What is the recommended dose of glutathione (Glutathione) for intravenous (IV) infusion?

Recommended Dosage for Intravenous Glutathione

The recommended dosage for intravenous glutathione administration is 1500-2500 mg per infusion, typically administered over 15-20 minutes. 1

Dosage Guidelines

Intravenous glutathione dosing varies based on clinical indication:

• Standard therapeutic dose range: 1500-2500 mg per infusion 1
• Specific administration protocols:
  • 2500 mg over 10 minutes (used in cardiovascular applications) 2
  • 1500 mg/m² in 100 mL of saline over 15 minutes 1
  • 3 g/m² infused over 20 minutes 1
  • Lower doses of 1400 mg three times weekly have been studied in Parkinson's disease 3
  • 600 mg twice daily has shown efficacy in early Parkinson's disease 4

Administration Protocol

1. Preparation: Dilute in appropriate carrier solution (typically saline)
2. Infusion rate: Administer over 15-20 minutes for standard doses
3. Frequency: Depends on clinical indication
   • For acute conditions: May be administered daily or multiple times per week
   • For chronic conditions: Typically 1-3 times weekly

Clinical Considerations

Patient Screening

• G6PD deficiency testing: Consider screening before administration, as glutathione may cause concerns similar to other reducing agents 1
• Medication interactions: Use caution in patients taking serotonergic medications

Monitoring

• Monitor for potential adverse reactions during infusion:
  • Skin rash
  • Headache
  • Gastrointestinal discomfort
  • Allergic reactions (rare)

Clinical Applications and Evidence

• Parkinson's disease: Studies have used 600 mg twice daily for 30 days 4 and 1400 mg three times weekly for 4 weeks 3
• Cardiovascular protection: 2500 mg over 10 minutes followed by repeated doses at 24,48, and 72 hours has shown benefit in reducing oxidative stress after cardiac procedures 2
• Renal protection: 100 mg/minute for 30 minutes (3000 mg total) before coronary angiography has demonstrated effectiveness in preventing contrast-induced oxidative stress 5

Common Pitfalls and Caveats

• Lack of standardization: Despite clinical use, there are no universally accepted dosing guidelines for IV glutathione
• Limited long-term safety data: Regular administration safety profile is not well-established 1
• Variable clinical response: Individual response may vary, requiring dose adjustments
• Storage considerations: Glutathione is unstable and should be properly stored and freshly prepared before administration

The evidence suggests that while glutathione is generally well-tolerated across a range of doses, the optimal therapeutic dose appears to be in the 1500-2500 mg range for most clinical applications.