Sildenafil / Aminophylline / Arginine Cream

Available Dosage Strengths

2% / 3% / 6%

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Disclaimer: Images are for reference only; actual products may vary.

Product Overview

Compounded Sildenafil_Aminophylline_Arginine Cream is a topical formulation designed to enhance female sexual arousal and genital sensitivity. It combines three active agents—sildenafil, aminophylline, a phosphodiesterase inhibitor, and L-arginine, a nitric oxide precursor. The combination of ingredients may improve blood flow to the genital tissues. This cream is typically applied to the vulvar or clitoral area before sexual activity to promote arousal, increase lubrication, and enhance orgasmic response in women experiencing Female Sexual Arousal Disorder (FSAD) or other forms of sexual dysfunction. 1-9

Sildenafil1-5

Sildenafil, a phosphodiesterase type 5 (PDE5) inhibitor, has a half-life of 4 hours. Clinically, the drug is used to treat erectile dysfunction and pulmonary hypertension. Studies have shown it may be beneficial for female sexual arousal disorder. Orally, because of the half-life, the drug is used “on-demand” prior to sexual activity.

Aminophylline6,7

Aminophylline is a complex of theophylline and ethylenediamine. This combination enhances the drugs solubility. Aminophylline has been used historically for asthma and chronic obstructive pulmonary disease and apnea of prematurity. It is thought to have vasodilatory activity. The drug may also have cardiac and diuretic effects. It may have several modes of activity in the body including 1) inhibition of type III or type IV phosphodiesterase (PDE), increased expression of calcium ion concentration in smooth muscle, inhibition of histamine release and antagonizing adenosine.

Arginine8,9

L-Arginine, an essential amino acid, is converted to nitric oxide. It is naturally found in red meat, poultry, fish, and dairy. Nitric oxide has been found to be a powerful vasodilator and neurotransmitter. Arginine supports protein synthesis, immune function and wound healing.

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.1

Common  (topically) 5,7,8,9

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

Rare

  • Anaphylactoid reactions, exfoliative dermatitis (ethylenediamine)

Oral (sildenafil)  

  • Flushing
  • Dyspepsia
  • Nasal congestion
  • Dizziness

 

Contraindications:  5,7,8,9

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

Precautions:

  • 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 may not cover all possible drug information about this product. 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 Wells Pharmacy Network pharmacist will be happy to answer any questions. For consultation, please call 1-800-622-4510.

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