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L-glutamine + sodium azulene sulfonate (Marzulene-S) is a small-molecule combination drug originally developed by Kotobuki Pharmaceutical for the treatment of gastrointestinal disorders. It combines **L-glutamine**, an amino acid that serves as a precursor for protein and hexosamine synthesis to promote mucosal cell regeneration, with **sodium azulene sulfonate**, a water-soluble derivative of azulene with potent anti-inflammatory properties. Sodium azulene sulfonate acts by inhibiting the release of histamine from mast cells and promoting the formation of granulation tissue, thereby accelerating the healing of ulcers and reducing mucosal inflammation. The combination is primarily indicated for gastric ulcers, duodenal ulcers, and both acute and chronic gastritis. It has also been investigated for its potential in reducing the severity of chemotherapy-induced oral mucositis.
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