| Name | L-Lysine |
| Uses | Essential amino acid used to support immune function, particularly for patients prone to herpes simplex virus (HSV) outbreaks. May also support collagen synthesis, skin health, and general immune resilience. Commonly included in wellness IVs for immune boosting, skin rejuvenation, and overall wellness support. |
| Route Of Administration | Intravenous (IV) |
| Frequency Of Use | Typically administered once weekly for immune and skin support. During active viral outbreaks, may be given up to twice weekly for 2 to 4 weeks, followed by reassessment. Long-term use should be re-evaluated every 8 to 12 weeks. |
| Concentration(s) | Common compounded concentrations range from 50 mg/mL to 100 mg/mL. |
| Maximum Dosage (Day, Wk) (g/mL)/mL | Maximum dose per infusion: 1,000 mg (1 g). Maximum weekly dose: 2,000 mg (2 g). Higher doses are not recommended for elective wellness patients without clear medical justification. |
| Contraindications | Severe renal impairment (due to potential amino acid accumulation). Severe hepatic impairment. Known hypersensitivity to L-lysine or any component of the formulation. Active hypercalcemia (lysine may enhance calcium absorption). Pregnancy and breastfeeding unless cleared by OB provider. |
| Possible Side Effects | Nausea, vomiting, or abdominal discomfort during or after infusion. Flushing or mild dizziness. Headache. Injection site irritation. Rare: allergic reactions (rash, itching, hypersensitivity). |
| Compatibility With Other Drugs | Compatible with normal saline and D5W. Should not be mixed directly with calcium-containing solutions. May be combined with other amino acids or vitamins in wellness IV formulations, but compatibility must always be verified prior to mixing. |
| Allergies | True allergy to L-lysine is rare. Reactions are more often linked to preservatives or stabilizers in compounded formulations. |
| Administration Time | Typical infusion time: 30 to 45 minutes for doses between 500 mg and 1,000 mg. Infusing too rapidly may increase the risk of nausea or flushing. |
| IV Dosing | For general immune or skin support: 500 mg to 1,000 mg IV once weekly. For acute viral outbreak support: 1,000 mg IV up to twice weekly for 2 to 4 weeks, followed by reassessment. Long-term use should be periodically reviewed. |
| IM/Push | May be given as a slow IV push for doses up to 500 mg over 5 to 10 minutes. Higher doses should be given via drip to improve tolerability. IM administration is possible but less preferred due to local irritation and variability in absorption. |
| What To Do If Adverse Reaction Occurs | 1. Stop the infusion immediately. 2. Assess vital signs (blood pressure, heart rate, oxygen saturation). 3. If nausea, dizziness, or flushing occurs, place the patient in a comfortable position and offer oral fluids if tolerated. 4. For allergic reactions (rash, itching, shortness of breath), administer antihistamines and consider epinephrine if severe. 5. If symptoms persist or worsen, arrange for emergency transfer to a higher level of care (call 911 if necessary). |