Arginine


Concise Prescribing Info
Indications/Uses
Evaluation of pituitary growth hormone reserve.
Dosage/Direction for Use
Adult : IV As 10% solution: 30 g as a single dose given over 30 minutes. May repeat test after 24 hours.
Dosage Details
Intravenous
Evaluation of pituitary growth hormone reserve
Adult: As 10% solution: 30 g as a single dose given via infusion over 30 minutes. May repeat test after 24 hours.
Child: <60 kg As 10% solution: 0.5 g/kg given via infusion over 30 minutes. Max: 30 g/dose; ≥60 kg As 10% solution: Same as adult dose. May repeat test after 24 hours.
Reconstitution
Dilute with appropriate amount of NaCl 0.9% or glucose 5% inj to provide a final concentration of 10%.
Contraindications
Hypersensitivity. Severe acidosis, hypotension or diseases related to nitric oxide production.
Special Precautions
Patient with electrolyte imbalance, anuria. Moderate renal and severe hepatic impairment. Children. Pregnancy and lactation. Not intended for therapeutic use.
Adverse Reactions
Significant: Local venous irritation, haematuria, decreased platelet count, extravasation (e.g. burn-like reaction).
Gastrointestinal disorders: Nausea, vomiting.
Metabolism and nutrition disorders: Rarely, severe hyperkalaemia.
Nervous system disorders: Headache, numbness.
Vascular disorders: Flushing. Rarely, hypotension.
Potentially Fatal: Extravasation (e.g. skin necrosis). Rarely, severe allergic reactions (e.g. anaphylaxis, rash).
IV/Parenteral: B
MonitoringParameters
Monitor blood pressure during use and for 24 hours after completion of infusion.
Overdosage
Symptoms: Metabolic acidosis with hyperventilation, cerebral oedema, hypotension, anaphylaxis, death. Management: Supportive therapy. Correct acidosis by a calculated dose of an alkalising agent.
Drug Interactions
Potentially Fatal: May cause severe hyperkalaemia with spironolactone in patient with severe hepatic impairment.
Action
Description: Arginine is an essential amino acid that stimulates the pituitary release of human growth hormone (hGH) and prolactin that may be used, instead of, or in addition to other diagnostic tests. It is also an important constituent for the storage and excretion of ammonia in the urea cycle and an acidifying agent in cases of severe metabolic alkalosis.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: Approx 20-30 minutes.
Distribution: Enters breast milk. Volume of distribution: Approx 33 L/kg.
Metabolism: Extensively metabolised in the liver and intestines via hydrolytic cleavage by the guanidine group to ornithine and urea.
Excretion: Via urine (16% during the 1st 90 minutes). Elimination half-life: 42 ± 2 minutes.
Chemical Structure

Chemical Structure Image
Arginine

Source: National Center for Biotechnology Information. PubChem Database. Arginine, CID=6322, https://pubchem.ncbi.nlm.nih.gov/compound/Arginine (accessed on Jan. 21, 2020)

Storage
Store at 25°C.
ATC Classification
B05XB01 - arginine hydrochloride ; Belongs to the class of amino acids solutions used in I.V. solutions.
References
Anon. Arginine. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 13/04/2018.

Anon. Arginine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 13/04/2018.

Buckingham R (ed). Arginine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/04/2018.

R-Gene 10 (Pharmacia and Upjohn Company LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 13/04/2018.

Disclaimer: This information is independently developed by MIMS based on Arginine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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