterized.
Q6: Does L-Glutathione Reduced interact with any medications?
A: Yes, potential interactions exist with medications such as acetaminophen, certain chemotherapy drugs, and nitroglycerin. Consult a doctor about all medications and supplements being used.
A: Yes, glutathione exists in reduced (GSH), oxidized (GSSG), and S-acetyl forms. Reduced glutathione is the active form. Liposomal glutathione exists as well.
Q8: How should L-Glutathione Reduced be stored?
A: Store in a cool, dry place, away from direct sunlight and moisture, as per the manufacturer’s instructions.
Q9: What are the signs of glutathione deficiency?
A: Glutathione deficiency can manifest as increased oxidative stress, impaired immune function, and increased susceptibility to certain diseases. However, it is important to consult a healthcare professional for diagnosis.
