arginine (generic name)
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Interactions with Drugs
Because arginine can increase the activity of some hormones in the body, many possible drug interactions may occur. The prescription drugs aminophylline and the sweetening agent xylitol may decrease the effect that arginine has on glucagon.
Estrogens (found in birth control pills and hormone replacement therapies) may increase the effects of arginine on growth hormone, glucagon, and insulin. In contrast, progestins (also found in birth control pills and some hormone replacement therapies) may decrease the responsiveness of growth hormone to arginine.
When used with arginine, some diuretics, such as spironolactone (Aldactone®), or ACE-inhibitor blood pressure drugs, such as enalapril (Vasotec®), may cause potassium levels in the blood to get too high. Monitoring of blood potassium levels may be required.
Arginine should be used carefully with drugs, such as nitroglycerin or sildenafil (Viagra®), because blood pressure may fall too low. Other side effects, such as headache and flushing, may occur when arginine is used with these drugs.
In theory, arginine may increase the risk of bleeding when used with anticoagulants (blood thinners) or antiplatelet drugs. Examples include warfarin (Coumadin®), heparin, and clopidogrel (Plavix®). Some pain relievers may also increase the risk of bleeding if used with arginine. Examples include aspirin, ibuprofen (Motrin®, Advil®), and naproxen (Naprosyn®, Aleve®, Anaprox®).
It is also possible that arginine may raise blood sugar levels. Patients taking oral or injected drugs for diabetes should be monitored closely by their healthcare providers while using arginine. Dosing adjustments may be necessary.
Studies suggest that a combination of ibuprofen and arginine (ibuprofen-arginate/Spedifen®) has a faster onset of pain relief than ibuprofen alone. Use of other ibuprofen-based pain relievers, such as Motrin® or Advil®, with ibuprofen-arginate may increase the risk of toxic effects. Patients should consult their healthcare providers before combining these medications.
Interactions with Herbs and Dietary Supplements
Arginine may block the benefits of lysine in treating cold sores. It may increase the activity of growth hormone if used with ornithine.
In theory, 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 raise blood sugar levels. People using other herbs or supplements that may raise blood sugar levels should be monitored closely by their healthcare providers while using arginine. Dosing adjustments may be necessary.
Arginine should be used cautiously in patients taking potassium supplements because of the possible additive effect.
This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Heather Boon, BScPhm, PhD (University of Toronto); Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Michelle Corrado, PharmD (Harvard Vanguard Medical Associates); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Sadaf Hashmi MD, MPH (Johns Hopkins School of Hygiene and Public Health); Jenna Hollenstein, MS, RD (Natural Standard Research Collaboration); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).