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Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Compatibility And Stability Powers J, Samaan K. Malnutrition in the ICU patient population. Crit Care Nurs Clin. 2014;26(2):227–42.
Mahmoodpoor A, Shokouhi G, Hamishehkar H, Soleimanpour H, Sanaie S, Porhomayon J, et al. A pilot trial of L-carnitine in patients with traumatic brain injury: effects on biomarkers of injury. J Crit Care. 2018;45:128–32. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran Acemetacin may decrease the excretion rate of Levocarnitine which could result in a higher serum level. Carnitine occurs in two main forms: D-carnitine and L-carnitine. They are isomers (or mirror images) of each other. L-carnitine, or levocarnitine, is the active form found in the body that transports fat to cells to be used as fuel in metabolic processes. D-carnitine does not occur naturally in humans. L-carnitine is synthesized in the brain, liver, and kidneys from the amino acids methionine and lysine and is critical to heart and brain function, muscle movement, and several other body processes. Insufficient carnitine can lead to problems in the liver, heart, and muscles. What Is Carnitine Prescribed For? Haghighatdoost F, Jabbari M, Hariri M. The effect of L-carnitine on inflammatory mediators: a systematic review and meta-analysis of randomized clinical trials. Eur J Clin Pharmacol. 2019;75(8):1037–46.
Acetaminophen may decrease the excretion rate of Levocarnitine which could result in a higher serum level.
The recommended dose of Carnitor is 50 mg/kg given as a slow 2-3 minute bolus injection or by infusion. What Drugs, Substances, or Supplements Interact with Carnitor Injection? CARNITOR ® Injection is compatible and stable when mixed in parenteral solutions of Sodium Chloride 0.9% or Lactated Ringer's in concentrations ranging from 250 mg/500 mL (0.5 mg/mL) to 4200 mg/500 mL (8.0 mg/mL) and stored at room temperature (25°C) for up to 24 hours in PVC plastic bags. HOW SUPPLIED Transient nausea and vomiting have been observed. Less frequent adverse reactions are body odor, nausea, and gastritis. An incidence for these reactions is difficult to estimate due to the confounding effects of the underlying pathology. Levocarnitine was not bound to plasma protein or albumin when tested at any concentration or with any species including the human. 9 Hou JW: Primary systemic carnitine deficiency presenting as recurrent Reye-like syndrome and dilated cardiomyopathy. Chang Gung Med J. 2002 Dec;25(12):832-7. [ Article]
Pediatric Use
Friedrich A, Prasad PD, Freyer D, Ganapathy V, Brust P: Molecular cloning and functional characterization of the OCTN2 transporter at the RBE4 cells, an in vitro model of the blood-brain barrier. Brain Res. 2003 Apr 4;968(1):69-79. [ Article] Brooks, H., Goldberg L., Holland, R. et al. 1977. Carnitine-induced effects on cardiac and peripheral hemodynamics. J. Clin. Pharmacol. 17:561-568.
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 accumulation of the potentially toxic metabolites, trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), since these metabolites are normally excreted in the urine. Carcinogenesis, Mutagenesis, Impairment Of Fertility
During pregnancy, Carnitor should be used only if prescribed. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding. Additional Information Lahjouji K, Elimrani I, Wu J, Mitchell GA, Qureshi IA: A heterozygote phenotype is present in the jvs +/- mutant mouse livers. Mol Genet Metab. 2002 May;76(1):76-80. [ Article] Levocarnitine may decrease the excretion rate of Aclidinium which could result in a higher serum level. Reproductive studies have been performed in rats and rabbits at doses up to 3.8 times the human dose on the basis of surface area and have revealed no evidence of impaired fertility or harm to the fetus due to CARNITOR ®. There are, however, no adequate and well controlled studies in pregnant women. levocarnitine) is a naturally occurring substance required in mammalian energy metabolism. It has been shown to facilitate long-chain fatty acid entry into cellular mitochondria, thereby delivering substrate for oxidation and subsequent energy production. Fatty acids are utilized as an energy substrate in all tissues except the brain. In skeletal and cardiac muscle, fatty acids are the main substrate for energy production.
After one week of CARNITOR ® therapy (3 doses), all patients had trough concentrations between 54 and 180 μmol/L (normal 40-50 μmol/L) and concentrations remained relatively stable or increased over the course of the study.It is recommended that a plasma carnitine concentration be obtained prior to beginning this parenteral therapy. Weekly and monthly monitoring is recommended as well. This monitoring should include blood chemistries, vital signs, plasma carnitine concentrations (the plasma free carnitine concentration should be between 35 and 60 μmol/L) and overall clinical condition. ESRD Patients On Hemodialysis International/Other Brands Albicar (Casasco) / Aveptol (Leovan Pharmaceuticals) / Biocarn (Medice) / Bitobionil (S.J.A.) / Cardimax (Integrated) / Cardispan (Grossman) / Carniben (Bennett Pharmaceuticals) / Carnicor (Sigma Tau) / Lecarna (Bennett Pharmaceuticals) Brand Name Prescription Products Name Rebouche, C.J. and Engel, A.G. 1983. Carnitine metabolism and deficiency syndromes. Mayo Clin. Proc. 58:533-540.
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