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Indications

Levocarnitine (L-carnitine) is used to treat carnitine deficiency. This can be primary (an inherited condition) or secondary, for example in people on long-term kidney dialysis, in some inherited metabolic disorders, and in people taking Valproic Acid for a long time. It is also sold as a nutritional supplement.

How It Works

Carnitine carries fats into the mitochondria, the energy-making parts of cells, so they can be burned for energy. This is especially important for the heart and muscles. It also helps the body remove some harmful by-products of metabolism.

Dosage and Administration

Adults, by mouth: commonly 1 to 3 g a day, split into two or three doses with or after meals, or as prescribed. Children and inherited metabolic disorders: dosed by body weight, as prescribed. Injection (for example after dialysis): given by a doctor or nurse, as prescribed. Oral solution can be mixed with a drink or food to improve the taste; take doses slowly and spread through the day to reduce stomach upset.

Interactions

• It may increase the effect of blood thinners such as Warfarin and Acenocoumarol; blood clotting tests may need checking.
• Valproic Acid, Pivampicillin-type antibiotics and some other medicines lower carnitine levels, which is one reason it is prescribed.

Contraindications

Allergy to levocarnitine or any ingredient of the product.

Side Effects

Common: nausea, vomiting, stomach cramps and diarrhoea, which are often dose related. Some people notice a fishy body odour. Seizures have been reported, mainly in people with a history of seizures.

Get urgent medical help if you have: a fit (seizure) or more frequent fits; or signs of a serious allergic reaction, such as swelling of the face, lips or throat, trouble breathing or a widespread rash.

Pregnancy and Lactation

Carnitine is a natural part of the body and diet, but there is limited information on medicine doses in pregnancy and breastfeeding. Use only if the doctor advises.

Precautions and Warnings

• People with severe kidney disease or on dialysis should use the oral form only as prescribed, as by-products can build up with high oral doses.
• Tell the doctor about any history of seizures.
• People with diabetes may need closer sugar monitoring.
• Do not use D-carnitine or mixed DL-carnitine products in place of levocarnitine.

Overdose

Too much may cause diarrhoea, stomach upset and a fishy body odour. Seek medical advice if symptoms are severe.

Therapeutic Class

Amino acid derivative; nutritional and metabolic agent.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep oral solution tightly closed and use it within the time stated on the label after opening.