Carnitine

In the U.S.

• Carnitine
• Carnitor

Available Dosage Forms:

• Capsule
• Tablet
• Solution
• Wafer
• Powder

Therapeutic Class: Amino Acid Supplement

Do not change brands or dosage forms of levocarnitine without first checking with your doctor. Different products may not work in the same way. If you refill your medicine and it looks different, check with your pharmacist.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• High blood pressure

• Fast heartbeat
• fever

• Seizures

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Abdominal or stomach cramps
• diarrhea
• headache
• nausea or vomiting

• Abdominal discomfort
• body odor
• depression
• dizziness
• impaired vision
• loss of appetite or weight
• swelling in hands, lower legs, and feet
• tingling sensation
• weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Consult your pharmacist.

How to use Carnitine Powder

Consult your pharmacist.

Consult your pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

METABOLIC DISORDERS:
Primary or secondary carnitine deficiency:
Oral solution:
Initial dose: 1 gram orally daily in evenly spaced divided doses (every 3 to 4 hours)
Maintenance dose: 1 to 3 grams orally daily in evenly spaced divided doses (every 3 to 4 hours)

Oral tablets:
990 mg orally 1 to 3 times a day, depending on clinical response

Intravenous solution:
50 mg/kg as a slow 2 to 3 minute bolus or by infusion, once a day
-A loading dose may be given in severe metabolic crisis, followed by an equivalent dose every 3 to 4 hours (but not less often than every 6 hours) over the following 24 hours
-Subsequent daily doses should be in the range of 50 mg/kg or as therapy may require
-The highest dose administered has been 300 mg/kg.


END STAGE RENAL PATIENTS ON HEMODIALYSIS
Intravenous solution:
Initial dose: 10 to 20 mg/kg as a slow 2 to 3 minute bolus injection into the venous return line after each dialysis session
-Consider therapy for pre-dialysis trough levels of plasma carnitine below normal (40 to 50 micromol/L).
-Dose adjustments should be guided by pre-dialysis levocarnitine trough levels.
-Downward dose adjustments may be made as early as the third or fourth week of treatment.

Comments:
-Increase dose slowly while assessing tolerance and therapeutic response.
-Periodically monitor blood chemistries, vital signs, plasma carnitine concentrations, and overall clinical condition.
-Administer higher doses with caution and only where clinical and biochemical considerations make it likely that higher doses will be beneficial.
-In some patients, particularly those presenting with cardiomyopathy, supplementation may rapidly alleviate signs and symptoms.
-Treatment should include supportive and other therapy as indicated by the patient's condition.

Uses:
-Primary systemic carnitine deficiency
-Acute and chronic treatment of inborn errors of metabolism resulting in secondary carnitine deficiency
-Prevention and treatment of carnitine deficiency in end stage renal disease patients undergoing dialysis (IV form only)

Data not available

Use is not recommended unless clearly needed. US FDA pregnancy category: B Comments: -Stopping treatment in a pregnant woman with primary systemic carnitine deficiency may carry serious consequences; the risk of stopping treatment may outweigh the theoretical risks to the fetus of continuing.

Animal studies showed no evidence of impaired fertility or fetal harm, however at 600 mg/kg daily there was a statistically insignificant increase in post implantation losses. There are no controlled data in human pregnancy. US FDA pregnancy category B: Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

Substance Name

Levocarnitine

CAS Registry Number

541-15-1; 3040-38-8; 3040-38-8; 17298-37-2

Drug Class

Complementary Therapies