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nulibry

Nulibry (Fosdenopterin Hydrobromide) is a cyclic pyranopterin monophosphate used to treat Inborn Errors Metal Metabolism.

Fosdenopterin Hydrobromide · by Sentynl Theraps Inc

Not yet rated· sourced from the FDA label
Rated against independent regulatory sources·Last updated June 7, 2026·How we rate
Verified againstopenFDANIH DailyMedRxClass

Key facts

Form
Injectable
Strength
Fosdenopterin Hydrobromide EQ 9.5MG BASE/VIAL
Type
Prescription (Rx)
Brand or generic
Brand-name
FDA application
NDA214018

What is Nulibry?

From the FDA label:NULIBRY (fosdenopterin) for injection is cyclic pyranopterin monophosphate (cPMP). Fosdenopterin is present as a dihydrate of the hydrobromide salt with the chemical name (4a R ,5a R ,11a R ,12a S )-8-amino-4a,5a,6,9,11,11a,12,12a-octahydro-2,12,12-trihydroxy-1,3,2-dioxaphosphorino[4',5':5,6]pyrano[3,2- g ]pteridin-10(4 H )-one 2-oxide. Fosdenopterin hydrobromide as a dihydrate is a crystalline solid. The molecular formula is C 10 H 14 N 5 O 8 P • HBr • 2H 2 O and the molecular weight is 480.16. The chemical structure is: NULIBRY is supplied as a sterile, preservative-free, white to pale yellow lyophilized powder or cake in a single-dose, clear glass vial for reconstitution for intravenous infusion. Each vial contains 9.5 mg fosdenopterin (equivalent to 12.5 mg fosdenopterin hydrobromide as a dihydrate). Each vial also contains the following inactive ingredients: 10 mg ascorbic acid USP, 187.5 mg mannitol USP, and 62.5 mg sucrose NF. Sodium hydroxide NF and hydrochloric acid NF are used to adjust pH to 5.0-7.0. chemical structure

How to use

Start NULIBRY if known or presumed MoCD Type A. Promptly discontinue if MoCD Type A is not confirmed by genetic testing. ( 2.1 ) NULIBRY is intended for administration by a healthcare provider. If deemed appropriate by a healthcare provider, NULIBRY may be administered at home by the patient's caregiver. ( 2.2 ) See the table below for the recommended dosage in patients less than one year of age. Administer NULIBRY by intravenous infusion once daily. For dose volumes less than 2 mL, consider administering by slow intravenous push. ( 2.3 ) Titration Duration Preterm Neonates (Gestational Age Less than 37 Weeks) Term Neonates (Gestational Age 37 weeks and Above) Initial Dosage 0.4 mg/kg once daily 0.55 mg/kg once daily Dosage at Month 1 and Month 2 0.7 mg/kg once daily 0.75 mg/kg once daily Dosage at Month 3 to Month 12 0.9 mg/kg once daily 0.9 mg/kg once daily Recommended Dosage in Patients One Year of Age or Older: 0.9 mg/kg given as an intravenous infusion once daily. ( 2.3 ) 2.1 Patient Selection Start NULIBRY if the patient has a diagnosis or presumptive diagnosis of MoCD Type A. In patients with a presumptive diagnosis of MoCD Type A, confirm the diagnosis of MoCD Type A immediately after initiation of NULIBRY treatment. In such patients, discontinue NULIBRY if the MoCD Type A diagnosis is not confirmed by genetic testing. 2.2 Important Recommendation Prior to NULIBRY…

Side effects

The most common adverse reactions (>25%) were catheter-related complications, pyrexia, viral infection, pneumonia, otitis media, vomiting, cough/sneezing, viral upper respiratory infection, gastroenteritis, bacteremia, and diarrhea. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Sentynl Therapeutcis, Inc. at 888-507-5206 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Overview of Safety Evaluation The safety of NULIBRY was assessed in 37 pediatric patients and healthy adults who received at least one intravenous infusion of NULIBRY or an E. coli derived non-salt, anhydrous form of cPMP (recombinant cPMP or rcPMP, which has the same active moiety and therefore the same biologic activity as NULIBRY). Of these 37 patients/healthy adults, 13 were pediatric patients with MoCD Type A in Studies 1, 2, and 3 [ see Clinical Studies ( 14 )] , 6 were pediatric patients with presumptive MoCD Type A but who were later confirmed to not have MoCD Type A, and 18 were healthy adults (without MoCD Type A) in a Phase 1 study. Adverse Reactions Assessment of adverse reactions for NULIBRY is based…

Warnings

Important safety information

Potential for Photosensitivity : Advise patients/caregivers to avoid patient exposure to sunlight, and to have the patient wear sunscreen, protective clothing, and sunglasses when exposed to the sun. If photosensitivity occurs, advise caregivers/patients to seek medical attention immediately and consider a dermatological evaluation. ( 5.1 , 13.2 ) 5.1 Potential for Photosensitivity Animal studies have identified that NULIBRY has phototoxic potential [ see Nonclinical Toxicology ( 13.2 ) ]. Advise NULIBRY-treated patients or their caregivers to avoid or minimize patient exposure to direct sunlight and artificial UV light exposure (i.e., UVA or UVB phototherapy) and adopt precautionary measures (e.g., have the patient wear protective clothing and hats, use broad spectrum sunscreen with high sun protection factor (SPF) in patients 6 months of age and older, and wear sunglasses when exposed to the sun). If photosensitivity occurs, advise caregivers/patients to seek medical attention immediately and consider a dermatological evaluation.

Who should not take Nulibry

None. None. ( 4 )

Drug class

May treat (source: NIH RxClass)

Dosage forms

Injectable

The forms currently marketed in the U.S., per the FDA National Drug Code Directory.

Ways to save

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Frequently asked questions

What does Nulibry treat?
Nulibry (Fosdenopterin Hydrobromide) may be used to treat inborn errors metal metabolism, based on NIH RxClass drug-classification data (conditions a drug may treat — not a verbatim copy of the FDA-approved label). This is general reference, not medical advice.
Is there a coupon or discount for Nulibry?
pharmaranks is an independent ratings site, not a pharmacy — we don't issue coupons or sell Nulibry. To pay less, ask your prescriber or pharmacist whether a generic equivalent exists, check the manufacturer's copay/savings card and patient-assistance program, and compare a pharmacy discount card against your insurance copay. Prices vary by pharmacy, insurance, and location, so always confirm at the counter. This is general reference, not medical or financial advice.
Who makes Nulibry?
Nulibry is marketed by Sentynl Theraps Inc. You can see Sentynl Theraps Inc's full profile, rating, and other products on pharmaranks.
Is Nulibry a brand-name or generic drug?
Nulibry is a brand-name product with the active ingredient Fosdenopterin Hydrobromide.
Is Nulibry available over the counter?
No. Nulibry is a prescription (Rx) medication in the US — you need a prescription from a licensed clinician (in person or via telehealth); it isn't sold over the counter. For some conditions there are OTC alternatives — ask your pharmacist.
What forms does Nulibry come in?
Nulibry is currently marketed as injectable, per the FDA's National Drug Code Directory.
What class of drug is Nulibry?
Nulibry is classified as cyclic pyranopterin monophosphate, per the FDA's Established Pharmacologic Class.
Is Nulibry FDA-registered?
Nulibry is on record with the U.S. FDA under application number NDA214018. You can verify this on its official FDA label.
Is Nulibry safe?
There's no single safe-or-not verdict, and we don't yet have a composite recall-safety score for Nulibry. Review its FDA-label side effects and warnings below, and always consult a licensed professional.
What are the side effects of Nulibry?
Nulibry's side effects are taken directly from its FDA label. From the label: The most common adverse reactions (>25%) were catheter-related complications, pyrexia, viral infection, pneumonia, otitis media, vomiting, cough/sneezing, viral upper respiratory infection, gastroenteritis, bacteremia, and diarrhea. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS,… Both common and serious reactions are documented in full on this page. This is general reference from the FDA, not medical advice — always consult a professional.

Clinical content sourced from the FDA label via openFDA (U.S. FDA). View the FDA label on DailyMed → Provided for general reference only — not medical advice. Always consult a licensed professional and the current prescribing information.

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