Skip navigation

L-arginine


What is it?

L-arginine is a chemical building block called “an amino acid.” It is obtained from the diet and is necessary for the body to make proteins. L-arginine is found in red meat, poultry, fish, and dairy products. It can also be made in a laboratory and used as medicine.

L-arginine is used for heart and blood vessel conditions including congestive heart failure (CHF), chest pain, high blood pressure, and coronary artery disease. L-arginine is also used for recurrent pain in the legs due to blocked arteries (intermittent claudication), decreased mental capacity in the elderly (senile dementia), erectile dysfunction (ED), and male infertility.

Some people use L-arginine for preventing the common cold, improving kidney function after a kidney transplant, high blood pressure during pregnancy (pre-eclampsia), improving athletic performance, boosting the immune system, and preventing inflammation of the digestive tract in premature infants.

L-arginine is used in combination with a number of over-the-counter and prescription medications for various conditions. For example, L-arginine is used along with ibuprofen for migraine headaches; with conventional chemotherapy drugs for treating breast cancer; with other amino acids for treating weight loss in people with AIDS; and with fish oil and other supplements for reducing infections, improving wound healing, and shortening recovery time after surgery.

Some people apply L-arginine to the skin to speed wound healing and for increasing blood flow to cold hands and feet, especially in people with diabetes. It is also used as a cream for sexual problems in both men and women.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for L-ARGININE are as follows:

Possibly effective for...

  • Improving recovery after surgery. Taking L-arginine with ribonucleic acid (RNA) and eicosapentaenoic acid (EPA) before surgery or afterwards seems to help reduce the recovery time, reduce the number of infections, and improve wound healing after surgery.
  • Congestive heart failure. Taking L-arginine along with usual treatment seems to help eliminate extra fluids that are a problem in congestive heart failure. But taking L-arginine doesn’t always improve exercise tolerance or quality of life. L-arginine should not be used instead of the usual treatments ordered by a healthcare provider.
  • Chest pain associated with coronary artery disease (angina pectoris). Taking L-arginine seems to decrease symptoms and improve exercise tolerance and quality of life in people with angina. But L-arginine doesn’t seem to improve the disease itself.
  • Bladder inflammation. Taking L-arginine seems to improve symptoms, but it may take up to three months of treatment to see improvement.
  • Wasting and weight loss in people with HIV/AIDS, when used with hydroxymethylbutyrate (HMB) and glutamine. This combination seems to increase body weight, particularly lean body mass, and improve the immune system.
  • Preventing loss of effect of nitroglycerin in people with angina pectoris.
  • Problems with erections of the penis (erectile dysfunction).
  • Improving kidney function in kidney transplant patients taking cyclosporine.
  • Preventing inflammation of the digestive tract in premature infants.
  • Cramping pain and weakness in the legs associated with blocked arteries (intermittent claudication).

Possibly ineffective for...

  • Heart attack. Taking L-arginine does not seem to help prevent a heart attack. It also doesn’t seem to be beneficial for treating a heart attack after it has occurred. In fact, there is concern that L-arginine might be harmful for people after a recent heart attack. Don't take L-arginine if you have had a recent heart attack.
  • Pre-eclampsia, an increase in blood pressure during pregnancy. Taking L-arginine doesn't seem to lower diastolic blood pressure (the second number) in women with pre-eclampsia in their 28th to 36th week of pregnancy.

Insufficient evidence to rate effectiveness for...

  • Migraine headache. Taking L-arginine by mouth along with the painkiller ibuprofen seems to be effective for treating migraine headache. This combination sometimes starts to work within 30 minutes. But it’s hard to know how much of the pain relief is due to L-arginine, since ibuprofen can relieve migraine pain on its own.
  • Decreased mental function in the elderly (senile dementia). Limited research suggests that L-arginine might improve senile dementia.
  • Improving healing of diabetic foot ulcers. There is interest in using L-arginine for preventing diabetic foot ulcers. Applying L-arginine to the feet seems to improve circulation in people with diabetes, which might be helpful in preventing ulcers. But if there is already an ulcer on the foot, injecting L-arginine under the skin near the ulcer doesn’t seem to shorten healing time by much or lower the chance of needing an amputation in the future.
  • High blood pressure. There is some evidence that taking L-arginine can slightly lower blood pressure in healthy people and in people with type 2 diabetes who have mild high blood pressure.
  • Male infertility.
  • Prevention of the common cold.
  • Improving athletic performance.
  • Breast cancer when used in combination with chemotherapy.
  • Wound healing.
  • Female sexual problems.
  • Sickle cell disease.
  • Improving the immune system in people with head and neck cancer.
More evidence is needed to rate L-arginine for these uses.

How does it work?

Return to top
L-arginine is converted in the body into a chemical called nitric oxide. Nitric oxide causes blood vessels to open wider for improved blood flow. L-arginine also stimulates the release of growth hormone, insulin, and other substances in the body.

Are there safety concerns?

Return to top
L-arginine is POSSIBLY SAFE for most people when taken appropriately by mouth short-term. It can cause some side effects such as abdominal pain, bloating, diarrhea, gout, blood abnormalities, allergies, airway inflammation, worsening of asthma, and low blood pressure.

Special precautions & warnings:

Pregnancy and breast-feeding: L-arginine is POSSIBLY SAFE when used appropriately short-term in pregnancy. Not enough is known about using L-arginine long-term in pregnancy or during breast-feeding. Stay on the safe side and avoid use.

Children: L-arginine is POSSIBLY SAFE when used by mouth in premature infants in appropriate doses. When used in high doses, L-arginine is POSSIBLY UNSAFE. Doses that are too high can cause serious side effects including death in children.

Allergies or asthma: L-arginine can cause an allergic response or make swelling in the airways worse. If you decide to take L-arginine, use it with caution.

Herpes: There is a concern that L-arginine might make herpes worse. There is some evidence that L-arginine is needed for the herpes virus to multiply.

Low blood pressure: L-arginine might lower blood pressure. This could be a problem if you already have low blood pressure.

Recent heart attack: There is a concern that L-arginine might increase the risk of death after a heart attack, especially in older people. If you have had a heart attack recently, don’t take L-arginine.

Surgery: L-arginine might affect blood pressure. There is a concern that it might interfere with blood pressure control during and after surgery. Stop taking L-arginine at least 2 weeks before a scheduled surgery.

Are there interactions with medications?

Return to top

Major

Do not take this combination.

Medications for high blood pressure (Antihypertensive drugs)
L-arginine seems to decrease blood pressure. Taking L-arginine along with medications for high blood pressure might cause your blood pressure to go too low.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.

Medications that increase blood flow to the heart (Nitrates)
L-arginine increases blood flow. Taking L-arginine with medications that increase blood flow to the heart might increase the chance of dizziness and lightheadedness.

Some of these medications that increase blood flow to the heart include nitroglycerin (Nitro-Bid, Nitro-Dur, Nitrostat), and isosorbide (Imdur, Isordil, Sorbitrate).

Moderate

Be cautious with this combination.

Sildenafil (Viagra)
Sildenafil (Viagra) can lower blood pressure. L-arginine can also lower blood pressure. Taking sildenafil (Viagra) and L-arginine together might cause the blood pressure to go too low. Blood pressure that is too low can cause dizziness and other side effects.

Are there interactions with herbs and supplements?

Return to top
Xylitol
L-arginine can cause an organ in the body called the pancreas to release a hormone called glucagon. Glucagon comes to the rescue when blood sugar levels are too low. Glucagon makes the liver convert stored sugar to useable sugar that is released into the bloodstream. Using L-arginine along with xylitol can keep L-arginine from stimulating the pancreas to release glucagon.

Are there interactions with foods?

Return to top
There are no known interactions with foods.

What dose is used?

Return to top
The following doses have been studied in scientific research:

BY MOUTH:
  • For congestive heart failure: doses range from 6-20 grams per day, as three divided doses.
  • For chest pain associated with coronary artery disease (angina pectoris): 3-6 grams three times per day for up to one month.
  • For preventing the loss of the effectiveness of nitroglycerin in relieving pain in people with chest pain due to coronary artery disease (angina pectoris): 700 mg four times daily.
  • For organic erectile dysfunction (ED): 5 grams per day. Taking lower doses might not be effective.
  • For preventing inflammation of the digestive tract in premature infants: 261 mg/kg added to oral feedings daily for the first 28 days of life.

Other names

Return to top
2-Amino-5-guanidinopentanoic Acid, (2S)-2-Amino-5-{[amino (imino) methyl]amino}pentanoic Acid, Acide 2-Amino-5-guanidinopentanoïque, Arg, Arginine, Arginine Ethyl Ester, Arginine Ethyl Ester Dihydrochloride, Arginine Ethyl Ester HCl, Arginine HCl, Arginine Hydrochloride, Di-Arginine Malate, Di-Arginine Orotate, Di-L-Arginine-L-Malate, Dl-Arginine, L-Arginina, L-Arginine Ethyl Ester Dichloride, L-Arginine HCl, L-Arginine Hexanoate, L-Arginine Hydrochloride, L-Arginine Ketoisocaproic Acid, L-Arginine L-Pyroglutamate, L-Arginine Pyroglutamate, L-Arginine Taurinate, Malate de Di-Arginine, Orotate de Di-Arginine, R-Gene 10.

Methodology

Return to top
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

Return to top
To see all references for the L-arginine page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/875.html.

  1. Anon. Arginine hydrochloride injection (marketed as R-Gene 10). FDA Drug Safety Newsletter 2009;2:16-18. Available at: www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/default.htm.
  2. Jude EB, Boulton AJ, Ferguson MW, Appleton I. The role of nitric oxide synthase isoforms and arginase in the pathogenesis of diabetic foot ulcers: possible modulatory effects by transforming growth factor beta 1. Diabetologia 1999;42:748-57. View abstract.
  3. Arana V, Paz Y, González A, Méndez V, Méndez JD. Healing of diabetic foot ulcers in L-arginine-treated patients. Biomed Pharmacother 2004;58:588-97. View abstract.
  4. Fossel ET. Improvement of temperature and flow in feet of subjects with diabetes with use of a transdermal preparation of L-arginine: a pilot study. Diabetes Care 2004;27:284-5. View abstract.
  5. Chauhan A, More RS, Mullins PA, et al. Aging-associated endothelial dysfunction in humans is reversed by L-arginine. J Am Coll Cardiol 1996;28:1796-804. View abstract.
  6. Bednarz B, Jaxa-Chamiec T, Maciejewski P, et al. Efficacy and safety of oral l-arginine in acute myocardial infarction. Results of the multicenter, randomized, double-blind, placebo-controlled ARAMI pilot trial. Kardiol Pol 2005;62:421-7. View abstract.
  7. Schulman SP, Becker LC, Kass DA, et al. L-arginine therapy in acute myocardial infarction. The vascular interaction with age in myocardial infarction (VINTAGE MI) randomized clinical trial. JAMA 2006;295:58-64. View abstract.
  8. Resnick DJ, Softness B, Murphy AR, et al. Case report of an anaphylactoid reaction to arginine. Ann Allergy Asthma Immunol 2002;88:67-8. View abstract.
  9. Staff AC, Berge L, Haugen G, et al. Dietary supplementation with L-arginine or placebo in women with pre-eclampsia. Acta Obstet Gynecol Scand 2004;83:103-7. View abstract.
  10. Morris CR, Morris SM Jr, Hagar W, et al. Arginine therapy: a new treatment for pulmonary hypertension in sickle cell disease? Am J Respir Crit Care Med 2003;168:63-9. View abstract.
  1. Venho B, Voutilainen S, Valkonen VP, et al. Arginine intake, blood pressure, and the incidence of acute coronary events in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr 2002;76:359-64.. View abstract.
  2. Huynh NT, Tayek JA. Oral arginine reduces systemic blood pressure in type 2 diabetes: its potential role in nitric oxide generation. J Am Coll Nutr 2002;21:422-7.. View abstract.
  3. Stanislavov R, Nikolova V. Treatment of erectile dysfunction with pycnogenol and L-arginine. J Sex Marital Ther 2003;29:207-13.. View abstract.
  4. de Luis DA, Izaola O, Cuellar L, et al. Effect of c-reactive protein and interleukins blood levels in postsurgery arginine-enhanced enteral nutrition in head and neck cancer patients. Eur J Clin Nutr 2003;57:96-9. View abstract.
  5. Parker JO, Parker JD, Caldwell RW, et al. The effect of supplemental L-arginine on tolerance development during continuous transdermal nitroglycerin therapy. J Am Coll Cardiol 2002;39:1199-203. View abstract.
  6. Amin HJ, Zamora SA, McMillan DD, et al. Arginine supplementation prevents necrotizing enterocolitis in the premature infant. J Pediatr 2002;140:425-31. View abstract.
  7. Ohtsuka Y, Nakaya J. Effect of oral administration of L-arginine on senile dementia. Am J Med 2000;108:439. View abstract.
  8. Houghton JL, Philbin EF, Strogatz DS, et al. The presence of African American race predicts improvement in coronary endothelial function after supplementary L-arginine. J Am Coll Cardiol 2002;39:1314-22. View abstract.
  9. Bocchi EA, Vilella de Moraes AV, Esteves-Filho A, et al. L-arginine reduces heart rate and improves hemodynamics in severe congestive heart failure. Clin Cardiol 2000;23:205-10. View abstract.
  10. Katz SD, Khan T, Zeballos GA, et al. Decreased activity of the L-arginine-nitric oxide metabolic pathway in patients with congestive heart failure. Circulation 1999;99:2113-7. View abstract.
  11. Wallace AW, Tom WL. Interaction of L-arginine and phosphodiesterase inhibitors in vasodilation of the porcine internal mammary artery. Anesth Analg 2000;90:840-6. View abstract.
  12. Chin-Dusting JP, Kaye DM, Lefkovits J, et al. Dietary supplementation with L-arginine fails to restore endothelial function in forearm resistance arteries of patients with severe heart failure. J Am Coll Cardiol 1996;27:1207-13. View abstract.
  13. Cheng JW, Balwin SN. L-arginine in the management of cardiovascular diseases. Ann Pharmacother 2001;35:755-64. View abstract.
  14. Mullen MJ, Wright D, Donald AE, et al. Atorvastatin but not L-arginine improves endothelial function in type I diabetes mellitus: a double-blind study. J Am Coll Cardiol 2000;36:410-6. View abstract.
  15. Wu G, Meininger CJ. Arginine nutrition and cardiovascular function. J Nutr 2000;130:2626-9. View abstract.
  16. Tepaske R, Velthuis H, Oudemans-van Straaten HM, et al. Effect of preoperative oral immune-enhancing nutritional supplement on patients at high risk of infection after cardiac surgery: a randomised placebo-controlled trial. Lancet 2001;358:696-701. View abstract.
  17. Siani A, Pagano E, Iacone R, et al. Blood pressure and metabolic changes during dietary L-arginine supplementation in humans. Am J Hypertens 2000;13:547-51. View abstract.
  18. Blum A, Hathaway L, Mincemoyer R, et al. Oral L-arginine in patients with coronary artery disease on medical management. Circulation 2000;101:2160-4. View abstract.
  19. Ceremuzynski L, Chamiec T, Herbaczynska-Cedro K. Effect of supplemental oral L-arginine on exercise capacity in patients with stable angina pectoris. Am J Cardiol 1997;80:331-3. View abstract.
  20. Maxwell AJ, Zapien MP, Pearce GL, et al. Randomized trial of a medical food for the dietary management of chronic, stable angina. J Am Coll Cardiol 2002;39:37-45. View abstract.
  21. Park KG. The immunological and metabolic effects of L-arginine in human cancer. Proc Nutr Soc 1993;52:387-401. View abstract.
  22. Kanaya Y, Nakamura M, Kobayashi N, Hiramori K. Effects of L-arginine on lower limb vasodilator reserve and exercise capacity in patients with chronic heart failure. Heart 1999;81:512-7. View abstract.
  23. Feskens EJM, Oomen CM, Hogendoorn E, et al. Arginine intake and 25-year CHD mortality: the seven countries study (letter). Eur Heart J 2001;22:611-2. View abstract.
  24. Hambrecht R, Hilbrich L, Erbs S, et al. Correction of endothelial dysfunction in chronic heart failure: additional effects of exercise training and oral L-arginine supplementation. J Am Coll Cardiol 2000;35:706-13. View abstract.
  25. Kemen M, Senkal M, Homann HH, et al. Early postoperative enteral nutrition with arginine-omega-3 fatty acids and ribonucleic acid-supplemented diet vs placebo in cancer patients: an immunologic evaluation of impact. Crit Care Med 1995;23:652-9. View abstract.
  26. Senkal M, Kemen M, Homann HH, et al. Modulation of postoperative immune response by enteral nutrition with a diet enriched with arginine, RNA, and omega-3 fatty acids in patients with upper gastrointestinal cancer. Eur J Surg 1995;161:115-22. View abstract.
  27. Daly JM, Lieberman MD, Goldfine J, et al. Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic and clinical outcome. Surgery 1992;112:56-67. View abstract.
  28. Watanabe G, Tomiyama H, Doba N. Effects of oral administration of L-arginine on renal function in patients with heart failure. J Hypertens 2000;18:229-34. View abstract.
  29. Rector TS, Bank AJ, Mullen KA, et al. Randomized, double-blind, placebo-controlled study of supplemental oral L-arginine in patients with heart failure. Circulation 1996;93:2135-41. View abstract.
  30. Blum A, Porat R, Rosenschein U, et al. Clinical and inflammatory effects of dietary L-arginine in patients with intractable angina pectoris. Am J Cardiol 1999;15:1488-90. View abstract.
  31. Boger RH, Bode-Boger SM, Thiele W, et al. Restoring vascular nitric oxide formation by L-arginine improves the symptoms of intermittent claudication in patients with peripheral arterial occlusive disease. J Am Coll Cardiol 1998;32:1336-44. View abstract.
  32. Korting GE, Smith SD, Wheeler MA, et al. A randomized double-blind trial of oral L-arginine for treatment of interstitial cystitis. J Urol 1999;161:558-65. View abstract.
  33. Oomen CM, van Erk MJ, Feskens E, et al. Arginine intake and risk of coronary heart disease mortality in elderly men. Arterioscler Thromb Vasc Biol 2000;20:2134-9. View abstract.
  34. Brittenden J, Park KGM, Heys SD, et al. L-Arginine stimulates host defenses in patients with breast cancer. Surgery 1994;115:205-12. View abstract.
  35. Tenenbaum A, Fisman EZ, Motro M. L-arginine: Rediscovery in progress. Cardiology 1998;90:153-9. View abstract.
  36. Wang R, Ghahary A, Shen YJ, et al. Human dermal fibroblasts produce nitric oxide and express both constitutive and inducible nitric oxide synthase isoforms. J Invest Dermatol 1996;106:419-27. View abstract.
  37. Peters H, Noble NA. Dietary L-arginine in renal disease. Semin Nephrol 1996;16:567-75. View abstract.
  38. Klotz T, Mathers MJ, Braun M, et al. Effectiveness of oral L-arginine in first-line treatment of erectile dysfunction in a controlled crossover study. Urol Int 1999;63:220-3. View abstract.
  39. Clark RH, Feleke G, Din M, et al. Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind, placebo-controlled study. JPEN J Parenter Enteral Nutr 2000;24:133-9. View abstract.
  40. FDA. List of orphan designations and approvals. Office of Orphan Products Development. Available at: www.fda.gov/orphan/designat/list.htm.
  41. Clarkson P, Adams MR, Powe AJ, et al. Oral L-arginine improves endothelium-dependent dilation in hypercholesterolemic young adults. J Clin Invest 1996;97:1989-94. View abstract.
  42. Creager MA, Gallagher SJ, Girerd XJ, et al. L-arginine improves endothelium-dependent vasodilation in hypercholesterolemic humans. J Clin Invest 1992;90:1248-53. View abstract.
  43. Chen J, Wollman Y, Chernichovsky T, et al. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. BJU Int 1999;83:269-73. View abstract.
  44. Saijyo T, Nomura M, Nakaya Y, Saito K, et al. Autonomic nervous system activity during infusion of L-arginine in patients with liver cirrhosis. Liver 1998;18:27-31. View abstract.
  45. Sapienza MA, Kharitonov SA, Horvath I, et al. Effect of inhaled L-arginine on exhaled nitric oxide in normal and asthmatic subjects. Thorax 1998;53:172-5. View abstract.
  46. Griffith RS, DeLong DC, Nelson JD. Relation of arginine-lysine antagonism to herpes simplex growth in tissue culture. Chemotherapy 1981;27:209-13. View abstract.
  47. Hibbard MK, Sandri-Goldin, RM. Arginine-rich regions succeeding the nuclear localization region of the herpes simplex virus type 1 regulatory protein ICP27 are required for efficient nuclear localization and late gene expression. J Virol 1995;69:4656-7. View abstract.
  48. Takano H, Lim HB, Miyabara Y, et al. Oral administration of L-arginine potentiates allergen-induced airway inflammation and expression of interleukin-5 in mice. J Pharmacol Exp Ther 1998;286:767-71. View abstract.
  49. Adams MR, McCredie R, Jessup W, et al. Oral L-arginine improves endothelium-dependent dilatation and reduces monocyte adhesion to endothelial cells in young men with coronary artery disease. Atherosclerosis 1997;129:261-9. View abstract.
  50. Wheeler MA, Smith SD, Saito N, et al. Effect of long-term oral L-arginine on the nitric oxide synthase pathway in the urine from patients with interstitial cystitis. J Urol 1997;158:2045-50. View abstract.
  51. Andres A, Morales JM, Praga M, et al. L-arginine reverses the antinatriuretic effect of cyclosporin in renal transplant patients. Nephrol Dial Transplant 1997;12:1437-40. View abstract.
  52. Lerman A, Burnett JC Jr, Higano ST, et al. Long-term L-arginine improves small-vessel coronary endothelial function in humans. Circulation 1998;97:2123-8. View abstract.
  53. Sandrini G, Franchini S, Lanfranchi S, et al. Effectiveness of ibuprofen-arginine in the treatment of acute migraine attacks. Int J Clin Pharmacol Res 1998;18:145-50. View abstract.
  54. Bode-Boger SM, Boger RH, Galland A, et al. L-arginine-induced vasodilation in healthy humans: pharmacokinetic-pharmacodynamic relationship. Br J Clin Pharmacol 1998;46:489-97. View abstract.
  55. Ehren I, Lundberg JO, Adolfsson J, Wiklund NP. Effects of L-arginine treatment on symptoms and bladder nitric oxide levels in patients with interstitial cystitis. Urology 1998;52:1026-9. View abstract.
  56. McKevoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Show more references
Show fewer references
Last reviewed - 08/21/2014




Page last updated: 08 September 2014