Natural Standard® Patient Monograph, Copyright © 2016 (www.naturalstandard.com). All Rights Reserved. Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
L-arginine was first isolated in 1886, reportedly from the extract of a lupine (Lupinus spp.) seedling. Lupinus is a genus in the legume (Fabaceae) plant family.
Arginine is an amino acid normally made by the body. Arginine is also found in many foods that have protein.
Arginine becomes nitric oxide (a blood vessel-widening agent called a vasodilator) in the body. Early evidence suggests that arginine may help treat medical conditions that improve with increased vasodilation. These conditions include chest pain, atherosclerosis (clogged arteries), heart disease, heart failure, erectile dysfunction, peripheral vascular disease, and headaches from blood vessel swelling).
Arginine also triggers the body to make protein and has been studied for healing wounds, bodybuilding, enhancing sperm production, and preventing tissue wasting in people with critical illnesses. However, caution is warranted. Arginine use was associated with death in some people with heart conditions. Caution is also needed when using arginine to treat pre-eclampsia (high blood pressure in pregnancy).
Arginine hydrochloride has been used to treat metabolic alkalosis. This use should be under the supervision of a qualified healthcare professional.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
Note: A suggested daily intake or tolerable upper intake for arginine is lacking. The therapeutic dosage (maximum dose considered to be safe) is 400-6,000 milligrams.
For altitude sickness, four grams in 200 milliliters of fruit punch three times daily has been taken by mouth while ascending to altitude (24 hours) and while at altitude (for 24 hours).
For asthma, a single dose of 50 milligrams of L-arginine per kilogram of body weight has been taken by mouth.
For breast cancer, 30 grams daily for three days has been taken by mouth.
For burns, 15 grams of L-arginine has been taken by mouth daily (duration unknown).
As a chemotherapy add-on, 30 grams has been taken by mouth daily for three days.
For chest pain, L-arginine (dose and duration unknown) has been taken by mouth.
For cognitive function, 1.6 grams of L-arginine has been taken by mouth daily for three months.
For coronary artery disease (CAD), up to nine grams of arginine has been taken by mouth daily in divided doses for three days to six months. 15 grams of L-arginine has been taken by mouth daily in addition to Cardiket™ (isosorbide dinitrate) for 10 days. A dose of 3.2 grams has been taken by mouth twice daily for six months. Three grams of L-arginine has been taken by mouth three times daily for the first three days, followed by nine grams on day four. People with Prinzmetal's angina pectoris took 9.26 grams by mouth daily for an unknown duration.
For diabetes (type 2), 3 grams of L-arginine has been taken by mouth three times daily. 3 grams of L-arginine in 10 milliliters of saline has been infused as a single dose. 30 grams has been given intravenously as a one-time dose and 0.1 grams per kilogram of body weight has also been intravenously given as a one-time dose.
For diabetic complications (peripheral neuropathy), 3 grams of L-arginine has been taken by mouth three times. A cream containing 4 milligrams of L-arginine per square centimeter has been applied to the feet in the morning and evening daily for two weeks.
For erectile dysfunction, 5 grams of L-arginine has been taken by mouth daily for six weeks.
For exercise performance, a single dose of 6 grams of L-arginine in a 500-milliliter beverage has been taken by mouth. Six grams of L-arginine in Gatorade® has been taken by mouth twice daily for 28 days, as have 6 grams of L-arginine daily with meals for 14 days and 14.2 grams of L-arginine daily for six months.
For heart disease, 3-12.6 grams of L-arginine has been taken by mouth daily for up to six weeks. 1-7 grams has been taken by mouth 2-3 times daily for up to six weeks for various disease states and risk factors related to heart disease. 5 milligrams per kilogram of body weight per minute has been infused intravenously for 20 minutes prior to exercise testing. An infusion of 60 grams of L-arginine over 20 minutes has also been used.
For heart failure, 5.6-12.6 grams of L-arginine has been taken by mouth daily for up to six weeks. Doses of 15 grams have been taken by mouth daily for five days. A dose of 2 grams of L-arginine has been taken by mouth three times daily for three months. 20 milligrams of L-arginine have been given intravenously as a one-time dose and 500 milligrams per kilogram of bodyweight has also been given intravenously as a one-time dose.
For high blood pressure (cardiac and pulmonary), 12 grams of L-arginine has been taken by mouth daily for four weeks. A single dose of two grams of L-arginine as an adjunct to 60 milligrams of isosorbide mononitrate has been taken by mouth. A dose of 0.5-1.5 grams of L-arginine per 10 kilograms of body weight has been taken by mouth for one week. Doses of 4-24 grams have been taken by mouth daily for 2-24 weeks. Two grams of L-arginine has been taken three times daily for six weeks.
For hyperlipidemia (high cholesterol), 7 grams of L-arginine has been taken by mouth three times daily for four weeks.
As an immunomodulator, L-arginine (dose unknown) has been taken by mouth for 60 days.
For infertility, up to 4 grams or 16 grams of L-arginine has been taken by mouth daily for unknown duration.
For interstitial cystitis, 1.5-2.4 grams of L-arginine has been taken by mouth daily for up to three months.
For intrauterine growth retardation, 3 grams has been taken by mouth daily for 20 days.
For MELAS syndrome, L-arginine (dose unknown) has been taken by mouth for up to two years. Intravenous L-arginine (dose and duration unknown) has been used.
For myocardial infarction (heart attack), 3 grams of L-arginine has been taken by mouth three times daily for up to six months. A dosage of 3 grams of L-arginine has been taken by mouth three times daily for 30 days.
For peripheral vascular disease and claudication, 24 grams of L-arginine has been taken by mouth daily for eight weeks, and 3.3 grams of L-arginine has been taken by mouth twice daily. Eight grams of L-arginine has been given intravenously twice daily for three weeks. Doses of 3-6 grams of L-arginine have been taken by mouth daily for one day to six weeks.
For pre-eclampsia (high blood pressure in pregnancy), 3 grams of L-arginine has been taken by mouth daily, in addition to standard therapy, for three weeks. Three grams of L-arginine has been taken by mouth every six hours, or intravenously (10 grams every eight hours) if the L-arginine taken by mouth was not tolerated, from diagnosis until day 10 postpartum. A dose of 4 grams of L-arginine has been taken by mouth daily for 10-12 weeks. A single intravenous infusion of L-arginine (20 grams per 500 milliliters) has been used. Five consecutive single daily infusions of L-arginine (20 grams per 500 milliliters), followed by 4 grams of arginine taken by mouth daily for two weeks, have been used. A dosage of L-arginine (20 grams per 500 milliliters) has been infused over two hours for four consecutive days.
For Raynaud's phenomenon, 8 grams of L-arginine has been taken by mouth daily for 28 days.
For respiratory infections, L-arginine (dose unknown) has been taken by mouth for 60 days.
For transplants, 0.1 gram of L-arginine per kilogram of body weight has been taken by mouth daily for six weeks, and 6 grams has been taken by mouth twice daily for six weeks. Also, 0.5 grams of L-arginine per kilogram has been given intravenously over 60 minutes, two hours prior to surgery.
For wound healing, 30 grams of arginine aspartate, containing 17 grams of arginine, has been taken by mouth in three divided doses for two weeks. A dose of 36.2 grams of L-arginine HCl has been taken by mouth daily for five days.
For anal fissures, a gel containing 400 milligrams of L-arginine per milliliter has been applied to the skin five times daily for at least 12 weeks.
For adrenoleukodystrophy (ALD), arginine butyrate (dose unknown) has been infused intravenously for over four months.
For autonomic failure, a single dose of 0.5 grams of L-arginine per kilogram of body weight has been given intravenously.
For circulation problems, a single dose of 30 grams of L-arginine has been intravenously given over 60 minutes.
For cyclosporine toxicity, graded doses of L-arginine (50, 100, or 150 milligrams per kilogram of body weight) have been delivered intravenously over three consecutive hours.
For growth hormone reserve test/pituitary disorder diagnosis, 30 grams of arginine hydrochloride has been injected.
For heart protection during coronary artery bypass grafting (CABG), a single venous infusion of 10% arginine hydrochloride (30 grams) over 15 minutes has been used. A dose of 7.5 grams of L-arginine in 500 milliliters of cardioplegic solution has been given intravenously.
For inborn errors of urea synthesis, doses of FDA-approved prescription parenteral arginine hydrochloride generally depend on specific institutional dosing guidelines.
For kidney protection during angiography, 330 milligrams of L-arginine per kilogram of body weight has been given intravenously over 20-30 minutes.
For malaria, 3, 6, and 12 grams of intravenous L-arginine have been infused over 30 minutes.
For the prevention of restenosis (recurrence of blood vessel narrowing) after coronary angioplasty (PTCA), 200 milligrams of L-arginine per kilogram of bodyweight were given by intravenous infusions over two hours prior to and during coronary surgery and 500 milligrams was given into the heart immediately before stent placement, followed by 6 grams of L-arginine by mouth daily for two weeks; however, there was a lack of benefit on scar tissue formation after coronary stenting. L-arginine has also been given through a dispatch catheter as 600 milligrams per six milliliters over 15 minutes after stent placement.
For sickle cell anemia, total daily doses of arginine butyrate of 500 milligrams per kilogram of bodyweight have been given intravenously for five days weekly for 12 weeks.
Children (younger than 18 years)
Arginine supplements are not suggested in children, because there is not enough scientific information available and because of potential side effects.
For birth outcomes, 1.5 millimoles of L-arginine per kilogram of bodyweight has been given by mouth daily with feeds and parenteral nutrition over the first 28 days in premature infants. In addition, daily doses of 1.5 millimoles per kilogram of bodyweight have been given to infants at risk for necrotizing enterocolitis (death of intestinal tissue).
For MELAS syndrome, 0.4 milligrams of L-arginine per kilogram of bodyweight have been used daily for an unknown duration in a 12 year-old child with MELAS syndrome. Intravenous administration of L-arginine (dose and duration unknown) followed by oral administration (dose and duration unknown) has also been used in a 15 year-old boy with MELAS syndrome.
For growth hormone reserve test and pituitary disorder diagnosis, injections of 0.5 grams of arginine hydrochloride per kilogram of bodyweight are commonly used.
For transplants, 0.1 grams of L-arginine per kilogram of bodyweight has been used daily for six weeks; however, improvement in kidney function was lacking.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Key to grades
- Strong scientific evidence for this use
- Good scientific evidence for this use
- Unclear scientific evidence for this use
- Fair scientific evidence against this use (it may not work)
- Strong scientific evidence against this use (it likely does not work)
|Evidence grade||Condition to which grade level applies|
Growth hormone reserve test / pituitary disorder diagnosis (arginine hydrochloride)Arginine is sometimes injected into a vein to measure growth hormone levels in people being tested for growth hormone deficiencies, such as panhypopituitarism, gigantism, acromegaly, or pituitary adenoma. The U.S. Food and Drug Administration (FDA) has approved this use.
Inborn errors of urea synthesisPeople with inborn errors of urea synthesis may have high ammonia levels in the blood and metabolic alkalosis. There is strong evidence supporting the use of arginine for this condition. Arginine should be avoided in people with high arginine levels in the blood. A qualified healthcare professional should supervise use.
Heart diseaseThere is good scientific evidence that dietary supplementation with L-arginine may help people with coronary artery disease, angina, or clogged arteries, due to its effects on blood vessels. Larger, longer-term studies are needed to confirm these initial positive effects.
Heart failureArginine has been studied in people with heart failure. Longer-term studies are required to confirm the clinical benefit of L-arginine supplementation in people with heart disease.
Peripheral vascular disease / claudicationPeripheral vascular disease, also known as intermittent claudication, is a narrowing of blood vessels in the legs and feet caused by fatty deposits. This condition causes decreased blood flow to the legs and feet, resulting in leg pain and tiredness. A small number of studies report that arginine therapy may improve walking distance in people with claudication. Further research is needed.
Adrenoleukodystrophy (ALD)Adrenoleukodystrophy (ALD) is a rare inherited metabolic disorder that involves damage to the nerves in the brain and the adrenal glands. This condition results in dementia and adrenal failure. Arginine injections may help manage this disorder; however, most study results are inconclusive. Further research is needed to evaluate the use of arginine in ALD.
Altitude sicknessLimited research has examined the effect of L-arginine on altitude sickness symptoms. Larger, well-designed trials are required before conclusions can be made.
Anal fissuresEarly research suggests that arginine helps heal chronic anal fissures, which are small tears that develop in the anus. Additional studies are needed.
AnxietyIn limited research, the combination of L-lysine and L-arginine reduced symptoms of anxiety. The effect of L-arginine alone is unknown. Additional research is needed in this area.
Autonomic failureArginine has been studied for treating autonomic failure, a condition that may include low blood pressure. Its effect is unclear. Well-designed studies are needed.
Birth outcomesThe effect of L-arginine on birth outcomes has been studied. Additional research is needed before conclusions can be made.
Blood flow enhancementIn limited research, L-arginine increased blood flow. Because of conflicting results from one study, additional research is needed.
Breast cancerThe therapeutic effect of arginine on breast cancer is unclear. Results from early human studies are mixed. High-quality studies are needed.
BurnsArginine may improve immune function and protein function in burns . Further research is needed before a conclusion can be drawn.
Cachexia (weight loss and muscle-wasting)A combination of beta-hydroxyl beta-methyl butyrate, glutamine, and arginine has been tested in people with cachexia associated with cancer, but conclusions could not be drawn. Further research is needed.
ChemotherapyEarly human studies suggest that arginine supplements may benefit people undergoing chemotherapy. Larger, high-quality studies are needed.
Chest painLimited human research reported that arginine taken by mouth improved chest pain in people with esophagus problems. Large, well-designed studies are needed.
Cognitive functionIn early research, L-arginine increased cognitive function in elderly people with cerebrovascular disease (problems with blood vessels in the brain). Better-designed studies are needed.
Critical illnessThe impact of L-arginine supplementation on critical illness is unclear. Further research is needed.
Cyclosporine toxicityResults of early studies of the effect of L-arginine on cyclosporine toxicity in renal transplant are mixed. Additional research is needed in this area.
Dental conditionsIn early research, arginine-containing toothpaste has reduced tooth sensitivity. An arginine-containing product was also effective in reducing dental caries. Additional research is needed to confirm these effects.
Diabetes (type 2)The effect of L-arginine on type 2 diabetes has been investigated. Large, well-designed studies are needed to understand the effect of arginine on type 2 diabetes.
Diabetic complicationsEarly research indicates that L-arginine may play a role in reducing complications associated with diabetes. However, further research is required before conclusions can be made.
Erectile dysfunctionEarly studies showed that arginine supplements helped treat erectile dysfunction (ED) in men with low nitrate or nitrite levels in their blood or urine. A combination of L-arginine, glutamate, and yohimbine hydrochloride was used to treat ED. However, because a combination product was used, and yohimbine hydrochloride is an FDA-approved therapy for this condition, the effects of arginine are unknown. More research is needed with arginine alone.
Exercise performanceDespite common use by athletes, the effect of arginine for exercise performance enhancement has not been studied extensively. Well-designed studies investigating arginine alone are needed before conclusions can be made.
Fetal developmentPreliminary research of pregnant mothers suggests that arginine supplements improve growth in smaller-than-average fetuses. Additional studies are needed.
Gastrointestinal cancer surgeryA combination of arginine, RNA, and omega-3 fatty acids may reduce the length of hospital stay and infections after surgery for gastrointestinal cancer. More research with arginine alone is needed.
Heart protection during coronary artery bypass grafting (CABG)An arginine-supplemented blood solution used during surgery may help protect the heart in people undergoing coronary artery bypass grafting. Further research is needed before a firm conclusion can be drawn.
High blood pressureEarly research reported that arginine taken by mouth reduced blood pressure in people with high blood pressure. Larger, high-quality studies are needed before a conclusion can be made.
High cholesterolSome research suggests that arginine may help treat high cholesterol. However, results are conflicting and more research is needed.
Immune functionL-arginine has immune effects in people undergoing surgery for colorectal cancer and in children with airway infections. In HIV, L-arginine in combination with omega-3 fatty acids and a nutritional supplement had no additional effects on immune response over a nutritional supplement alone. Additional well-designed research is needed.
InfertilityLimited research has investigated the effect of L-arginine on male and female infertility. Further research is required before conclusions can be made.
MELAS syndromeEarly studies found that supplementation with L-arginine significantly improved endothelial function in people with MELAS syndrome (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke). Further research is needed in this area.
Metabolic disordersLimited research suggests that L-arginine may decrease symptoms associated with creatine deficiency syndromes. Further research is required before conclusions can be drawn.
Polycystic ovarian syndromeIn early research, treatment with N-acetyl cysteine (NAC) and L-arginine restored some function in people with polycystic ovary syndrome. Further research is required before conclusions can be drawn.
Pre-eclampsia (high blood pressure in pregnancy)Effects of L-arginine in women with pre-eclampsia are mixed. Longer-term treatment appeared to be more effective than short-term treatment. Further research is needed before a conclusion can be made.
Pressure ulcersStudies of arginine for pressure ulcers show mixed results. Further research is needed before a conclusion can be drawn.
Prevention of restenosis after coronary angioplasty (PTCA)Injection of L-arginine into surgically placed stents was investigated with mixed results. Early research suggested that L-arginine may or may not prevent restenosis (narrowing) in the arteries. Further well-designed studies are required.
Raynaud's phenomenonEarly research in humans investigated the effect of arginine on blood vessel activity in Raynaud's phenomenon, a condition causing the blood vessels in the fingers, toes, nose, and ears to narrow in response to cold temperatures or stress. However, the effects of arginine are unclear. Large, well-designed trials are needed.
Recovery after surgeryIn early research, arginine combined with other supplements helped recovery after surgery. However, the role of arginine alone is unclear. More research is needed in this area.
Respiratory infectionsEarly research suggests that arginine supplements may decrease the risk of respiratory (lung) infections. Large, well-controlled studies are needed to clarify this relationship.
SclerodermaIn early research, L-arginine may be useful for pregnant women with scleroderma (buildup of scar tissue in the skin). Further research is needed in this area.
Sickle cell anemiaClinical studies investigating the effects of L-arginine on sickle cell anemia are limited. Early research suggests the potential for immune benefits. Further research is needed in this field.
TransplantsIn human research, L-arginine improved kidney function in people with a kidney transplant, and improved quality of life and exercise tolerance in people with heart transplants. Additional clinical research is needed.
Uterine disordersIn early research, L-arginine improved endometrial thickness in people with a thin endometrium (the lining of the uterus). Further studies are required before conclusions can be drawn.
AsthmaEarly research has suggested a lack of benefit in the use of arginine for asthma.
Interstitial cystitisArginine has been proposed as a treatment for interstitial cystitis (inflammation of the bladder). However, most studies found a lack of effect.
Kidney disease or failureOverall evidence from early research fails to support the use of L-arginine for kidney disease or failure. Until the evidence is more consistent, conclusions cannot be made.
Kidney protection during angiographyThe contrast media, or dye, used during angiography to map arteries may be poisonous (toxic) to the kidneys, especially in people with kidney disease. Early researcher has found a lack of evidence that injections of L-arginine protected the kidney from damage due to contrast agents.
Wound healingIn human research, arginine appeared to lack benefit in wound healing. Further research is required before conclusions can be made.
Myocardial infarction (heart attack)Until potential safety issues are addressed, L-arginine should be avoided in people having a heart attack.
Uses based on tradition or theory
Aging, AIDS/HIV, ammonia toxicity, amyotrophic lateral sclerosis (ALS), antibacterial, anti-inflammatory, antioxidant, anti-platelet agent, beta-hemoglobinopathies (blood disorder), cancer, cirrhosis, cold prevention, cystic fibrosis, depression, epilepsy, eye disorders, food uses, glaucoma, growth, gut disorders, heavy metal/lead toxicity, hemolytic uremic syndrome (blood disorder), hepatic encephalopathy (confused thinking due to liver disorders), hyperhomocysteinemia (high homocysteine in the blood), increased muscle mass, inflammatory bowel disease (IBD), liver disease, liver protection, lower esophageal sphincter relaxation, malaria, metabolic acidosis, migraine, mitochondrial disorders, neurological problems, obesity/weight loss, osteoporosis / osteopenia, pain, parasites, peritonitis (inflammation of the stomach lining), Peyronie's disease (abnormal curvature and scar tissue in the penis), pre-term labor contractions, pruritus (itching), rabies, sexual function in women, stomach motility disorders, stomach ulcers, stress, stroke, supplementation to a low protein diet, thrombotic thrombocytopenic purpura (blood disorder), trauma, ulcerative colitis, vaccine adjunct, vascular disorders.
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Interactions with Drugs
Arginine may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.
Arginine may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Arginine may change blood sugar levels. Caution is advised when using medications that may affect blood sugar levels. People taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Arginine may also interact with ACE (angiotensin-converting enzyme) inhibitors, agents for pain or for the heart, agents that affect the nervous system, agents that increase potassium levels (including angiotensin II receptor antagonists and heparin), agents that decrease the immune system, agents used to treat blood disorders, aminophylline, antacids, antibiotics, anticancer agents, anti-inflammatories, antimalarials, antiobesity agents, antiseizure agents, aspirin, cardiac glycosides, cholesterol-lowering agents, contraceptives (birth control), cyclophosphamide, cyclosporine, diuretics, estrogens, glucagon, growth hormones, H2 blockers, insulin, iron salts, isoproterenol, nicotine, nitrates, nitroderivatives, phenylephrine, phosphodiesterase inhibitors, potassium salts, progestin, propofol, proton pump inhibitors, sertraline, spironolactone, and stomach and intestinal agents.
Interactions with Herbs and Dietary Supplements
Arginine may lower blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.
Arginine may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Arginine may change blood sugar levels. Caution is advised when using herbs or supplements that may also change blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Arginine may also interact with antacids; antibacterials; anticancer herbs and supplements; anti-inflammatories; antimalarials; antioxidants; athletic performance enhancers; branched chain amino acids; cardiac glycosides; cholesterol-lowering herbs and supplements; citrulline; conjugated linoleic acid (CLA); creatine; diuretics; gingko; green tea extract; herbs and supplements for the heart, obesity, pain, or seizures; herbs and supplements that affect the nervous system or reduce immune function; hormonal herbs and supplements; iron; lysine; magnesium; N-acetyl cysteine; omega-3 fatty acids; ornithine; phytoestrogens; pine bark extract; piplartine; Pycnogenol®; sodium; stomach and intestinal herbs and supplements; vitamin C; vitamin E; wound healing herbs and supplements; xylitol; and yohimbine.
This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
2-Amino-5-guanidinopentanoic acid, agmatine, Arg, arginine, arginine hydrochloride (intravenous formulation), Ark 1, decarboxylated arginine, dipeptide arginyl aspartate, HeartBars, L-arg, L-arginine, L-arginine aspartate, NG-monomethyl-L-arginine, Sargenor, Spedifen®.
Dietary sources of arginine: Almonds, barley, Brazil nuts, brown rice, buckwheat, cashews, cereals, chicken, chocolate, coconut, corn, dairy products, filberts, gelatin, meats, oats, peanuts, pecans, raisins, sesame seeds, sunflower seeds, walnuts.
Note: Arginine analogs (N(omega)-nitro-L-arginine methyl ester, N(G)-nitro-L-arginine methyl ester, N-monomethyl-L-arginine, dimethylarginine), and ibuprofen arginate are not specifically discussed in this monograph.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid with known allergy or sensitivity to arginine. Symptoms may include rash, itching, or shortness of breath. Anaphylaxis (severe allergic reaction) has occurred after arginine injections. In clinical research, one patient experienced a mild allergic skin reaction to intravenous L-arginine. Hives have also been reported.
Side Effects and Warnings
Note: According to the U.S. Food and Drug Administration (FDA) website, pediatric overdose of arginine hydrochloride injection (R-Gene 10®) has been reported, due to packaging and labeling confusion. Revisions have since been made to the product's packaging. The new label warns that R-Gene 10® infusions should be used cautiously in children to prevent overdose, which may result in hyperchloremic metabolic acidosis, cerebral edema, or possibly death.
Arginine is likely safe when taken in levels normally found in foods.
Arginine may increase the risk of bleeding. Caution is advised in people with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Arginine may change blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Arginine may cause hyperkalemia (abnormally high levels of blood potassium). Use cautiously in people with impaired kidney function or those at risk for hyperkalemia, including those with diabetes or using drugs that elevate potassium levels, such as potassium-sparing diuretics and potassium supplements. Fatal cardiac arrhythmias from hyperkalemia occurred in one person.
Use cautiously in children and in pregnant women, due to insufficient available evidence and safety data.
Use caution with phosphodiesterase inhibitors (e.g., sildenafil [Viagra®]).
Use with caution in postmenopausal women or people with the herpes virus, peripheral arterial disease and intermittent claudication, immune disorders, acrocyanosis (blue coloring of hands and feet), sickle cell anemia, hyperchloremic acidosis (acid-base imbalance in the body), gastrointestinal problems, muscle or joint problems, urinary disorders, asthma, cycstic fibrosis, methyltransferase (GAMT) deficiency (a genetic disorder), or at risk for headaches.
Avoid with known allergy or sensitivity to arginine.
Avoid in doses over 30 grams due to increased risk of toxic effects.
Avoid in women with high-risk pregnancies, as, in women with multiple diseases, intravenous arginine resulted in premature delivery, pre-eclampsia, and death in two cases.
Arginine may cause low blood pressure. Avoid use in those with low blood pressure or those using blood pressure-lowering agents.
Avoid with nitrates and spironolactone as well as in people with pulmonary hypertension, cancer, and those at risk for or with a history of heart attack.
Arginine may also cause bloating; diarrhea; hematuria (blood in urine), hives; hormonal changes; increased blood urea nitrogen, serum creatine, and serum creatinine; increased inflammatory response (in people with asthma or cystic fibrosis); leg restlessness, lower back pain; nausea, night sweats and flushing (with arginine withdrawal), numbness (with arginine injection); rash; reduction in hematocrit; severe tissue damage (with arginine injection); stomach and intestine discomfort; systemic acidosis; or venous irritation.
In people with heart disease or heart transplants, arginine may cause high white blood cell counts, increased post-heart attack deaths, lack of energy and strength, vertigo, or increased blood pressure.
Pregnancy and Breastfeeding
Use cautiously in pregnant or breastfeeding women, due to a lack of sufficient available safety and efficacy data.
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This evidence-based monograph was prepared by The Natural Standard Research Collaboration