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AMMONAPS 940 mg/g GRANULES

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About the medicine

How to use AMMONAPS 940 mg/g GRANULES

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

AMMONAPS 940 mg/g Granules

Sodium Phenylbutyrate

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack and other information:

  1. What is AMMONAPS and what is it used for
  2. What you need to know before you take AMMONAPS
  3. How to take AMMONAPS
  4. Possible side effects
  5. Storage of AMMONAPS
  6. Contents of the pack and further information

1. What is AMMONAPS and what is it used for

AMMONAPS is prescribed to patients with urea cycle disorders. Patients with these rare disorders lack certain liver enzymes. Since nitrogen is a constituent of proteins, it accumulates in the body after protein consumption. Excess nitrogen, in the form of ammonia, is particularly toxic to the brain and, in severe cases, can cause a reduction in the level of consciousness and coma.

AMMONAPS helps the body eliminate excess nitrogen and reduces the amount of ammonia in the body.

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2. What you need to know before you take AMMONAPS

Do not take AMMONAPS:

  • If you are pregnant.
  • If you are breast-feeding.
  • If you are allergic (hypersensitive) to sodium phenylbutyrate or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Consult your doctor or pharmacist before taking AMMONAPS

  • If you have heart failure, reduced kidney function or other conditions where the sodium content of this medicine may worsen your condition.
  • If you have reduced liver or kidney function, as AMMONAPS is eliminated from the body through the kidneys and liver.

AMMONAPS should be combined with a low-protein diet that your doctor or dietitian has specifically designed for you. You should follow this diet carefully.

AMMONAPS does not completely prevent excess ammonia in the blood and is not suitable for treating this condition, which is a medical emergency.

If you are to have tests, it is important that you remind your doctor that you are taking AMMONAPS, as sodium phenylbutyrate may alter the results of some tests.

Taking AMMONAPS with other medicines

Tell your doctor or pharmacist if you are using, have recently used or might use any other medicines.

It is especially important that you tell your doctor if you are taking medicines that contain:

  • valproic acid (an antiepileptic medicine)
  • haloperidol (used to treat some psychotic disorders)
  • corticosteroids (medicines similar to cortisone used to relieve inflamed areas of the body)
  • probenecid (for the treatment of hyperuricemia associated with gout)

These medicines may change the effect of AMMONAPS, and you may need to have blood tests more frequently. If you are not sure if your medicines contain these substances, consult your doctor or pharmacist.

Pregnancy and breast-feeding

Do not take AMMONAPS if you are pregnant, as this medicine may harm the fetus. If you could become pregnant, you must use an effective contraceptive method during treatment with AMMONAPS.

Do not use AMMONAPS if you are breast-feeding, as this medicine may pass into breast milk and harm your baby.

Driving and using machines

No studies on the ability to drive and use machines have been performed.

AMMONAPS contains sodium

A small white spoonful of AMMONAPS granules contains 149 mg of sodium.

A medium yellow spoonful of AMMONAPS granules contains 408 mg of sodium.

A large blue spoonful of AMMONAPS granules contains 1,200 mg of sodium.

Consult your doctor or pharmacist if you need 2 or more small white spoonfuls or 1 or more medium yellow spoonfuls or large blue spoonfuls daily for a prolonged period, especially if you have been advised to follow a low-salt (sodium) diet.

3. How to take AMMONAPS

Follow the instructions for administration of this medicine exactly as prescribed by your doctor.

In case of doubt, consult your doctor or pharmacist again.

Dosage

The daily dose of AMMONAPS will be calculated according to your tolerance to proteins, diet, and body weight or body surface area. You will need to have regular blood tests to adjust the correct daily dose. Your doctor will tell you how many tablets to take.

Method of administration

AMMONAPS should be taken in equal doses by mouth, through gastrostomy (a tube that goes from the abdomen to the stomach) or through a nasogastric tube (a tube that goes from the nose to the stomach).

AMMONAPS should be taken while following a special low-protein diet.

AMMONAPS should be taken with each meal or feeding. In small children, this may be 4 to 6 times a day.

To measure the dose:

  • Shake the bottle slightly before opening it.
  • Use the correct spoon depending on the amount of AMMONAPS you need: 1.2 g = small white spoon, 3.3 g = medium yellow spoon, and 9.7 g = large blue spoon.
  • Take a heaped spoonful of granules from the bottle.
  • Pass a flat surface, e.g. the back of a knife blade, over the spoon to remove excess granules.
  • The granules remaining in the spoon correspond to the measure of one spoonful.
  • Remove the correct number of spoonfuls of granules from the bottle.

If administration is by mouth:

Mix the measured dose with solid foods (such as mashed potato or apple sauce) or with liquids (such as water, apple juice, orange juice, or protein-free infant formula) and swallow immediately after mixing.

Patients with gastrostomy or nasogastric tube:

Mix the granules with water until no dry granules remain (stirring the solution helps to dissolve the granules). When the granules are dissolved in water, you will get a white, milky liquid. Take the solution immediately after mixing.

You will need to follow the diet and treatment for life unless you have a successful liver transplant.

If you take more AMMONAPS than you should

Patients who have taken very high doses of AMMONAPS have experienced:

  • drowsiness, fatigue, dizziness, and, less frequently, confusion.
  • headache.
  • changes in taste (taste disorders).
  • reduced hearing.
  • disorientation.
  • memory problems.
  • worsening of existing neurological conditions.

If you experience any of these symptoms, you should contact your doctor or the emergency department of the nearest hospital immediately for symptomatic treatment.

If you forget to take AMMONAPS

You should take a dose as soon as possible with the next meal. Make sure that at least 3 hours pass between two doses. Do not take a double dose to make up for forgotten doses.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Medicine questions

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4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

The following frequencies are used to describe the occurrence of side effects:

Very common:

Affect more than 1 in 10 people.

Common:

Affect between 1 and 10 in 100 people.

Uncommon:

Affect between 1 and 10 in 1,000 people.

Rare:

Affect between 1 and 10 in 10,000 people.

Very rare:

Affect less than 1 in 10,000 people.

Not known:

Frequency cannot be estimated from the available data.

Very common side effects: irregular menstrual periods and cessation of menstruation.

It is possible that the absence of menstruation in sexually active women is not caused by the use of AMMONAPS. If this occurs, consult your doctor, as you may be pregnant (see "Pregnancy and breast-feeding" in the previous section).

Common side effects: changes in blood cell counts (red blood cells, white blood cells, and platelets), reduced appetite, depression, irritability, headache, fainting, fluid retention (swelling), changes in taste (taste disorders), abdominal pain, vomiting, nausea, constipation, body odor, rash, abnormal kidney function, weight gain, alteration of test results.

Uncommon side effects: low red blood cell count (anemia) due to bone marrow depression, bruising, altered heart rhythm, rectal bleeding, stomach irritation, gastroduodenal ulcer, pancreatitis.

If you experience persistent vomiting, you should consult your doctor immediately.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of AMMONAPS

Keep this medicine out of the sight and reach of children.

Do not use AMMONAPS after the expiry date which is stated on the packaging and the label on the bottle after "EXP". The expiry date is the last day of the month stated.

Do not store above 25°C.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.

6. Contents of the pack and further information

Composition of AMMONAPS

  • The active substance is sodium phenylbutyrate.

One gram of AMMONAPS granules contains 940 mg of sodium phenylbutyrate.

  • The other ingredients are magnesium stearate and anhydrous colloidal silica.

Appearance and packaging of the product

AMMONAPS granules are white.

The granules are packaged in plastic bottles with child-resistant caps. Each bottle contains 266 or 532 g of granules. Three spoons (one small white spoon, one medium yellow spoon, and one large blue spoon) are included to measure the daily dose.

Marketing authorisation holder

Immedica Pharma AB

SE-113 29 Stockholm

Sweden

Manufacturer

PATHEON France – BOURGOIN JALLIEU

40 boulevard de Champaret

BOURGOIN JALLIEU

38300

France

Date of last revision of this leaflet:

Detailed information on this medicine is available on the European Medicines Agency website http://www.ema.europa.eu.

Online doctors for AMMONAPS 940 mg/g GRANULES

Discuss questions about AMMONAPS 940 mg/g GRANULES, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques. For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance. Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults. In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions. Patients commonly seek his care for: 

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

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Joao Silva

General medicine 6 years exp.

Dr. João Silva is a physician with training and experience in the field of General and Family Medicine, dedicated to providing healthcare focused on the well-being and quality of life of his patients. Throughout his professional career, he has developed broad clinical competencies, striving to maintain a medical practice based on scientific evidence and continuous knowledge updates.

Between 2013 and 2019, he completed the Integrated Master's Degree in Medicine at the Abel Salazar Institute of Biomedical Sciences in Porto, where he acquired a solid academic and clinical education.

Subsequently, between January 2021 and December 2021, he completed the General Internship at the Entre Douro e Vouga Hospital Center in Santa Maria da Feira, where he had the opportunity to work in different hospital settings and deepen his competencies in several areas of medicine.

From January 2022 until March 2026, he works as a Resident Physician in General and Family Medicine at USF Salvador Machado in Oliveira de Azeméis, developing clinical activities in primary healthcare, follow-up of chronic patients, and health promotion in the community.

Complementing his medical training, Dr. João Silva also completed a Postgraduate Degree in Continuing and Palliative Care at CESPU, strengthening his preparation in the comprehensive approach to patient care, especially in situations requiring prolonged care and multidisciplinary support.

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Frequently Asked Questions

Is a prescription required for AMMONAPS 940 mg/g GRANULES?

AMMONAPS 940 mg/g GRANULES requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.

What is the active substance in AMMONAPS 940 mg/g GRANULES?

The active ingredient in AMMONAPS 940 mg/g GRANULES is sodium phenylbutyrate. This information helps identify medicines with the same composition but different brand names.

Who manufactures AMMONAPS 940 mg/g GRANULES?

AMMONAPS 940 mg/g GRANULES is manufactured by Immedica Pharma Ab. Pharmacy brands and packaging may differ depending on the distributor.

Which doctors can assess the use of AMMONAPS 940 mg/g GRANULES online?

Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether AMMONAPS 940 mg/g GRANULES is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.

How to buy AMMONAPS 940 mg/g GRANULES in Spain?

Spain has a well-developed healthcare infrastructure across major cities such as Madrid, Barcelona, Valencia, and Seville. Pharmacies are widely available and operate under strict regulations, ensuring access to prescribed medications.

You can buy AMMONAPS 940 mg/g GRANULES in Madrid, Barcelona, Seville, or Valencia at any local pharmacy with a valid prescription.

To obtain a prescription, you can use Oladoctor:

What are the alternatives to AMMONAPS 940 mg/g GRANULES?

Other medicines with the same active substance (sodium phenylbutyrate) include AMMONAPS 500 mg TABLETS, PHEBURANE 350 MG/ML ORAL SOLUTION, PHEBURANE 483 mg/g GRANULES. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.

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