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levocarnitine

Pronunciation

Generic Name: levocarnitine (oral) (LEE voe KAR ni teen)
Brand Name: Carnitor, L-Carnitine

What is levocarnitine?

Levocarnitine is a naturally occurring substance that the body needs for energy.

Levocarnitine is used to treat carnitine deficiency.

Levocarnitine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about levocarnitine?

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What should I discuss with my healthcare provider before taking levocarnitine?

To make sure levocarnitine is safe for you, tell your doctor if you have:

  • kidney disease (or if you are on dialysis);

  • a history of seizures; or

  • if you use a blood thinner (warfarin, Coumadin, Jantoven) and you have routine "INR" or prothrombin time tests.

Levocarnitine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether levocarnitine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I take levocarnitine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

The liquid medicine can be taken alone or mixed with a beverage or soft food. Sip or eat the mixture slowly.

Levocarnitine should be taken at evenly spaced intervals every 3 or 4 hours. This medicine works best if you take it with a meal or within 30 minutes after a meal.

While using levocarnitine, you may need frequent blood tests.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking levocarnitine?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Levocarnitine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • a seizure (convulsions).

Common side effects may include:

  • stomach pain;

  • nausea, vomiting; or

  • diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Levocarnitine dosing information

Usual Adult Dose for Carnitine Deficiency:

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)

Usual Pediatric Dose for Carnitine Deficiency:

METABOLIC DISORDERS:
Oral solution or tablets:
Initial dose: 50 mg/kg/day orally in evenly divided doses
Maintenance dose: 50 to 100 mg/kg/day orally in evenly divided doses
Maximum dose: 3 grams per day

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)

What other drugs will affect levocarnitine?

Other drugs may interact with levocarnitine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

See also: Side effects (in more detail)

Where can I get more information?

  • Your pharmacist can provide more information about levocarnitine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.03.

Date modified: October 13, 2017
Last reviewed: June 15, 2015

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