Questions Regarding Arginine Hydrochloride Inhalation

Abstract

With regard to the recent study of Dietzsch et al.1 on the use of arginine hydrochloride inhalation in cystic fibrosis patients, I wish to point out that these investigators acted irresponsibly in exposing their patients for an appreciable period (seven weeks) to a preparation which is known to be irritating. They chose to disregard published instructions which are devised to protect the patients.2 Specifically, they used sodium hydroxide instead of arginine free base for neutralization to obtain a solution which was about three times as acid at pH 7.0 as the recommended solution (pH 7.4 to 7.6). In addition to exposing their patients to this hazard, they also leave the reader with the mistaken impression that the previously reported arginine treatment is dangerous or ineffective.