Usage
L-Lysine Monohydrochloride is primarily prescribed as a dietary supplement for preventing and treating lysine deficiency. It is also used for treating herpes simplex labialis (cold sores). Its pharmacological classification can be considered as a dietary supplement/essential amino acid. It acts by providing the essential amino acid lysine, which is crucial for protein synthesis and various metabolic functions. Lysine’s antiviral activity against herpes simplex may be due to its interference with arginine, another amino acid the virus requires to replicate.
Alternate Names
- L-2,6-Diaminohexanoic acid monohydrochloride
- Lysine HCl
- Lysine monohydrochloride
Brand names include Super Lysine Plus. (Please note this information is from the provided source material dated 2024. Brand names may vary based on region and availability. Always consult up-to-date local resources for accurate brand information).
How It Works
Pharmacodynamics: Lysine is incorporated into proteins and plays a role in calcium absorption, collagen formation, and hormone and enzyme production. It also affects carnitine levels which play a role in fatty acid metabolism for energy production. Regarding herpes simplex, lysine appears to inhibit viral replication by competing with arginine.
Pharmacokinetics: Lysine is absorbed in the small intestine via active transport. The amount of lysine absorbed can be affected by other amino acids consumed simultaneously. It is metabolized within the body via various pathways and is not stored as free lysine. Elimination pathways have not been clearly defined in the provided sources.
Mode of Action: At the cellular level, lysine is a building block of proteins and influences various metabolic processes. In herpes simplex, it likely competes with arginine, hindering viral replication. Receptor binding, enzyme inhibition, or neurotransmitter modulation concerning lysine’s general metabolic role and its effect on herpes simplex are not specified within the provided resources. Elimination pathways including renal/hepatic excretion, metabolism by CYP enzymes have not been detailed within the provided source material.
Dosage
Standard Dosage
Adults:
Oral dosages for cold sores range from 1000 mg once daily to 1000 mg three times a day. For prevention, 500-1248 mg daily or 1000 mg three times daily. Doses up to 3000 mg daily have been used for up to a year. Topical application is also an option for cold sores.
Children:
Dosage recommendations for children are not consistently provided in the available sources. One source estimates 12 mg/kg of body weight for adults and 44 mg/kg for children 11 to 12 years old. Another source mentions 97 mg/kg for infants 3 to 6 months old. It is important to consult with a pediatrician before giving lysine to children. Some sources advise against lysine supplementation for children.
Special Cases:
- Elderly Patients: Dose adjustments are not specifically addressed for elderly patients in the available sources. Clinical judgment based on kidney and liver function is advisable.
- Patients with Renal Impairment: Dosage adjustments are not specifically addressed in the source materials. However, given potential interactions with aminoglycoside antibiotics which affect kidney function, it is crucial to exercise caution. Monitor patients with existing renal impairment.
- Patients with Hepatic Dysfunction: Dosage adjustments are not specifically addressed in the sources. General caution is advised in patients with hepatic impairment.
- Patients with Comorbid Conditions: No specific dosage adjustments are found in the sources. Caution is recommended for patients with kidney or liver problems. Monitor cholesterol levels in patients taking lysine. Patients recovering from severe injuries may need a higher daily intake.
Clinical Use Cases
The provided sources do not contain dosage recommendations for L-Lysine in the clinical use cases you specified: intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations.
Dosage Adjustments
The sources do not offer specific dose modifications for renal/hepatic dysfunction, metabolic disorders, or genetic polymorphisms affecting drug metabolism. Clinical judgment based on patient-specific factors is crucial.
Side Effects
Common Side Effects
Stomach pain and diarrhea are the most commonly mentioned side effects.
Rare but Serious Side Effects
Chronic renal failure and interstitial nephritis have been mentioned, though the direct causality is not explicitly established within the sources.
Long-Term Effects
Not specified in the sources.
Adverse Drug Reactions (ADR)
No specific ADRs are mentioned in the provided sources.
Contraindications
The sources do not mention specific contraindications for lysine. However, caution is advised for individuals with kidney or liver disease, and pregnant or breastfeeding women. One source specifically mentions avoiding lysine supplements in these groups. Children with lysinuric protein intolerance should also avoid lysine supplementation.
Drug Interactions
Lysine may interact with arginine, potentially reducing the body’s ability to utilize arginine for circulatory function. A significant interaction is with aminoglycoside antibiotics (like streptomycin and neomycin), potentially leading to kidney damage. Lysine might reduce the effects of 5-HT4 agonist gastrointestinal drugs. As lysine increases calcium absorption, monitor calcium intake. The effect of food, alcohol, or smoking with lysine is not mentioned within the sources.
Pregnancy and Breastfeeding
Lysine supplementation is generally not recommended during pregnancy and breastfeeding due to lack of sufficient safety data.
Drug Profile Summary
- Mechanism of Action: Provides essential amino acid for protein synthesis; may inhibit herpes simplex replication by competing with arginine.
- Side Effects: Stomach pain, diarrhea. Rarely: chronic renal failure, interstitial nephritis.
- Contraindications: Use with caution in patients with kidney or liver issues and pregnant or breastfeeding women.
- Drug Interactions: Arginine, aminoglycoside antibiotics, 5-HT4 agonist gastrointestinal drugs, calcium supplements.
- Pregnancy & Breastfeeding: Avoid use.
- Dosage: Variable depending on indication and individual factors. See Dosage section.
- Monitoring Parameters: Monitor kidney function if using aminoglycoside antibiotics concurrently; monitor cholesterol levels; monitor calcium levels if supplementing calcium.
Popular Combinations
The sources do not list specific common drug combinations for lysine. Some sources recommend using vitamin C and zinc supplements in addition to lysine for boosting the immune system, particularly when treating cold sores.
Precautions
- General Precautions: Assess kidney and liver function, especially if using aminoglycoside antibiotics. Screen for lysinuric protein intolerance in children before supplementation. Monitor cholesterol levels and calcium intake.
- Specific Populations: Avoid use in pregnancy and breastfeeding. Exercise caution in children and elderly individuals, and individuals with renal or hepatic impairments.
- Lifestyle Considerations: Effects of alcohol, smoking, and specific dietary interactions (other than concurrent protein intake) with lysine are not detailed in the sources.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for L-Lysine Monohydrochloride?
A: The dosage varies considerably depending on the intended use and individual patient factors. For cold sores, it can range from 1000 mg daily to 1000 mg three times a day. For prevention of cold sores, 500–1248 mg daily or 1000 mg three times daily might be used. Always consult with a healthcare professional for personalized recommendations.
Q2: What is the role of lysine in protein synthesis?
A: Lysine is an essential amino acid, meaning the body cannot produce it, and it must be obtained through diet or supplementation. It is a crucial building block for proteins, playing a fundamental role in protein synthesis.
Q3: How might lysine help with cold sores?
A: Lysine is thought to inhibit the replication of the herpes simplex virus, possibly by interfering with arginine, another amino acid crucial for viral replication.
Q4: Can lysine be used during pregnancy or while breastfeeding?
A: Due to limited safety data, it is generally recommended to avoid lysine supplementation during pregnancy and breastfeeding. Consult with a healthcare provider for guidance.
Q5: Are there any known drug interactions with lysine?
A: Yes, lysine can interact with arginine, aminoglycoside antibiotics, and 5-HT4 agonist gastrointestinal drugs. It also increases calcium absorption, hence calcium intake should be monitored. It is important to disclose all medications and supplements to your doctor to assess potential interactions.
Q6: What are the potential side effects of lysine supplementation?
A: The most common side effects are stomach pain and diarrhea. Rare but serious side effects might include chronic renal failure and interstitial nephritis.
Q7: Is lysine effective for any other conditions besides cold sores?
A: While lysine is being explored for various other uses (such as athletic performance, diabetes, and canker sores), there isn’t enough conclusive scientific evidence to support its widespread use for these conditions.
Q8: How is lysine metabolized and eliminated from the body?
A: Lysine is absorbed in the small intestine and metabolized via various pathways within the body. The specifics of its elimination have not been fully detailed in the available sources.
Q9: Can children take lysine supplements?
A: Some sources recommend specific dosages for children based on body weight, while others advise against lysine supplementation in children. Consult with a pediatrician before administering lysine to a child.
Q10: Can I take lysine if I have kidney problems?
A: Caution is advised for individuals with kidney or liver diseases due to possible complications and potential drug interactions. Consult with a healthcare professional.
