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Data updated: May 26, 2026

CARBAGLU (carglumic acid)

Carbamoyl Phosphate Synthetase 1 Activators
Rare Disease Approved 2010-03-18

Carbaglu (carglumic acid) is a carbamoyl phosphate synthetase 1 (CPS 1) activator indicated for use in pediatric and adult patients to treat hyperammonemia. It is used as adjunctive therapy to standard of care for **acute** hyperammonemia caused by N-acetylglutamate synthase (NAGS) deficiency, propionic acidemia (PA), or methylmalonic acidemia (MMA). It is also indicated for the **maintenance** treatment of chronic hyperammonemia specifically in patients with NAGS deficiency.

Source: FDA Label • RECORDATI RARE • Carbamoyl Phosphate Synthetase 1 Activator

How CARBAGLU Works

Carglumic acid is a synthetic structural analogue of N-acetylglutamate (NAG), which is the essential allosteric activator of carbamoyl phosphate synthetase 1 (CPS 1). CPS 1 is the mitochondrial liver enzyme that catalyzes the initial step of the urea cycle. In patients with NAGS deficiency, or during acute metabolic decompensation in PA and MMA, endogenous NAG levels are insufficient. Carglumic acid mimics NAG to activate CPS 1, thereby restoring urea cycle function and facilitating the detoxification of ammonia into urea for renal excretion.

2
Indications
--
Phase 3 Trials
2
Priority Reviews
16
Years on Market

Details

Status
Prescription
First Approved
2010-03-18
Patent Cliff
2028

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Routes
ORAL
Dosage Forms
TABLET, FOR SUSPENSION

Companies

Active Ingredient: CARGLUMIC ACID

CARBAGLU Approval History

2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
12 FDA actions from 2010 to 2024 · 1 indication expansions
Jan 2024 SUPPL
Label · Labeling
Aug 2021 SUPPL
Label · Labeling
Jan 2021 SUPPL Priority
Efficacy

What CARBAGLU Treats

4 indications

CARBAGLU is approved for 4 conditions since its original approval in 2010. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Hyperammonemia
  • N-Acetylglutamate Synthase Deficiency
  • Propionic Acidemia
  • Methylmalonic Acidemia
Source: FDA Label

CARBAGLU Competitive Set

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Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.

Drugs Similar to CARBAGLU

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CARGLUMIC ACID
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2 shared
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Shared indications:
HyperammonemiaN-Acetylglutamate Synthase Deficiency
RAVICTI
GLYCEROL PHENYLBUTYRATE
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HORIZON THERAP US
Shared indications:
HyperammonemiaN-Acetylglutamate Synthase Deficiency
SODIUM PHENYLACETATE AND SODIUM BENZOATE
SODIUM BENZOATE
1 shared
MAIA PHARMS INC
Shared indications:
Hyperammonemia
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Clinical Trial Registry

2 trials
Trial Sponsor ID Phase Status Title
NCT01599286 STO results posted NCGC0008 Ph 2 completed Short-Term Outcome of N-Carbamylglutamate in the Treatment of Acute Hyperammonemia
NCT02426775 CAMP RC 13/116 Ph 3 completed Carglumic Acid in Methylmalonic Acidemia and Propionic Acidemia
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Active Pipeline

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Key Completed Trials

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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

CARBAGLU FDA Label Details

Indications & Usage

FDA Label (PDF)

CARBAGLU is indicated for the treatment of Hyperammonemia; N-Acetylglutamate Synthase Deficiency; Propionic Acidemia; Methylmalonic Acidemia.

CARBAGLU Patents & Exclusivity

Exclusivity: Jan 2028

Exclusivity

ODE-345 Until Jan 2028
Source: FDA Orange Book

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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.