Arginine glutamate

Summary

Arginine glutamate is a salt of L-arginine and L-glutamic acid used primarily as a hepatoprotective and detoxifying agent. It is used clinically for hepatic encephalopathy, ammonia toxicity, and as a nutritional supplement in some jurisdictions. It promotes ammonia metabolism through the urea cycle and supports nitrogen homeostasis.

Mechanism of Action

Arginine serves as a precursor to nitric oxide via nitric oxide synthase, supporting vasodilation and ammonia detoxification via the urea cycle; glutamate participates in nitrogen metabolism, neurotransmission, and protein synthesis. Together they provide synergistic support for hepatic ammonia clearance and nitrogen balance.

Routes of Administration

Goals & Uses

• Nitrogen balance supportNutritional SupportLow
• Liver protection / hepatoprotectionHepatologyLow
• Hepatic encephalopathy managementHepatologyModerate
• Nitric oxide precursor supportCardiovascularLow
• Ammonia detoxificationMetabolic SupportModerate

Contraindications

• Severe renal failureRenal ImpairmentHigh
• Severe metabolic alkalosisElectrolyte/acid Base DisorderModerate
• HyperargininemiaMetabolic DisorderHigh
• Known hypersensitivity to arginine or glutamateAllergyHigh

Adverse Effects

• Injection site reactionsLocalUncommon
• HypotensionCardiovascularUncommonLow blood pressure
• FlushingVascularUncommonWarmth and redness of the skin
• Nausea and vomitingGastrointestinalCommon
• HyperkalemiaElectrolyte ImbalanceUncommon

Drug Interactions

• Antihypertensive agentsLow
• Potassium-sparing diuretics / ACE inhibitorsModerate
• Lysine supplementsLow

Population Constraints

• PregnancyReproductive SafetyRelative
• Pediatric patientsAgeRelative
• Patients with active herpes simplex infectionInfectious DiseaseRelative

Regulatory Status

• European UnionApprovedApproved: Hepatic encephalopathy, Hyperammonemia supportApproved in some EU member states (e.g., Ukraine, Romania) as a pharmaceutical; not centrally approved by EMA.
• United StatesUnapprovedNot FDA-approved as a drug. Constituent amino acids are available as dietary supplements (GRAS status).
• United KingdomUnknownNo specific MHRA approval identified for arginine glutamate as a pharmaceutical entity.

Approved in several European and Asian countries as a parenteral or oral hepatoprotective agent. Not independently FDA-approved in the United States as a drug, though its constituent amino acids are GRAS. Available as a pharmaceutical product (e.g., Glutargin) in Ukraine and some Eastern European countries.

Evidence & Sources

No sources recorded yet.