Levocarnitine

Levocarnitine is a prescription medication used for treating carnitine deficiency and end-stage renal disease.

• Levocarnitine is available under the following different brand names: Carnitor, carnitine

Adult and pediatric dosage

Tablets

• 250mg
• 330mg
• Capsule
• 250mg

Oral solution

• 1g/10mL

Injectable solution

• 200mg/mL

Carnitine Deficiency

Adult and pediatric dosage

• Tablet: 990 mg orally every 8-12 hours, up to 3 g/day
• Oral solution: 1000 mg/day orally initially divided
• 50 mg/kg IV bolus, THEN 50 mg/kg over next 24 hr (divided every 3-6 hours)

End-Stage Renal Disease

Adult and pediatric dosage

• Initial dose: 10-20 mg/kg IV bolus infused over 2-3 minutes; administer into venous return line after a dialysis session

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Levocarnitine include:

• upset stomach,
• nausea,
• vomiting,
• diarrhea,
• headache,
• muscle pain,
• weakness,
• swelling of the hands, lower legs, or feet,
• tingling skin, and
• body odor ("fishy" smell).

Serious side effects of Levocarnitine include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• severe dizziness,
• seizure, and
• itching

Rare side effects of Levocarnitine include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Levocarnitine has severe interactions with no other drugs.
• Levocarnitine has serious interactions with no other drugs.
• Levocarnitine has moderate interactions with the following drug:
  • warfarin
• Levocarnitine has minor interactions with at least 24 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• None listed by the manufacturer

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Levocarnitine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Levocarnitine?”

Cautions

• Monitor blood chemistries, plasma carnitine concentration, vital signs
• INR may increase in patients receiving warfarin therapy; monitor INR levels following initiation of levocarnitine therapy and after dose adjustments
• GI reactions may occur from too rapid consumption of carnitine
• Carcinogenic potential unknown
• Serious hypersensitivity reactions, including rash, urticarial, and facial edema reported; serious reactions, including anaphylaxis, laryngeal edema, and bronchospasm reported following intravenous administration, mostly in patients with end-stage renal disease undergoing dialysis; discontinue use and instruct patients to seek medical attention if they experience symptoms suggestive of a hypersensitivity reaction;
• Oral administration
  • Gastrointestinal reactions may result from a too rapid consumption of carnitine; oral Solution and sugar-free; the oral solution may be consumed alone, or dissolved in drinks or other liquid foods to reduce taste fatigue; they should be consumed slowly and doses should be spaced evenly throughout the day to maximize tolerance
  • The safety and efficacy of oral levocarnitine has not been evaluated in patients with renal insufficiency chronic administration of high doses of oral levocarnitine in patients with severely compromised renal function or in ESRD patients on dialysis may result in the accumulation of potentially toxic metabolites, trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), since these metabolites are normally excreted in the urine

Pregnancy and Lactation

• There are no adequate and well-controlled studies on pregnant women.
• Lactation
  • Supplementation in nursing mothers has not been specifically studied; studies in dairy cows indicate that the concentration of levocarnitine in milk is increased following exogenous administration of levocarnitine
  • In nursing mothers receiving levocarnitine, any risks to the child of excess carnitine intake need to be weighed against benefits of drug supplementation to the mother; consideration may be given to discontinuation of nursing or of levocarnitine treatment