Glutathione (GSH) is a tripeptide thiol (γ-L-glutamyl-L-cysteinylglycine) that serves as the body's primary endogenous antioxidant and detoxifying agent. In the Indian pharmaceutical context, it is widely used as an oral supplement and in injectable forms for its skin-lightening, hepatoprotective, and antioxidant properties. Its clinical use is supported by its role in neutralizing reactive oxygen species (ROS), conjugating xenobiotics, and regenerating vitamins C and E.
Adult: Oral: 50mg to 300mg per day, typically 50mg-100mg twice daily. For skin lightening, doses of 500mg/day are common but often use higher-strength formulations. IV: 600mg to 1.2g once or twice weekly, administered slowly.
Note: Oral: Take on an empty stomach (30-60 mins before food) for better absorption, with water. IV: Must be administered by healthcare professional. Dilute in appropriate IV fluid (e.g., Normal Saline). Infuse slowly over 15-30 minutes to avoid adverse effects like dyspnea or abdominal cramps.
Glutathione exerts its effects through three primary mechanisms: 1) Direct chemical scavenging of free radicals and reactive oxygen species (ROS). 2) Serving as an essential cofactor for antioxidant enzymes like Glutathione Peroxidase (which reduces hydrogen peroxide and lipid peroxides to water and alcohols) and Glutathione S-Transferase (which conjugates electrophilic toxins, drugs, and carcinogens, making them water-soluble for excretion). 3) Regeneration of exogenous antioxidants like Vitamins C and E back to their active reduced states.
Pregnancy: Category N (Not classified by US FDA). Animal studies inadequate. Use only if potential benefit justifies potential risk to the fetus. Not recommended for cosmetic purposes.
Driving: Unlikely to affect ability. However, if dizziness occurs, avoid driving or operating machinery.
| Acetaminophen (Paracetamol) | Glutathione may help prevent NAPQI-induced hepatotoxicity from overdose. No negative interaction at therapeutic doses. | Moderate |
| Chemotherapy drugs (Cisplatin, Cyclophosphamide, Doxorubicin) | May reduce chemotherapy-associated toxicity (nephro, neuro, cardiotoxicity). Evidence is mixed; consult oncologist as it may theoretically interfere with efficacy. | Major |
| Immunosuppressants (Cyclosporine, Tacrolimus) | Theoretical risk of reducing immunosuppressive effect due to antioxidant activity; monitor transplant rejection. | Moderate |
| Antipsychotics (e.g., Haloperidol) | May reduce oxidative side effects like tardive dyskinesia. | Minor |