Nitrogen-binding agent
Glycerol phenylbutyrate
Brand names: Ravicti
Adult dose
Dose: Per BNF/SmPC; weight-based
Route: PO
Frequency: divided
Clinical pearls
- Chronic urea cycle disorders; specialist metabolic service
Contraindications
- Acute hyperammonaemic crisis (use IV)
- Hypersensitivity
Side effects
- GI upset
- Hyperammonaemia (if dose insufficient)
- Hypokalaemia
- Headache
Interactions
- Probenecid
- Corticosteroids (raise ammonia)
- Valproate (raise ammonia)
Monitoring
- Ammonia
- U&E
- LFTs
- Phenylacetate/phenylbutyrate
Reference: BNF; SmPC; https://bnf.nice.org.uk/drugs/glycerol-phenylbutyrate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Variceal Upper GI Bleed · BSG 2015; Baveno VII (2022)
- Spontaneous Bacterial Peritonitis (SBP) · BSG / EASL 2018
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Hepatic Encephalopathy · EASL 2014; West Haven criteria
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021