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Carglumic acid is a synthetic structural analog of N-acetylglutamate (NAG) used to treat acute and chronic hyperammonemia in patients with N-acetylglutamate synthase (NAGS) deficiency, as well as for hyperammonemia due to propionic acidemia and methylmalonic acidemia. It acts by replacing the function of NAG as an essential allosteric activator of carbamoyl phosphate synthetase 1 (CPS1), the first enzyme in the urea cycle, thereby facilitating ammonia detoxification. Carglumic acid is administered orally and was approved by the FDA in March 2010. The drug is available under brand names such as Carbaglu and Ucedane.
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