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levocarnitine

A16AA01

Forms & Strengths

Oral solution: 100 mg/mL
Tablets: 330 mg
Solution for injection: 1 g/5 mL (200 mg/mL)

Adult Dosing

Primary carnitine deficiency (oral): 990 mg to 3 g daily in divided doses
Secondary carnitine deficiency (oral): 1 g to 3 g daily in divided doses
End-stage renal disease / hemodialysis (IV): 10 mg/kg to 20 mg/kg dry body weight administered IV at the end of each dialysis session

Pediatric Dosing

Primary carnitine deficiency (oral): 50 mg/kg to 100 mg/kg daily in divided doses (up to 3 g/day)
Secondary carnitine deficiency (oral): 50 mg/kg to 100 mg/kg daily in divided doses
End-stage renal disease / hemodialysis (IV, neonates/infants/children): 10 mg/kg to 20 mg/kg IV post-dialysis

Indications

Primary carnitine deficiency
Secondary carnitine deficiency associated with inborn errors of metabolism
Prevention and treatment of carnitine deficiency in patients with end-stage renal disease undergoing hemodialysis

Mechanism of Action

Essential cofactor in intermediary metabolism required for the transport of long-chain fatty acids across the inner mitochondrial membrane
Facilitates beta-oxidation of fatty acids and subsequent energy production
Modulates the acylCoA/CoA ratio in cells and removes toxic acyl groups

Contraindications

Hypersensitivity to levocarnitine or any component of the formulation

Adverse Reactions

Nausea
Vomiting
Abdominal cramps
Diarrhea
Body odor (fishy odor)
Seizures (in patients with pre-existing seizure disorders)
Hypertension
Gastritis

Drug Interactions

Acenocoumarol / Warfarin: Increased INR and risk of bleeding reported when co-administered with oral levocarnitine
Valproic acid: May precipitate or worsen carnitine deficiency; concurrent use increases hepatotoxicity risk
Glucocorticoids: May increase renal clearance of carnitine

Curated Content: Needs Vetting Before Put to Clinical Use