Glentek/Riluzol (riluzole) vs Ammonaps (sodium phenylbutyrate)

Glentek (riluzole) is primarily used for the treatment of amyotrophic lateral sclerosis (ALS), a neurodegenerative disorder, and works by reducing glutamate-related nerve damage. Ammonaps (sodium phenylbutyrate), on the other hand, is used to treat urea cycle disorders, which are genetic conditions that affect the body's ability to remove ammonia from the bloodstream. When deciding between these two medications, it is crucial to consider the specific condition being treated, as they are used for very different diseases and have distinct mechanisms of action.

Difference between Glentek/Riluzol and Ammonaps

Metric	Glentek/Riluzol (riluzole)	Ammonaps (sodium phenylbutyrate)
Generic name	Riluzole	Sodium phenylbutyrate
Indications	Amyotrophic lateral sclerosis (ALS)	Urea cycle disorders
Mechanism of action	Inhibits glutamate release, inactivates voltage-dependent sodium channels, and interferes with intracellular events that follow transmitter binding at excitatory amino acid receptors.	Converts to phenylacetate in vivo, which then conjugates with glutamine to form phenylacetylglutamine, thereby reducing ammonia levels in the blood.
Brand names	Glentek, Rilutek, Teglutik	Ammonaps, Buphenyl
Administrative route	Oral	Oral
Side effects	Dizziness, gastrointestinal disturbances, elevation of liver enzymes, weakness	Body odor, headache, nausea, vomiting, amenorrhea, irregular menstruation
Contraindications	Liver disease, caution in patients with a history of neutropenia or lung disease	Hepatic insufficiency, hypersensitivity to sodium phenylbutyrate or its components
Drug class	Antiglutamate agent	Urea cycle disorder agent
Manufacturer	Sanofi	Horizon Pharma

Efficacy

Efficacy of Riluzole (Glentek/Rilutek) in ALS

Riluzole, marketed under brand names such as Glentek and Rilutek, is a medication that has been approved for the treatment of Amyotrophic Lateral Sclerosis (ALS), a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord. The efficacy of riluzole in ALS has been demonstrated in several clinical trials, which have shown that the drug can extend survival by several months. Riluzole is believed to reduce the damage to motor neurons by decreasing the release of glutamate, which can be toxic in excessive amounts.

While riluzole does not halt the progression of ALS or reverse the damage already done, it is currently one of the few treatments available that has a positive impact on life expectancy. The clinical benefit of riluzole is generally considered modest, but significant, as it is one of the only pharmacological interventions that has been shown to extend survival in ALS patients. It is typically prescribed to patients soon after diagnosis to maximize its potential benefits.

Efficacy of Sodium Phenylbutyrate (Ammonaps) in ALS

Sodium phenylbutyrate, sold under the brand name Ammonaps among others, is a drug that has been used for the treatment of urea cycle disorders. Its efficacy in ALS is less well-established than that of riluzole. Sodium phenylbutyrate is thought to have neuroprotective effects potentially relevant to ALS through its influence on gene expression and cellular stress responses. However, its use in ALS is considered off-label, and more research is needed to fully understand its efficacy in this context.

There have been studies investigating sodium phenylbutyrate as a potential treatment for ALS, often in combination with other drugs, such as taurursodiol. These studies aim to assess whether sodium phenylbutyrate can slow the progression of ALS or improve survival. However, the results have been mixed, and no consensus has been reached regarding its effectiveness for ALS patients. As such, sodium phenylbutyrate is not widely used or recommended as a standard treatment for ALS at this time.

Regulatory Agency Approvals

Glentek/Riluzol

European Medical Agency (EMA), European Union
Therapeutic Goods Administration (TGA), Australia
Medicines & Healthcare products Regulatory Agency (MHRA), United Kingdom
The Medicines Evaluation Board (MEB), The Netherlands

Ammonaps

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Therapeutic Goods Administration (TGA), Australia

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