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Citrulline has been used as an oral (by mouth) supplement for many years, without reports of serious safety concerns. Although side effects of citrulline are uncommon, there have been some reports of mild symptoms such as nausea, indigestion, and diarrhea.
Contraindications
A contraindication is a treatment, medication, or procedure (such as surgery) that is not recommended because of a high potential of causing harm to the patient. This means that in specific conditions (such as pregnancy) a medication, supplement, or procedure should not be given/performed. It may also indicate that two specific medications (including prescription drugs, over the counter medications and natural supplements) should not be given together. Contraindications for L-citrulline include:
- Pregnancy (there is not enough clinical research data to prove the safety of citrulline during pregnancy).
- Breastfeeding (there is not enough clinical research data to prove the safety of citrulline during breastfeeding).
Those who are taking certain prescription drugs should not take citrulline, these include:
- Phosphodieterase-5 inhibitors (medication for erectile dysfunction such as Viagra and Levitra) because both L-citrulline and phosphodieterase-5 inhibitors can lower blood pressure and the combination of these two medications together can cause hypotension (low blood pressure)
- Nitrates (drugs that increase the blood flow to the heart): Taking nitrate medications (often used to treat angina) along with citrulline may result in an increase in blood flow to the heart that could cause side effects such as headaches, flushing, dizziness, fainting, low blood pressure (hypotension), or irregular heart rhythms (arrhythmia). Nitrate drugs include Dilatrate-SR and Isordil (isosorbide dinitrate), ISMO (isosorbide mononitrate), and Nitro-Dur, Nitrolingual or Nitrostat (nitrogylcerin).
- Antihypertensive drugs (high blood pressure medications) such as Norvasc or Lotrel (amlodipine), Cardizem CD, Cardizem SR, Dilacor XR, or Tiazac (diltiazem), Calan SR ( verapamil), HydroDIURIL (hydrochlorothiazide), Lasix (furosemide), and more.
Other prescription medications could interact with citrulline and it could have a negative impact on certain clinical states (such as those with associated hypotension), hence its possible use should be discussed with a physician. *