Basic Information
EMA regulatory identification and product classification information
EMA Identifiers
Overview Summary
Comprehensive product overview and regulatory summary
This is a summary of the European public assessment report (EPAR) for Carbaglu. It explains how the Committee for Medicinal Products for Human Use (CHMP) assessed the medicine to reach its opinion in favour of granting a marketing authorisation and its recommendations on the conditions of use for Carbaglu.
Active Substances (1)
carglumic acid
Documents (12)
Carbaglu : EPAR - Scientific Discussion
November 9, 2006
INITIAL_MARKETING_AUTHORISATION_DOCUMENTS
Carbaglu : EPAR - Procedural steps taken before authorisation
November 9, 2006
INITIAL_MARKETING_AUTHORISATION_DOCUMENTS
Carbaglu : EPAR - All Authorised presentations
November 9, 2006
AUTHORISED_PRESENTATIONS
Carbaglu : EPAR - Procedural steps taken and scientific information after authorisation
September 20, 2009
CHANGES_SINCE_INITIAL_AUTHORISATION
Carbaglu : EPAR - Risk management plan summary
July 19, 2023
RISK_MANAGEMENT_PLAN_SUMMARY
CHMP post-authorisation summary of positive opinion for Carbaglu
April 14, 2011
CHANGES_SINCE_INITIAL_AUTHORISATION
Carbaglu-H-C-PSUSA-564-201501 : EPAR - Scientific conclusions and grounds recommending the variation to the terms of the marketing authorisation
March 1, 2016
CHANGES_SINCE_INITIAL_AUTHORISATION
Carbaglu-H-C-461-II-0013 : EPAR - Assessment Report - Variation
July 18, 2011
CHANGES_SINCE_INITIAL_AUTHORISATION
Carbaglu : EPAR - Summary for the public
April 7, 2009
OVERVIEW_DOCUMENT
Carbaglu : EPAR - Product Information
September 20, 2009
DRUG_PRODUCT_INFORMATION
Carbaglu : EPAR - Scientific Discussion
November 9, 2006
CHANGES_SINCE_INITIAL_AUTHORISATION
Carbaglu : EPAR - Procedural steps taken before authorisation
November 9, 2006
CHANGES_SINCE_INITIAL_AUTHORISATION
Overview Q&A (9)
Question
How is Carbaglu used?
Answer
Carbaglu treatment should be started by a doctor who has experience in treating patients with metabolic diseases.
In patients with NAGS deficiency, treatment may be started as early as the first day of life and the medicine is used for the patient’s whole life. In patients with organic acidaemias, treatment is started when the patient has a hyperammonaemia crisis and continued until the crisis is finished.
The initial daily dose of Carbaglu should be 100 mg per kilogram body weight, but up to 250 mg/kg can be used if necessary. The dose should then be adjusted to maintain normal blood ammonia levels. The tablets should be dispersed (mixed) in a small amount of water before being given to the patient. They can easily be broken into two equal halves.
Question
How does Carbaglu work?
Answer
When ammonia builds up in the blood, it is toxic to the body, especially the brain. Carbaglu is very similar in structure to N-acetylglutamate, which activates an enzyme that breaks down ammonia. Carbaglu therefore helps break down ammonia, reducing ammonia blood levels and its toxic effects.
Question
Other information about Carbaglu
Answer
The European Commission granted a marketing authorisation valid throughout the European Union for Carbaglu to Orphan Europe on 24 January 2003. The marketing authorisation is valid for an unlimited period.
For more information about treatment with Carbaglu, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.
Question
How has Carbaglu been studied?
Answer
Carbaglu has been studied in 20 patients, 12 of whom had NAGS deficiency and were treated for an average of about three years. The other eight patients were treated for hyperammonaemia of another cause. The company also presented information from the published literature on a further four patients treated with the active substance in Carbaglu.
Carbaglu has also been studied in 57 patients (about two-thirds were newborn babies) with isovaleric acidaemia, methylmalonic acidaemia or propionic acidaemia who were treated with Carbaglu during hyperammonaemia crises.
In all of the studies, the main measure of effectiveness was the change in ammonia levels in the blood.
Question
What benefit has Carbaglu shown during the studies?
Answer
In patients with NAGS deficiency, ammonia levels were brought back to normal after Carbaglu treatment. Patients on Carbaglu could be kept stable without a need for restrictions to the diet or the use of other medicines.
In patients with isovaleric acidaemia, methylmalonic acidaemia or propionic acidaemia, Carbaglu also induced a decrease in ammonia levels in the blood, following an average of 5.5 days of treatment.
Question
Why has Carbaglu been approved?
Answer
The CHMP concluded that Carbaglu was effective in reducing blood ammonia to normal levels and decided that Carbaglu’s benefits are greater than its risks. The Committee recommended that Carbaglu be given marketing authorisation.
Question
What is Carbaglu?
Answer
Carbaglu is a medicine that contains the active substance carglumic acid. It is available as dispersible tablets. ‘Dispersible’ means that the tablets can be dispersed (mixed) in water.
Question
What is Carbaglu used for?
Answer
Carbaglu is used for the treatment of hyperammonaemia (high blood levels of ammonia) in patients with the following metabolic diseases:
- N-acetylglutamate synthase (NAGS) deficiency. Patients with this lifelong disease lack a liver enzyme called NAGS, which normally helps to break down ammonia. If the enzyme is not present, ammonia cannot be broken down and it builds up in the blood;
- some organic acidaemias (isovaleric acidaemia, methylmalonic acidaemia and propionic acidaemia) where patients lack certain enzymes involved in protein metabolism.
Because the number of patients with these diseases is low, they are considered ‘rare’ and Carbaglu was designated an ‘orphan medicine’ (a medicine used in rare diseases) on various dates (see below).
The medicine can only be obtained with a prescription.
Question
What is the risk associated with Carbaglu?
Answer
The most common side effect with Carbaglu (seen in between 1 and 10 patients in 100) is increased sweating. For the full list of side effects reported with Carbaglu, see the package leaflet.
Carbaglu should not be used in people who may be hypersensitive (allergic) to carglumic acid or any of the other ingredients. Carbaglu must not be used in women who are breastfeeding.