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Drug Safety-related Labeling Changes (SrLC)

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OLPRUVA (NDA-214860)

(SODIUM PHENYLBUTYRATE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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10/10/2025 (SUPPL-7)

Approved Drug Label (PDF)

6 Adverse Reactions

Additions and/or revisions underlined:

Clinical Adverse Reactions with Use of Phenylacetate

Nervous system disorders: Neurotoxicity was reported in cancer patients receiving intravenous phenylacetate, the major metabolite of OLPRUVA (OLPRUVA is not approved for intravenous use or for treatment of patients with cancer). Signs and symptoms were predominately somnolence, fatigue, and dizziness (lightheadedness); other signs and symptoms included headache, dysgeusia, hypoacusis, disorientation, memory impairment, and exacerbation of a pre-existing neuropathy.

8 Use in Specific Populations

8.1 Pregnancy

Additions and/or revisions underlined:

Risk Summary

Available data with sodium phenylbutyrate use in pregnant women are insufficient to identify a drug associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. Animal reproduction studies have not been conducted with sodium phenylbutyrate. Based on published animal data, phenylacetate, the major metabolite of OLPRUVA, may be neurotoxic to the developing brain (see Data).

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8.4 Pediatric Use

Additions and/or revisions underlined:

The safety and effectiveness of OLPRUVA have been established as adjunctive therapy to the standard of care, which includes dietary management, in the chronic management of pediatric patients 1 year of age and older who weigh 7 kg or greater with urea cycle disorders (UCDs) involving deficiencies of carbamylphosphate synthetase (CPS), ornithine transcarbamylase (OTC), or argininosuccinic acid synthetase (AS).

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The safety and effectiveness of OLPRUVA have not been established in pediatric patients less than 1 year of age or who weigh less than 7 kg. OLPRUVA is not recommended in patients younger than 1 year of age because the total daily volume of free water necessary for administration has the potential to cause hyponatremia which may result in serious complications such as lethargy or seizures [see Dosage and Administration (2.5)].

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

PATIENT INFORMATION

Additions and/or revisions underlined:

What is OLPRUVA?

  • OLPRUVA is a prescription medicine used along with other therapy, including a specific diet, for the long-term management of adults and children 1 year of age and older weighing 15.5 pounds (7 kg) or more, with urea cycle disorders (UCDs), involving deficiencies of carbamylphosphate synthetase (CPS), ornithine transcarbamylase (OTC) or argininosuccinic acid synthetase (AS).

  • Episodes of sudden, rapid increase of ammonia in the blood (acute hyperammonemia) may happen in people during treatment with OLPRUVA. OLPRUVA is not for the treatment of acute hyperammonemia, which can be life-threatening and requires emergency medical treatment.

  • OLPRUVA is not recommended in children under 1 year of age.

  • It is not known if OLPRUVA is safe and effective for use in children under 1 year of age or weighing less than 15.5 pounds (7 kg).

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How should I or my child take OLPRUVA?

Read the detailed Instructions for Use that comes with OLPRUVA for information about the right way to prepare and take or give a dose of OLPRUVA.

  • Take OLPRUVA exactly as prescribed by your healthcare provider.

  • Your healthcare provider may change your dose if needed. Do not change your dose unless your healthcare provider tells you to.

  • Your healthcare provider will prescribe OLPRUVA based on your or your child’s weight.

  • OLPRUVA is for use in children 1 year of age and older who weigh 15.5 pounds (7 kg) or more.

  • Take or give OLPRUVA doses by mouth or through a gastrostomy tube with food each day.

  • Do not take or give OLPRUVA through a nasogastric tube.

  • If you miss a dose of OLPRUVA, take or give it as soon as possible on the same day.

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