Dipeptiven

Alanylglutamine

Treatment option:

Medically reviewed

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Dipeptiven

Dipeptiven is a specialized, synthetic medicinal product used exclusively in clinical nutrition to provide essential amino acid support to critically ill patients.

Property	Description
Active ingredient	Alanylglutamine
Form	Concentrate for solution for intravenous infusion
Pharmacological class	Amino acids – concentrate for solution for parenteral nutrition
Common purpose	Nutritional support in hypercatabolic states
Origin	Synthetic (manufactured dipeptide)

Specialized Preparation for Parenteral Nutrition and Product Differentiation

Dipeptiven is classified as a highly specialized medicinal product belonging to the pharmacological class of amino acids – concentrate for solution for parenteral nutrition (ATC code B05X B02). The formulation is widely clinically recognized for its inclusion in specialized intravenous feeding regimens, and is supplied as a sterile, aqueous concentrate for solution for intravenous infusion. The product is typically categorized as prescription-only (Rx), reflecting its intended use in highly controlled hospital or clinical settings under medical supervision.

The Active Ingredient: Compositional Identity of Alanylglutamine

The active ingredient is Alanylglutamine, which is chemically defined as the dipeptide N(2)-L-alanyl-L-glutamine. This molecule is synthetically constructed from two amino acids: L-alanine and the conditionally essential amino acid L-glutamine. The dipeptide structure provides a crucial advantage over standard formulations, offering superior stability and solubility when incorporated into the required aqueous solution for injection. This unique chemical approach allows for the safe and effective delivery of large amounts of L-glutamine intravenously.

General Purpose: Why is Glutamine Supplementation Necessary?

The primary purpose of administering Dipeptiven is to provide a reliable exogenous source of glutamine to the body. Once infused, the dipeptide rapidly undergoes hydrolysis (splitting) into its component parts, ensuring a controlled release of L-glutamine and L-alanine for metabolic use. This provision is vital for supporting patients in hypercatabolic or hypermetabolic states, such as those with severe illness or major trauma, whose body's high demand for L-glutamine cannot be met by its natural production alone. The product supports nutritional status in critically ill patients receiving specialized intravenous feeding regimens.

What side effects are possible with Dipeptiven?

Possible Side Effects and Safety Information

The safety profile of Dipeptiven, an alanylglutamine concentrate, is defined by strict constraints on administration and patient eligibility, rather than a broad list of common adverse reactions. Official regulatory documentation states that no undesirable effects are known when the product is administered correctly and within established limits.

Adverse Reactions and Frequency Classification

Adverse effects are documented primarily in the context of an excessive rate of administration. Should the maximum rate of infusion be exceeded, the following reactions may occur, categorized by the affected body system:

Gastrointestinal Disorders: Nausea, Vomiting
General Disorders: Chills (Shivering)

These events are generally classified as very rare. Hypersensitivity (allergic reaction) is also noted as a clinically significant safety concern, forming an absolute restriction for use.

Safety Restrictions and Special Populations

The use of Dipeptiven is strictly limited by a comprehensive list of contraindications, which are patient states where the medicine must not be administered. These include conditions related to severe physiological stress and organ dysfunction, such as severe hepatic insufficiency, severe renal insufficiency (creatinine clearance less than 25 mL/minute), circulatory shock, multiple organ failure, severe metabolic acidosis, and hypoxia.

Furthermore, the medicine is not recommended for use in certain populations, including children, pregnant women, or nursing mothers, due to insufficient data on safety and efficacy in these specific groups. Experience with the product's use for periods longer than nine days is also officially limited.

Overdose and Emergency Response

Overdose and when to seek help

Overdose of Dipeptiven is considered unlikely because the concentrate is administered solely under the direct supervision of a doctor or nurse in a clinical setting. Clinical staff provide continuous monitoring and perform required blood and urine tests throughout the treatment course to prevent and manage administration errors.

Officially Documented Overdose Manifestations

Overdose Presentation	Description from Regulatory Sources
Acute Signs	Over-exposure, typically resulting from receiving an excessive quantity or infusion rate, may result in specific clinical signs documented in official labeling, including the acute onset of chills, nausea, and vomiting.
Risk Context	Official regulatory guidance notes specific constraints for use: the product should not be administered to patients experiencing unresuscitated shock accompanied by renal failure. This is because the body's metabolic capacity for the glutamine component may be exceeded in such compromised states, which could increase overall patient risk.

Required Emergency Action

The official regulatory guidance mandates immediate communication with the healthcare team in the event that overdose is suspected. This procedure is required, as the documentation does not list a specific antidote for this product. The explicit instruction for the patient or caregiver is to inform your doctor or nurse immediately if there is any suspicion that too much Dipeptiven has been administered. This allows the treating physician, who is responsible for clinical recognition and management, to intervene promptly.

Therapeutic Uses of Dipeptiven

What Dipeptiven Treats: Main Uses and Benefits

Dipeptiven is applied in clinical settings that involve acute or unstable symptom patterns, when the body's requirement for certain nutrients may be increased. It is used as part of a clinical nutrition regimen in patients with conditions marked by increased physiological stress. It is relevant when supportive symptom management is appropriate to help with the physiological challenges associated with these demanding conditions.

Supporting Nutritional Needs in High-Stress Conditions

Dipeptiven is applied across domains where additional symptomatic support is needed to address symptoms related to systemic imbalance. This includes conditions presenting with systemic or localized discomfort. This product provides support that helps ease the overall symptom burden and contributes to improved comfort during periods of heightened symptoms marked by temporary physiological imbalance.

Quick Fact: Relevant for Physiological Strain

Assistance During Recovery and Critical Care

This product is commonly used when symptoms cluster into patterns requiring supportive management. It may assist with maintaining a sense of stability when symptoms become more noticeable, and provides supportive relief when symptoms interfere with routine activities.

Regulatory References

Official Clinical Information Source

Eligibility and Restrictions for Use

The eligibility for Dipeptiven is strictly defined by government health authorities, limiting its use to adults who require specialized amino acid support as part of an official clinical nutrition regimen.

Population Status	Regulatory Rule
Allowed Population	Adults in hypercatabolic and/or hypermetabolic states, only as part of a clinical nutrition regimen.
Contraindicated	Prohibited in severe renal insufficiency (creatinine clearance < 25 mL/min), severe hepatic insufficiency, circulatory shock, hypoxia, severe metabolic acidosis, or multiple organ failure.
Not Recommended	Use is not recommended in children, pregnant women, and nursing mothers, as safety and efficacy have not been established in these groups.
Conditional Use	Patients with compensated hepatic insufficiency may use the medicine but require regular monitoring of liver function parameters.

Official labeling establishes absolute contraindications for individuals with critical physiological instability, including severe kidney or liver impairment, circulatory shock, and severe metabolic acidosis. The drug is classified as not recommended for the pediatric, pregnant, and lactating populations due to insufficient supporting data.

What should I know about interactions with other medicines?

The official interaction profile for Dipeptiven is characterized by the explicit regulatory statement that no interactions with other medicinal products have been reported to date. Consequently, there are no documented pharmacokinetic or pharmacodynamic interactions with specific co-administered medicines, nor are there reported interactions involving CYP enzymes or drug transporters. The interaction structure is instead governed by administration-timing rules and metabolic constraints related to its classification as a concentrated component of a nutritional regimen.

The key interaction constraints involve additive exposure to its active components: all amino acids supplied via oral or enteral glutamine-supplemented formulas and other protein sources must be factored into the dose. This consideration is required because the components of Dipeptiven add to the total daily amino acid/protein load, which must not exceed the maximum limit set by the regulatory documentation.

An essential administration restriction mandates that the concentrate must not be mixed with any non-specified medicinal products, constituting a strict incompatibility rule. The product must be mixed only with a compatible amino acid carrier solution prior to infusion.

Furthermore, the product carries population-specific interaction notes that are classified as formal contraindications: The medicinal product is prohibited in patients with severe renal insufficiency or severe hepatic insufficiency. This restriction addresses the heightened risk of metabolite accumulation in these populations. For patients with compensated hepatic insufficiency, regulatory labeling advises regular monitoring of liver function parameters.

Mechanism of Action

Glutamine Delivery: The Dipeptide Hydrolysis Cascade

Dipeptiven is a stable dipeptide pro-drug (L-alanyl-L-glutamine) that acts as a protected source of the conditionally essential amino acid, L-glutamine. Its primary mechanistic cascade involves rapid cleavage by ubiquitous peptidases in the body, releasing active L-glutamine. This provides a stable route for the circulatory introduction of L-glutamine, contributing glutamine to the circulation, where supply levels may be diminished during hypercatabolic states.

Modulation of Cellular and Metabolic Pathways

The released L-glutamine is a key substrate in core metabolic pathways, acting as a critical fuel for highly metabolically active cells. This mechanism supports nitrogen transport and is a precursor for both nucleotides (DNA/RNA) and the major intracellular antioxidant, glutathione. This targeted pathway adjustment contributes to the maintenance of cellular function and nitrogen balance via its role in protein synthesis and degradation pathways.

Substrate Provision for Immune and Epithelial Systems

Glutamine is the preferred respiratory fuel for enterocytes (gut lining cells) and rapidly dividing immune cells (lymphocytes). By engaging this specific mechanistic domain, glutamine provides necessary metabolic substrate to enterocytes, which influences the structural maintenance of the intestinal mucosa. Furthermore, it supports immune cell function through its role as a necessary energy and substrate source, serving as a respiratory fuel for these cells, linking glutamine availability to the proliferative capacity of the immune and epithelial systems.

Dosage and Administration Information

Dipeptiven is a concentrate for solution for infusion and is administered as part of an intravenous parenteral nutrition (IV drip) regimen. It is a supplement to amino acid solutions, providing the dipeptide alanyl-glutamine to help meet increased protein/amino acid needs, particularly in hypercatabolic or hypermetabolic states.

Preparation and Administration

Dilution is Mandatory: Dipeptiven must be diluted with a compatible carrier solution, such as an amino acid solution or an amino acid-containing infusion regimen, prior to administration. It is not intended for direct, undiluted infusion.
Infusion Route: The choice between a peripheral or central vein for the infusion is determined by the final mixture's osmolarity. Solutions with an osmolarity above 800 mOsmol/L are generally recommended for infusion via a central venous route.
Infusion Rate: The product is typically infused continuously over 20 to 24 hours per day. The infusion rate is carefully controlled by a healthcare provider and should not exceed 0.1 g amino acids per kg body weight per hour.

Dosing

The prescribed dose is individualized based on the patient's clinical condition, body weight, and total protein/amino acid requirements.
The maximum daily dosage of the active substance (N(2)-L-alanyl-L-glutamine) should not exceed 2.5 mL per kg body weight per day.
The amino acids supplied by Dipeptiven should typically not exceed approximately 30% of the patient's total amino acid/protein supply.
Treatment duration is usually short-term, as experience with use for longer than nine days is limited, and the overall duration should not exceed three weeks.

Recent Clinical Evidence

The research for Dipeptiven (Alanylglutamine) was studied for use as a specialized component of intravenous nutrition in patients dealing with severe physiological challenges. The overall evidence landscape consists mainly of randomized controlled trials (RCTs) and meta-analyses, which are research tools used to evaluate health patterns in different patient groups.

Evidence for Nutritional Support During Critical Illness

Research has explored the use of Dipeptiven as a nutritional supplement for adults who are critically ill within research contexts involving patients in the Intensive Care Unit (ICU). The trials monitored outcomes monitoring physiological strain, specifically assessing the length of stay (LOS) in the ICU and hospital, the duration of mechanical ventilation, and the incidence of hospital-acquired infections.

Studies described patterns related to measurements of the LOS in the hospital and ICU in some observed populations. Research also reported measurements related to infectious complication rates, which were evaluated against the control group receiving standard nutritional support. However, research exploring the effect on overall patient mortality tracked over time yielded mixed findings.

Evidence for Nutritional Support in Major Surgery

Dipeptiven was evaluated in research contexts involving surgical recovery. These studies monitored patients undergoing major elective surgery, such as abdominal procedures, who were receiving intravenous nutrition. The research examined outcomes related to systemic or functional imbalance, including tracking the length of hospital stay (LOS) and the incidence of postoperative infectious complications.

Findings describe patterns observed in these populations, where measurements of the hospital LOS were tracked and outcomes related to infectious complications were evaluated. The certainty for these measurements remains low because evidence quality varies across studies, and many had sample sizes that were modest.

What Remains Uncertain in the Research Landscape

A significant area of uncertainty involves the inconsistency of findings related to the effect on overall mortality, particularly when comparing results from smaller trials versus large, multi-center studies. Long-term effects are not fully established, and there is limited information regarding outcomes tracked well beyond the immediate hospital discharge. Additionally, data for certain groups remain insufficient, and currently, comparative evidence is limited for some key outcomes.

Key Studies & References

Frequently Asked Questions (FAQ)

Common questions about Dipeptiven (FAQ)

Q: Can I receive Dipeptiven at home?

Dipeptiven is used as part of a specialized intravenous nutrition regimen for patients with increased protein/amino acid needs. The official product information indicates it is a sterile concentrate that requires careful dilution with a compatible solution and is then infused continuously over many hours. The complexity of its preparation and the nature of the conditions it treats suggest its administration is typically managed within a hospital or clinical setting under medical supervision, although official labeling does not explicitly forbid home administration of all parenteral nutrition.

Q: What are the common side effects of Dipeptiven?

According to official regulatory documents, no undesirable effects are known when Dipeptiven is administered correctly and within its established limits. Very rare side effects, such as nausea, vomiting, and chills (shivering), have been reported, but these events have been documented only in the context of an excessive rate of infusion.

Q: How does Dipeptiven work in the body?

Dipeptiven is a specialized molecule called a dipeptide (L-alanyl-L-glutamine) that serves as a stable, protected source of the amino acid L-glutamine. Once infused into the bloodstream, the dipeptide is rapidly broken down by enzymes. This process releases L-glutamine and L-alanine, which are made available to the body for metabolic use, a provision considered vital during periods of hypercatabolic states such as severe illness or major trauma.

How should Dipeptiven be stored and disposed of?

Official Storage and Disposal Requirements

Dipeptiven concentrate must be stored under specific conditions to maintain stability. The unopened product must be kept out of the sight and reach of children and not stored above 25 C.

The concentrate should remain in the original outer carton to protect the solution from light.
The overall shelf-life of the unopened product is 24 months, and it must not be used past the expiry date.

Stability and Handling

As a sterile concentrate, Dipeptiven is for single use only. Once the concentrate is opened and mixed with a carrier solution (admixture), it must be used immediately. If immediate use is not possible, the prepared admixture can be stored for a maximum of 24 hours under refrigeration (2 C to 8 C).

Disposal Protocol

Any unused portion of the solution must be disposed of. The disposal of the unused product and all related waste materials must strictly follow the local requirements for medicinal products, as mandated by regulatory authorities.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.