Sildenafil / Aminophylline / Arginine

Cream

2% / 3% / 6%

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Product Overview

Sildenafil / Aminophylline / Arginine Description1-9

Compounded Sildenafil_Aminophylline_Arginine Cream is a topical formulation intended to support female sexual arousal and genital sensitivity. It contains three active ingredients: sildenafil, aminophylline (a phosphodiesterase inhibitor), and L-arginine (a nitric oxide precursor). This combination may help improve blood flow to the genital tissues. The cream is typically applied to the vulvar or clitoral area before sexual activity to promote arousal, enhance lubrication, and support orgasmic response in women experiencing Female Sexual Arousal Disorder (FSAD) or other sexual dysfunctions.

Sildenafil1-5

Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor with a half-life of approximately 4 hours. It is clinically used to treat erectile dysfunction and pulmonary hypertension. Research indicates it may also support female sexual arousal. Due to its half-life, oral sildenafil is typically used “on-demand” before sexual activity.

Aminophylline6,7

Aminophylline is a complex of theophylline and ethylenediamine, which improves its solubility. Historically, aminophylline has been used for asthma, chronic obstructive pulmonary disease, and apnea of prematurity. It is thought to have vasodilatory activity and may also exert cardiac and diuretic effects. Its actions in the body may include inhibition of type III or IV phosphodiesterase (PDE), increasing calcium ion concentration in smooth muscle, inhibiting histamine release, and antagonizing adenosine.

Arginine8,9

L-Arginine is an essential amino acid converted in the body to nitric oxide, a potent vasodilator and neurotransmitter. It is naturally present in red meat, poultry, fish, and dairy, and also supports protein synthesis, immune function, and wound healing.

References

  1. Sildenafil Prescribing Information – Pfizer. www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf Revised March 2014. Accessed May 31, 2025
  2. Clinical Pharmacology Sildenafil clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  3. Smith BP, Babos M. Sildenafil. [Updated 2023 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558978/  
  4. Alatas E, Yagci AB. The effect of sildenafil citrate on uterine and clitoral arterial blood flow in postmenopausal women. MedGenMed. 2004 Oct 13;6(4):51. PMID: 15775878; PMCID: PMC1480594.
  5. Thurman AR, Johnson I, Cornell KA, Hatheway J, Kim NN, Parish SJ, Dart C, Friend DR, Goldstein A. Safety of topical sildenafil cream, 3.6% in a randomized, placebo-controlled trial for the treatment of female sexual arousal disorder. J Sex Med. 2024 Sep 3;21(9):793-799.
  6. Jilani TN, Preuss CV, Sharma S. Theophylline. StatPearls. May 1, 2023. Accessed August 7, 2025
  7. Clinical Pharmacology Aminophylline clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  8. L-Arginine – Patient Handout; NatMed Pro; 2025; https://naturalmedicines-therapeuticresearch-com.lp.hscl.ufl.edu/databases/food,-herbs-supplements/patienthandout.aspx?productid=875&lang=en
  9. Oyovwi MO, Atere AD. Exploring the medicinal significance of l-Arginine mediated nitric oxide in preventing health disorders. European Journal of Medicinal Chemistry Reports.Volume 12,2024:100175.

Sildenafil1-4

Phosphodiesterase (PDE) has many isoforms and is an enzyme that has many functions in the body including degrading the effect of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). PDE5 is an enzyme that is found in many parts of the body including in the smooth muscle of the corpus cavernosum, prostate, bladder, the vascular and visceral smooth muscle, skeletal muscle, urethra, platelets, kidney, lung, cerebellum, heart, liver, testis, seminal vesicle, and pancreas. Sildenafil is structurally similar to cGMP and prevents degradation of cGMP by competitively binding and inhibiting activity of PDE5. When PDE5 is inhibited, cGMP accumulates and leads to smooth muscle relaxation. Studies have shown that sildenafil facilitates the relaxation of the clitoral corpus cavernosum through the nitric oxide-cGMP pathway. This may improve genital blood flow and vaginal engorgement.

Aminophylline6,7

Phosphodiesterase activity-Inhibits phosphodiesterase (PDE), leading to increased intracellular cyclic AMP (cAMP) levels. Elevated cAMP may promote smooth muscle relaxation and vasodilation, improving blood flow to applied areas.

Nonselective adenosine receptor antagonist-It acts on A1, A2, and A3 receptors with similar affinity which may explain the drug’s cardiac effects. Adenosine-mediated channels also increase the contraction force of diaphragmatic muscles by enhancing their calcium uptake.

Arginine8,9

L-Arginine is necessary for making proteins and is commonly used to promote circulation. The body converts arginine to nitric oxide (NO) through the action of nitric oxide synthase which may relax blood vessels, allowing blood to flow.

Adverse Reactions5,7,8,9

Common (topically)

  • Application site erythema
  • Application site discomfort
  • Itching, burning
  • Rash, pruritic
  • Headache

Rare

  • Anaphylactoid reactions, exfoliative dermatitis (ethylenediamine)

Oral (sildenafil)  

  • Flushing
  • Dyspepsia
  • Nasal congestion
  • Dizziness

 

Contraindications5,7,8,9

  • Known hypersensitivity or intolerance to sildenafil, aminophylline or arginine
  • Use of nitrates and alpha-blockers due to risk of life-threatening hypotension

Precautions5,7,8,9

  • Use with caution in patients with:
  • Severe hepatic impairment (Child-Pugh Class C)
  • Severe renal impairment (creatinine clearance <30 mL/min)
  • History of NAION (non-arteritic anterior ischemic optic neuropathy)
  • Recent history of myocardial infarction, stroke, or unstable angina

Store at 20–25°C (68–77°F). Protect from excessive heat, light, and moisture.

  1. Sildenafil Prescribing Information – Pfizer. www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf Revised March 2014. Accessed May 31, 2025
  2. Clinical Pharmacology Sildenafil clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  3. Smith BP, Babos M. Sildenafil. [Updated 2023 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558978/  
  4. Alatas E, Yagci AB. The effect of sildenafil citrate on uterine and clitoral arterial blood flow in postmenopausal women. MedGenMed. 2004 Oct 13;6(4):51. PMID: 15775878; PMCID: PMC1480594.
  5. Thurman AR, Johnson I, Cornell KA, Hatheway J, Kim NN, Parish SJ, Dart C, Friend DR, Goldstein A. Safety of topical sildenafil cream, 3.6% in a randomized, placebo-controlled trial for the treatment of female sexual arousal disorder. J Sex Med. 2024 Sep 3;21(9):793-799.
  6. Jilani TN, Preuss CV, Sharma S. Theophylline. StatPearls. May 1, 2023. Accessed August 7, 2025
  7. Clinical Pharmacology Aminophylline clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  8. L-Arginine – Patient Handout; NatMed Pro; 2025; https://naturalmedicines-therapeuticresearch-com.lp.hscl.ufl.edu/databases/food,-herbs-supplements/patienthandout.aspx?productid=875&lang=en
  9. Oyovwi MO, Atere AD. Exploring the medicinal significance of l-Arginine mediated nitric oxide in preventing health disorders. European Journal of Medicinal Chemistry Reports.Volume 12,2024:100175.
This information is for educational purposes only.
This compounded product has not been reviewed, approved, or evaluated by the Food and Drug Administration for safety and effectiveness. This product is not intended to diagnose, treat, cure, or prevent any disease. No claims are made regarding treatment, cure, or prevention of any disease or condition.
This information is a summary. It may not cover all possible drug information about this product. For complete product information, refer to the manufacturer’s prescribing information and labeling. Call your doctor for medical advice and/or about side effects. You may report side effects to the FDA at 1-800-FDA-1088. A WP Pharma Labs pharmacist will be happy to answer any questions. For consultation, please call 1-800-441-0048.

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