L-arginine - Hydrochlorothiazide, Reserpine Interaction
Herbal: L-arginine
Also Known As: 2-Amino-5-guanidinopentanoic acid
Drug: Hydrochlorothiazide, Reserpine
Brand names:
Hydropres, Serpasil-Esidrix, Serpasil-Esidrix #1, Serpasil-Esidrix #2

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 04, 2025
Interaction Details
Hydrochlorothiazide, Reserpine is classified as belonging to the following category: Antihypertensive Drugs
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
L-arginine increases nitric oxide, which causes vasodilation. Clinical evidence shows that L-arginine can reduce blood pressure in some individuals with hypertension. Furthermore, combining L-arginine with some antihypertensive drugs seems to have additive vasodilating and blood pressure-lowering effects.
Interaction Rating
Likelihood of Occurrence
ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
References
- 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.
- Cheng JW, Balwin SN. L-arginine in the management of cardiovascular diseases. Ann Pharmacother 2001;35:755-64.
- 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..
- Higashi Y, Oshima T, Sasaki S, et. al. Angiotensin-converting enzyme inhibition, but not calcium antagonism, improves a response of the renal vasculature to L-arginine in patients with essential hypertension. Hypertension. 1998 Jul;32(1):16-24.
- Komers, R., Komersova, K., Kazdova, L., Ruzickova, J., and Pelikanova, T. Effect of ACE inhibition and angiotensin AT1 receptor blockade on renal and blood pressure response to L-arginine in humans. J Hypertens. 2000;18(1):51-59.
- Nagaya, N., Uematsu, M., Oya, H., Sato, N., Sakamaki, F., Kyotani, S., Ueno, K., Nakanishi, N., Yamagishi, M., and Miyatake, K. Short-term oral administration of L-arginine improves hemodynamics and exercise capacity in patients with precapillary pulmona
- Stokes, G. S., Barin, E. S., Gilfillan, K. L., and Kaesemeyer, W. H. Interactions of L-arginine, isosorbide mononitrate, and angiotensin II inhibitors on arterial pulse wave. Am J Hypertens. 2003;16(9 Pt 1):719-724.
- Palloshi, A., Fragasso, G., Piatti, P., Monti, L. D., Setola, E., Valsecchi, G., Galluccio, E., Chierchia, S. L., and Margonato, A. Effect of oral L-arginine on blood pressure and symptoms and endothelial function in patients with systemic hypertension,
- Ast, J., Jablecka, A., Bogdanski, P., Smolarek, I., Krauss, H., and Chmara, E. Evaluation of the antihypertensive effect of L-arginine supplementation in patients with mild hypertension assessed with ambulatory blood pressure monitoring. Med.Sci.Monit. 2
- Dong, J. Y., Qin, L. Q., Zhang, Z., Zhao, Y., Wang, J., Arigoni, F., and Zhang, W. Effect of oral L-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials. Am.Heart J 2011;162(6):959-965.
- Dell'Omo, G., Catapano, G., Ebel, M., Gazzano, A., Ducci, M., Del, Chicca M., Clerico, A., and Pedrinelli, R. [Pressor, renal and endocrine effects of systemic infusion of L-arginine in hypertensive patients]. Ann.Ital Med.Int. 1995;10(2):107-112.
- Higashi, Y., Oshima, T., Ozono, R., Watanabe, M., Matsuura, H., and Kajiyama, G. Effects of L-arginine infusion on renal hemodynamics in patients with mild essential hypertension. Hypertension 1995;25(4 Pt 2):898-902.
- Li H, Liu Q, Zou Z, et al. L-arginine supplementation to mitigate cardiovascular effects of walking outside in the context of traffic-related air pollution in participants with elevated blood pressure: A randomized, double-blind, placebo-controlled trial.
- Shiraseb F, Asbaghi O, Bagheri R, Wong A, Figueroa A, Mirzaei K. The Effect of L-arginine Supplementation On Blood Pressure in Adults: A Systematic Review and Dose-response Meta-analysis of Randomized Clinical Trials. Adv Nutr 2021.
L-arginine Overview

L-arginine - More Interactions
L-arginine interacts with 398 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
Unknown | No interactions have been reported or no interaction data is currently available. |
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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Drug descriptions are provided by MedlinePlus.