Arginine (arginine)

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Arginine hydrochloride is administered by IV infusion via an indwelling needle or soft catheter into the antecubital or other suitable vein. Because of its hypertonicity, the injection should only be injected IV.

For use in acute hyperammonemia, 10% arginine hydrochloride should be administered through a central IV line. The drug may be mixed in the same infusion container with sodium phenylacetate and sodium benzoate; however, other infusion solutions and drug products should not be admixed with the drugs.

Arginine hydrochloride injection should be inverted and inspected visually prior to administration to ensure that the solution is clear. The manufacturer states that warming the injection prior to use is not necessary, but solutions that are not clear or containers lacking a vacuum should be discarded.

No dosing information is available for this tab.

No dosing information is available for this tab.

Estrogens and estrogen-progestin combination oral contraceptives may elevate growth hormone response, and reduce glucagon and insulin response to arginine. Reduction of arginine-induced growth hormone response by medroxyprogesterone acetate and of insulin response by norethindrone has also been reported.

Plasma insulin concentrations following arginine stimulation may be further elevated by thiazide diuretics, xylitol, and aminophylline. The latter 2 drugs may also reduce glucagon response to arginine.

Long-term administration of sulfonylurea oral antidiabetic agents may suppress plasma glucagon response to arginine. In one study, phenytoin reduced the plasma insulin response to arginine when glucose intolerant patients were given a glucose load.

Severe, potentially fatal, hyperkalemia has occurred following arginine hydrochloride therapy for metabolic alkalosis in several patients with severe hepatic disease who had recently received spironolactone. Severe hyperkalemia, requiring treatment, developed within several hours after initiating arginine therapy; spironolactone had been discontinued 2-3 days prior to initiation of arginine. Death occurred in one patient subsequent to ventricular tachycardia and asystole despite attempts to decrease serum potassium concentrations and treat cardiac abnormalities. Severe hyperkalemia in these patients probably resulted from an arginine-induced extracellular shift of potassium from cells, impaired hepatic metabolism of arginine, and/or a spironolactone-induced decrease in renal excretion of the ion; spironolactone's effect on potassium persists for several days following discontinuance of the drug. Patients receiving a potassium-sparing diuretic are at increased risk of arginine-induced hyperkalemia, and therefore combined use of the drugs should be avoided.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

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There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

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