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L-arginine Drug Interactions, Uses, Effectiveness, Safety & More

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L-arginine Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant L-arginine drug interaction appears low for most people, though a few medication groups deserve real attention. None of the listed interactions are rated major, and most reflect predicted additive effects rather than proven harm.

Interactions deserving the most attention

The best-supported concern involves blood pressure medications, including ACE inhibitors and ARBs, since human studies show L-arginine can lower blood pressure on its own and may add to these drugs' effects; ACE inhibitors and ARBs can also raise potassium, and L-arginine has been linked to high potassium in some patients. People taking diabetes medications should know L-arginine has lowered blood sugar in early research, which could add to their effect. There is also a theoretical bleeding concern with anticoagulant and antiplatelet drugs, since L-arginine may reduce platelet clumping, though its real-world significance is unclear.

What the rest of the list means

The long list of interacting medications does not mean each combination is harmful. Most entries are theoretical, based on the idea that L-arginine's effects on blood vessels, potassium, or blood sugar could add to a drug's action. In some cases, such as sildenafil, the predicted drop in blood pressure did not actually occur in studies of people using the two together.

Check your medications against L-arginine

Based on HelloPharmacist’s L-arginine interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with L-arginine

403 medications have a known interaction with L-arginine, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
AbciximabReoPro› AbrocitinibCibinqo› AcarboseGlucobay, Prandase, Precose› AcebutololRhotral, Sectral› AcenocoumarolSintrom› Acetaminophen, AspirinGemnisyn› Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine› Acetaminophen, IbuprofenCombogesic› AcetazolamideAk-Zol, Diamox› AcetohexamideDymelor› Acetylsalicylic AcidEntrophen› AlbiglutideTanzeum› AliskirenTekturna› AlogliptinNesina› Alogliptin, MetforminKazano› Alogliptin, PioglitazoneOseni› Alteplase, TpaActilyse, Activase› Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2› Aluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin› AmbrisentanLetairis, Volibris› AmilorideAmilamont, Midamor› Amiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic› AmlodipineNorliqva› Amlodipine BenzoateKaterzia› Amlodipine BesilateIstin› Amlodipine BesylateNorvasc› Amlodipine Besylate, BenazeprilLotrel› Amlodipine, CelecoxibConsensi› Ammonium ChlorideAmmonium Chloride› Anacaulase-bcdbNexoBrid›
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact L-arginine combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs L-arginine affects

Every type of medication (drug category) L-arginine is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 9 drug categories L-arginine interacts with
Ace Inhibitors (aceis)Angiotensin Receptor Blockers (arbs)Anticoagulant/antiplatelet DrugsAntidiabetes DrugsAntihypertensive DrugsIsoproterenol (isuprel)Potassium-sparing DiureticsSildenafil (viagra)Testosterone
Ace Inhibitors (Aceis)

Theoretically, concomitant use of L-arginine and ACE inhibitors may increase the risk for hypotension and hyperkalemia.
Combining L-arginine with some antihypertensive drugs, especially ACE inhibitors, seems to have additive vasodilating and blood pressure-lowering effects. Furthermore, ACE inhibitors can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ACE inhibitors with L-arginine may increases the risk of hyperkalemia.

Likelihood Probable Evidence D
Angiotensin Receptor Blockers (Arbs)

Theoretically, concomitant use of L-arginine and ARBs may increase the risk of hypotension and hyperkalemia.
L-arginine increases nitric oxide, which causes vasodilation. Combining L-arginine with ARBs seems to increase L-arginine-induced vasodilation. Furthermore, ARBs can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ARBs with L-arginine may increases the risk of hyperkalemia.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Preliminary research suggests that L-arginine infusions reduce platelet aggregation in humans. The clinical significance of this effect is unclear.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, concomitant use of L-arginine might have additive effects with antidiabetes drugs.
Preliminary clinical research shows that L-arginine decreases blood glucose levels in patients with type 2 diabetes.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence D
Isoproterenol (Isuprel)

Theoretically, concurrent use of isoproterenol and L-arginine might result in additive effects and hypotension.
Preliminary clinical evidence suggests that L-arginine enhances isoproterenol-induced vasodilation in patients with essential hypertension or a family history of essential hypertension.

Likelihood Probable Evidence D
Potassium-Sparing Diuretics

Theoretically concomitant use of potassium-sparing diuretics with L-arginine may increases the risk of hyperkalemia.
Potassium-sparing diuretics can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients.

Likelihood Possible Evidence D
Sildenafil (Viagra)

Theoretically, concurrent use of sildenafil and L-arginine might increase the risk for hypotension.
In vivo, concurrent use of L-arginine and sildenafil has resulted in increased vasodilation. Theoretically, concurrent use might have additive vasodilatory and hypotensive effects. However, in studies evaluating the combined use of L-arginine and sildenafil for erectile dysfunction, hypotension was not reported.

Likelihood Possible Evidence D
Testosterone

Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
In clinical research, L-arginine increases the level of testosterone in male patients with erectile dysfunction. The clinical significance of this finding is unclear.

Likelihood Possible Evidence D
Monograph

L-arginine: Uses, Safety & Side Effects

The bottom line

L-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for blood pressure, erectile dysfunction, and exercise, but the evidence is mixed and stronger for some uses than others. It is generally well tolerated in healthy adults, but talk with a pharmacist or doctor before using it, especially if you have heart problems or take other medicines.

L-arginine
Part used
Amino acid (made by the body and found in protein-rich foods)
Common forms
Capsules, tablets, powders, sustained-release products
People commonly use it for
  • High blood pressure
  • Erectile dysfunction
  • Athletic performance
  • Chest pain (angina)
  • Improving blood flow

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Often well tolerated short-term, but it can lower blood pressure and may not be safe for everyone.

PregnancyPossibly Safe

When used orally and appropriately, short-term. L-arginine 12 grams daily for 2 days has been used with apparent safety in pregnancy during the third...

Read the full pregnancy detail
BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

L-arginine is an amino acid, which is one of the building blocks the body uses to make proteins. Your body can make some L-arginine on its own, and you also get it from protein-rich foods like meat, poultry, fish, dairy, nuts, and beans.

Because it is a normal part of the diet, L-arginine is considered a "conditionally essential" amino acid. This means most people make enough, but during times of stress, illness, or rapid growth the body may need more than it can produce.

As a supplement, L-arginine is most often taken for heart and blood vessel health, erectile dysfunction, and exercise performance. It is sold as capsules, tablets, and powders, sometimes combined with other ingredients.

How it works

The main proposed mechanism is that the body converts L-arginine into nitric oxide, a molecule that signals blood vessels to relax and widen. Wider blood vessels can improve blood flow and may slightly lower blood pressure.

This nitric oxide pathway is the reason L-arginine is studied for conditions tied to blood flow, such as high blood pressure and erectile dysfunction.

L-arginine also plays roles in the body's handling of waste products (the urea cycle), wound healing, and immune function. Many of these effects are based on laboratory and animal research, and do not always translate into clear benefits in people.

Effectiveness

Does L-arginine work?

Evidence overview · 63 uses evaluated
6 Possibly effective 5 Leans ineffective 52 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.
Possibly Effective Angina
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine seems to improve symptoms and exercise tolerance in patients with angina.

Possibly Effective Erectile dysfunction (ED)
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine might improve symptoms of ED. When taken with phosphodiesterase type 5 (PDE5) inhibitors, L-arginine seems to provide a small additional benefit.

Possibly Effective Necrotizing enterocolitis (NEC)
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine may help prevent NEC in premature infants.

Possibly Effective Peripheral arterial disease (PAD)
Rating & evidence shown verbatim from Natural Medicines

Short-term use of intravenous or oral L-arginine may improve symptoms of PAD, but long-term use does not seem to be beneficial.

Possibly Effective Pre-eclampsia
Rating & evidence shown verbatim from Natural Medicines

Intravenous L-arginine may have beneficial effects in pre-eclampsia. However, it is unclear if oral L-arginine is effective.

Possibly Effective Pregnancy-induced hypertension
Rating & evidence shown verbatim from Natural Medicines

Intravenous L-arginine may have beneficial effects in pregnancy-induced hypertension.

Possibly Ineffective Chronic kidney disease (CKD)
Rating & evidence shown verbatim from Natural Medicines

Oral or intravenous L-arginine does not seem to improve CKD.

Possibly Ineffective Hypercholesterolemia
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine does not seem to reduce cholesterol levels.

Possibly Ineffective Myocardial infarction (MI)
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine does not seem to improve outcomes after MI.

Possibly Ineffective Tuberculosis
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine does not seem to improve symptoms or the clearance of tuberculosis infection.

Possibly Ineffective Wound healing
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine does not seem to improve wound healing.

Also studied for 52 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Acute respiratory distress syndrome (ARDS)
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral L-arginine may prevent ARDS.

Insufficient Reliable Evidence To Rate Altitude sickness
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with altitude sickness.

Insufficient Reliable Evidence To Rate Anemia of chronic disease
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial for anemia in patients with chronic kidney disease.

Insufficient Reliable Evidence To Rate Anthracycline cardiotoxicity
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral L-arginine for anthracycline cardiotoxicity, there is insufficient reliable information about the clinical effects of L-arginine for this purpose.

Insufficient Reliable Evidence To Rate Asthma
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with asthma.

Insufficient Reliable Evidence To Rate Athletic performance
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral L-arginine may improve measures of athletic performance.

Insufficient Reliable Evidence To Rate Beta-thalassemia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in children with beta-thalassemia.

Insufficient Reliable Evidence To Rate Breast cancer
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with breast cancer.

Insufficient Reliable Evidence To Rate Cognitive impairment
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with cognitive impairment.

Insufficient Reliable Evidence To Rate Coronary artery bypass graft (CABG) surgery
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial for preventing complications after CABG surgery.

Insufficient Reliable Evidence To Rate Coronavirus disease 2019 (COVID-19)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with severe COVID-19 infection.

Insufficient Reliable Evidence To Rate Critical illness (trauma)
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effects when used alone are unclear.

Insufficient Reliable Evidence To Rate Cyclosporine-induced nephrotoxicity
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral L-arginine for cyclosporine-induced nephrotoxicity, there is insufficient reliable information about the clinical effects of L-arginine for this purpose.

Insufficient Reliable Evidence To Rate Cystic fibrosis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with cystic fibrosis.

Insufficient Reliable Evidence To Rate Dental caries
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that using a dentifrice containing L-arginine might prevent dental caries.

Insufficient Reliable Evidence To Rate Dental hypersensitivity
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Depression
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in adults with depression.

Insufficient Reliable Evidence To Rate Diabetes
Rating & evidence shown verbatim from Natural Medicines

Small, low-quality studies suggest that oral L-arginine does not improve glycemic control in people with type 2 diabetes.

Insufficient Reliable Evidence To Rate Diabetic foot ulcers
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral or subcutaneous L-arginine is beneficial in patients with diabetic foot ulcers.

Insufficient Reliable Evidence To Rate Diabetic neuropathy
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with diabetic neuropathy.

Insufficient Reliable Evidence To Rate Head and neck cancer
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with head and neck cancer.

Insufficient Reliable Evidence To Rate Heart failure
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with heart failure.

Insufficient Reliable Evidence To Rate Heart transplant complications
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients that have received a heart transplant.

Insufficient Reliable Evidence To Rate HIV/AIDS-related wasting
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Impaired glucose tolerance (prediabetes)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine can prevent the development of type 2 diabetes in adults with prediabetes.

Insufficient Reliable Evidence To Rate Interstitial cystitis
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral L-arginine may improve pain in interstitial cystitis.

Insufficient Reliable Evidence To Rate Intrauterine growth restriction (IUGR)
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral or intravenous L-arginine may increase birthweight in IUGR.

Insufficient Reliable Evidence To Rate Kidney transplant
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral L-arginine may not improve kidney function in patients after kidney transplantation.

Insufficient Reliable Evidence To Rate Male infertility
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in males with infertility.

Insufficient Reliable Evidence To Rate Migraine headache
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral L-arginine for migraine, there is insufficient reliable information about the clinical effects of L-arginine for this condition.

Insufficient Reliable Evidence To Rate Mitochondrial myopathies
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that intravenous L-arginine may modestly improve symptoms in patients with MELAS (mitochondrial encephalopathy with lactic acidosis and stroke-like episodes syndrome).

Insufficient Reliable Evidence To Rate Muscular dystrophy
Rating & evidence shown verbatim from Natural Medicines

There is limited evidence on the oral use of L-arginine in patients with Duchenne muscular dystrophy.

Insufficient Reliable Evidence To Rate Nitrate tolerance
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial for nitrate tolerance.

Insufficient Reliable Evidence To Rate Obesity
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral L-arginine may be beneficial for weight loss.

Insufficient Reliable Evidence To Rate Oral mucositis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial for oral mucositis.

Insufficient Reliable Evidence To Rate Periodontitis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with periodontitis.

Insufficient Reliable Evidence To Rate Physical performance
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial for improving physical performance in older adults.

Insufficient Reliable Evidence To Rate Polycystic ovary syndrome (PCOS)
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Postoperative infection
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Postoperative pain
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Postoperative recovery
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Pressure ulcers
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Preterm labor
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral L-arginine may prevent preterm labor.

Insufficient Reliable Evidence To Rate Pulmonary hypertension
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in children with pulmonary hypertension related to beta-thalassemia.

Insufficient Reliable Evidence To Rate Radiation dermatitis
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Respiratory tract infections
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral L-arginine for respiratory tract infections, there is insufficient reliable information about the clinical effects of L-arginine for these conditions.

Insufficient Reliable Evidence To Rate Restenosis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if intravenous L-arginine helps to prevent restenosis after stent implantation.

Insufficient Reliable Evidence To Rate Schizophrenia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial in patients with schizophrenia.

Insufficient Reliable Evidence To Rate Sexual dysfunction
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral L-arginine is beneficial for sexual dysfunction in females.

Insufficient Reliable Evidence To Rate Sickle cell disease
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral or intravenous L-arginine may modestly improve complications in patients with sickle cell disease.

Insufficient Reliable Evidence To Rate Stress
Rating & evidence shown verbatim from Natural Medicines

Oral L-arginine has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Valproic acid-induced toxicities
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using intravenous L-arginine for valproic acid toxicity, there is insufficient reliable information about the clinical effects of L-arginine for this purpose.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

For most healthy adults, L-arginine appears to be reasonably well tolerated when used short-term. Still, it is not right for everyone.

Because L-arginine can widen blood vessels and lower blood pressure, use caution if you already have low blood pressure. People with heart disease, especially those who have recently had a heart attack, should avoid using it unless a doctor recommends it, since some research suggested possible harm in that group.

People with herpes (cold sores or genital herpes) sometimes worry that arginine may trigger outbreaks; this is not well proven but worth discussing with your provider. Those with kidney or liver problems should also check first, since these organs help process amino acids.

Pregnancy: L-arginine has sometimes been used in medical settings during pregnancy, but only under supervision. Do not self-treat during pregnancy without your doctor's guidance.

Breastfeeding: There is not enough reliable information about supplement use while breastfeeding, so it is best avoided unless your doctor advises otherwise.

Always talk with a pharmacist or doctor before starting L-arginine, especially if you have a medical condition or take other medicines.

Side effects

The most common side effects are digestive, including stomach upset, bloating, nausea, and diarrhea, especially at higher doses.

Because it can lower blood pressure, some people may feel dizzy or lightheaded. Allergic reactions are possible but uncommon.

Rarely, high doses may cause more serious problems, and there have been safety concerns when used in people with existing heart disease. Stop and seek medical care if you have chest pain, severe dizziness, trouble breathing, or signs of an allergic reaction.

L-arginine: Reported Adverse Effects

Documented safety reports on L-arginine from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Oral, intravenous, and topical L-arginine are generally well tolerated.

Most Common Adverse Effects:

Orally: Abdominal pain, bloating, nausea, diarrhea, headache, insomnia, flushing.

Intravenously: Excessively rapid infusion can cause flushing, headache, nausea and vomiting, numbness, and venous irritation.

Reports by condition
Asthma Pulmonary/Respiratory
Back pain Musculoskeletal
Breast cancer Oncologic
Cluster headache Neurologic/CNS

Orally, L-arginine has been associated with headache, insomnia, fatigue, and vertigo.

  1. Cartledge, J. J., Davies, A. M., and Eardley, I. A randomized double-blind placebo-controlled crossover trial of the efficacy of L-arginine in the treatment of interstitial cystitis. BJU.Int. 2000;85(4):421-426.
  2. Mansoor, J. K., Morrissey, B. M., Walby, W. F., Yoneda, K. Y., Juarez, M., Kajekar, R., Severinghaus, J. W., Eldridge, M. W., and Schelegle, E. S. L-arginine supplementation enhances exhaled NO, breath condensate VEGF, and headache at 4,342 m. High Alt.M
  3. Khan, F., Litchfield, S. J., McLaren, M., Veale, D. J., Littleford, R. C., and Belch, J. J. Oral L-arginine supplementation and cutaneous vascular responses in patients with primary Raynaud's phenomenon. Arthritis Rheum. 1997;40(2):352-357.
  4. Vadillo-Ortega F, Perichart-Perera O, Espino S, et al. Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial. BMJ. 2011 May 19;342:d2901.
  5. Gallo L, Pecoraro S, Sarnacchiaro P, Silvani M, Antonini G. The daily therapy with L-arginine 2,500 mg and tadalafil 5 mg in combination and in monotherapy for the treatment of erectile dysfunction: A prospective, randomized multicentre study. Sex Med. 20
  6. El-Wakeel LM, Fouad FA, Saleem MD, Saber-Khalaf M. Efficacy and tolerability of sildenafil/l-arginine combination relative to sildenafil alone in patients with organic erectile dysfunction. Andrology. 2020;8(1):143-147.
  7. Doutreleau, S., Rouyer, O., Di, Marco P., Lonsdorfer, E., Richard, R., Piquard, F., and Geny, B. L-arginine supplementation improves exercise capacity after a heart transplant. Am J Clin.Nutr. 2010;91(5):1261-1267.
Diarrhea Gastrointestinal

Orally, L-arginine has been reported to cause nausea, diarrhea, vomiting, dyspepsia, gastrointestinal discomfort, and bloating.

Orally, L-arginine has been reported to cause esophagitis in at least six adolescents. Symptoms, which included pain and dysphagia, occurred within 1-3 months of treatment in most cases. There are at least two cases of acute pancreatitis possibly associated with oral L-arginine. In one case, a 28-year-old male developed pancreatitis after consuming a shake containing 1.2 grams of L-arginine daily as arginine alpha-ketoglutarate. The shake also contained plant extracts, caffeine, vitamins, and other amino acids. Although there is a known relationship between L-arginine and pancreatitis in animal models, it is not clear if L-arginine was directly responsible for the occurrence of pancreatitis in this case.

Intravenously, excessively rapid infusion of L-arginine has been reported to cause nausea and vomiting.

  1. 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.
  2. Cartledge, J. J., Davies, A. M., and Eardley, I. A randomized double-blind placebo-controlled crossover trial of the efficacy of L-arginine in the treatment of interstitial cystitis. BJU.Int. 2000;85(4):421-426.
  3. 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
  4. Savoye, G., Jemaa, Y., Mosni, G., Savoye-Collet, C., Morcamp, P., Dechelotte, P., Bouin, M., Denis, P., and Ducrotte, P. Effects of intragastric L-arginine administration on proximal stomach tone under basal conditions and after an intragastric diet. Dig
  5. Facchinetti, F., Saade, G. R., Neri, I., Pizzi, C., Longo, M., and Volpe, A. L-arginine supplementation in patients with gestational hypertension: a pilot study. Hypertens.Pregnancy. 2007;26(1):121-130.
  6. Khan, F., Litchfield, S. J., McLaren, M., Veale, D. J., Littleford, R. C., and Belch, J. J. Oral L-arginine supplementation and cutaneous vascular responses in patients with primary Raynaud's phenomenon. Arthritis Rheum. 1997;40(2):352-357.
  7. Bauer JD, Isenring E, Waterhouse M. The effectiveness of a specialised oral nutrition supplement on outcomes in patients with chronic wounds: a pragmatic randomised study. J Hum Nutr Diet. 2013 Oct;26(5):452-8.
  8. Vadillo-Ortega F, Perichart-Perera O, Espino S, et al. Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial. BMJ. 2011 May 19;342:d2901.
  9. Camarena Pulido EE, García Benavides L, Panduro Barón JG, et al. Efficacy of L-arginine for preventing preeclampsia in high-risk pregnancies: A double-blind, randomized, clinical trial. Hypertens Pregnancy. 2016;35(2):217-25.
  10. Yokota T, Hamauchi S, Yoshida Y, et al. A phase II study of HMB/Arg/Gln against oral mucositis induced by chemoradiotherapy for patients with head and neck cancer. Support Care Cancer. 2018;26(9):3241-3248.
  11. Gallo L, Pecoraro S, Sarnacchiaro P, Silvani M, Antonini G. The daily therapy with L-arginine 2,500 mg and tadalafil 5 mg in combination and in monotherapy for the treatment of erectile dysfunction: A prospective, randomized multicentre study. Sex Med. 20
  12. El-Wakeel LM, Fouad FA, Saleem MD, Saber-Khalaf M. Efficacy and tolerability of sildenafil/l-arginine combination relative to sildenafil alone in patients with organic erectile dysfunction. Andrology. 2020;8(1):143-147.
  13. de la Parra PR, González-Cruz MÁ, Ferreiro-Marin A, Casaubón-Garcín PR. L-arginine-induced esophagitis, report of six cases. Bol Med Hosp Infant Mex. 2020;77(1):38-41.
  14. Binet Q, Dufour I, Agneessens E, et al. The second case of a young man with L-arginine-induced acute pancreatitis. Clin J Gastroenterol. 2018;11(5):424-427.
  15. Tenenbaum A, Fisman EZ, Motro M. L-arginine: Rediscovery in progress. Cardiology 1998;90:153-9.
  16. Anon. Arginine hydrochloride injection (marketed as R-Gene 10). FDA Drug Safety Newsletter 2009;2(2):16-18. Available at: www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/default.htm.
Gout Renal
Niacin-induced flushing Other
Pruritus Dermatologic

Orally, arginine can cause flushing, rash, and hives. The skin reactions were likely of allergic etiology as oral L-arginine has been associated with eosinophilia. In one case report, intravenous administration caused allergic reactions including urticaria, periorbital edema, and pruritus. Excessively rapid infusion of L-arginine has caused flushing, local venous irritation, numbness. Extravasation has caused necrosis and superficial phlebitis.

  1. 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.
  2. Fontanive P, Saponati G, Iurato A, et al. Effects of L-arginine on the Minnesota Living with Heart Failure Questionnaire quality-of-life score in patients with chronic systolic heart failure. Med.Sci.Monit. 2009;15:CR606-11.
  3. Gallo L, Pecoraro S, Sarnacchiaro P, Silvani M, Antonini G. The daily therapy with L-arginine 2,500 mg and tadalafil 5 mg in combination and in monotherapy for the treatment of erectile dysfunction: A prospective, randomized multicentre study. Sex Med. 20
  4. Liao SY, Showalter MR, Linderholm AL, et al. l-Arginine supplementation in severe asthma. JCI Insight. 2020;5(13):e137777.
  5. Resnick DJ, Softness B, Murphy AR, et al. Case report of an anaphylactoid reaction to arginine. Ann Allergy Asthma Immunol 2002;88:67-8.
  6. Tenenbaum A, Fisman EZ, Motro M. L-arginine: Rediscovery in progress. Cardiology 1998;90:153-9.
  7. Anon. Arginine hydrochloride injection (marketed as R-Gene 10). FDA Drug Safety Newsletter 2009;2(2):16-18. Available at: www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/default.htm.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no single official dose of L-arginine that fits all uses, and the amounts used in studies have varied widely. Because of this, a standardized dose is often not established.

The best approach is to follow the directions on the product label and to start with the lowest reasonable amount. A pharmacist can help you decide whether a product and dose make sense for your situation.

Do not assume that more is better. Higher doses are more likely to cause stomach upset and other side effects.

Pregnancy & Breastfeeding

L-arginine & Pregnancy

Possibly Safe

When used orally and appropriately, short-term. L-arginine 12 grams daily for 2 days has been used with apparent safety in pregnancy during the third trimester. L-arginine 3 grams daily has been taken safely during the second and/or third trimesters. ...when used intravenously and appropriately, short-term. Intravenous L-arginine 20-30 grams daily has been used safely in pregnancy for up to 5 days.

  1. 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.
  2. Rytlewski, K., Olszanecki, R., Korbut, R., and Zdebski, Z. Effects of prolonged oral supplementation with l-arginine on blood pressure and nitric oxide synthesis in preeclampsia. Eur.J Clin.Invest 2005;35(1):32-37.
  3. Goto E. Effects of prenatal oral L-arginine on birth outcomes: a meta-analysis. Sci Rep 2021;11(1):22748.
  4. Monari F, Menichini D, Pignatti L, Basile L, Facchinetti F, Neri I. Effect of L-arginine supplementation in pregnant women with chronic hypertension and previous placenta vascular disorders receiving Aspirin prophylaxis: a randomized control trial. Minerv
  5. Facchinetti, F., Longo, M., Piccinini, F., Neri, I., and Volpe, A. L-arginine infusion reduces blood pressure in preeclamptic women through nitric oxide release. J Soc Gynecol.Investig. 1999;6(4):202-207.
  6. Neri, I., Blasi, I., and Facchinetti, F. Effects of acute L-arginine infusion on non-stress test in hypertensive pregnant women. J Matern.Fetal Neonatal Med. 2004;16(1):23-26.
  7. Neri, I., Jasonni, V. M., Gori, G. F., Blasi, I., and Facchinetti, F. Effect of L-arginine on blood pressure in pregnancy-induced hypertension: a randomized placebo-controlled trial. J Matern.Fetal Neonatal Med. 2006;19(5):277-281.
  8. Facchinetti, F., Saade, G. R., Neri, I., Pizzi, C., Longo, M., and Volpe, A. L-arginine supplementation in patients with gestational hypertension: a pilot study. Hypertens.Pregnancy. 2007;26(1):121-130.

L-arginine & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 66 references that drive our L-arginine monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. 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.
  2. 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. PubMed
  3. Tenenbaum A, Fisman EZ, Motro M. L-arginine: Rediscovery in progress. Cardiology 1998;90:153-9.
  4. Brittenden J, Park KGM, Heys SD, et al. L-Arginine stimulates host defenses in patients with breast cancer. Surgery 1994;115:205-12.
  5. 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. DOI
  6. 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.
  7. 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. PubMed
  8. Cheng JW, Balwin SN. L-arginine in the management of cardiovascular diseases. Ann Pharmacother 2001;35:755-64. PubMed
  9. 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. DOI
  10. 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.. PubMed
  11. 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.
  12. Resnick DJ, Softness B, Murphy AR, et al. Case report of an anaphylactoid reaction to arginine. Ann Allergy Asthma Immunol 2002;88:67-8. PubMed
  13. Anon. Arginine hydrochloride injection (marketed as R-Gene 10). FDA Drug Safety Newsletter 2009;2(2):16-18. Available at: www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/default.htm.
  14. 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.
  15. Facchinetti, F., Longo, M., Piccinini, F., Neri, I., and Volpe, A. L-arginine infusion reduces blood pressure in preeclamptic women through nitric oxide release. J Soc Gynecol.Investig. 1999;6(4):202-207. DOI
Keep reading

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.

Parts of this content are provided by the Therapeutic Research Center, LLC.

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.

© 2021 Therapeutic Research Center, LLC

Product directory

Supplement products with L-arginine

26 products in our database contain L-arginine. Open any to see its full ingredient list and every drug interaction we check.

Pharmacist Counseling Corner

L-arginine: Common Questions

What is L-arginine used for, and does it work?
People use L-arginine for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting L-arginine for Angina, Erectile dysfunction (ED), Necrotizing enterocolitis (NEC) and Peripheral arterial disease (PAD). For most other uses it has been studied for, the evidence is currently insufficient to rate. See the graded list on this page, and always confirm with your pharmacist or doctor.
Does L-arginine interact with prescription medications?
Yes. We list 403 medications with a known interaction with L-arginine. Use the checker above to see how L-arginine interacts with a specific drug.
How are L-arginine interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take L-arginine with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this L-arginine interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is L-arginine used for?
People most commonly use it for blood pressure, erectile dysfunction, and exercise performance, mainly because it helps the body make nitric oxide, which relaxes blood vessels. The evidence is mixed, and it is stronger for some uses than others.
Is L-arginine safe?
It is generally well tolerated in healthy adults for short-term use, but it can lower blood pressure and may not be safe for people with heart disease or after a heart attack. Check with a pharmacist or doctor before using it.
Can I get L-arginine from food instead of a supplement?
Yes. L-arginine is found in protein-rich foods like meat, poultry, fish, dairy, nuts, and beans, and most people get enough from a normal diet.
What are the most common side effects?
The most common side effects are digestive, such as stomach upset, bloating, nausea, and diarrhea, and some people may feel dizzy because it can lower blood pressure.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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