Levocarnitine (Systemic)
   
Levocarnitine (Systemic)
US Brand Names
• Carnitor
Canadian Brand Names
• Carnitor
Another commonly used name is L-carnitine .
Description
Levocarnitine (lee-voe-KAR-ni-teen) is used to prevent and treat a lack of carnitine. It is used to prevent and treat this condition in patients with kidney disease on dialysis. It is given to people whose body cannot properly use carnitine from their diet. Lack of carnitine can lead to liver, heart, and muscle problems. Your doctor may treat lack of carnitine by prescribing levocarnitine for you.
Carnitine comes in two forms. Levocarnitine (L-carnitine) should not be confused with the D,L-carnitine form (labeled as "vitamin BT"'). Only the L-form of carnitine is used by the body to treat serious carnitine deficiency. The D,L-form does not help the body use fat and can actually interfere with and cause a lack of levocarnitine.
Certain levocarnitine products have been specifically approved by the U.S. Food and Drug Administration for medical use and are available only with your doctor's prescription. Other levocarnitine products are sold without a prescription as food supplements and should not be used to treat serious levocarnitine deficiency.
Levocarnitine is available by prescription in the following dosage forms:
Oral
• Solution (U.S. and Canada)
• Tablets (U.S. and Canada)
Parenteral
• Injection (U.S. and Canada)
Special Considerations
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For levocarnitine, the following should be considered:
Allergies
Tell your health care professional if you are allergic to any substances, such as foods, preservatives, or dyes.
Pregnancy
Studies have not been done in humans. However, levocarnitine has not been shown to cause birth defects or other problems in animal studies.
Breast-feeding
It is not known whether levocarnitine passes into the breast milk. Carnitine normally is present in breast milk, even in women not taking supplements of it, because it is obtained from the diet.
Children
Although there is no specific information comparing use of levocarnitine in children with use in other age groups, this dietary supplement is not expected to cause different side effects or problems in children than it does in adults.
Older adults
There is no specific information comparing use of levocarnitine in the elderly with use in other age groups; however, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.
Other medicines
Although certain medicines should not be used together at all, in other cases they may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Other medical problems
The presence of other medical problems may affect the use of levocarnitine. Make sure you tell your doctor if you have any other medical problems, especially:
• Seizures-occur more often and are more severe in patients with a history of seizure activity
• Severe renal dysfunction-administration of high doses of oral levocarnitine for long periods of time may build up in the body of patients with severe kidney disease
Administration
Take levocarnitine with or just after meals. Also, if you are taking it in liquid form, drink it slowly. It will be less likely to upset your stomach if you take it this way. The liquid form may be taken alone or dissolved in drink or other liquid food.
This medicine is also less likely to cause unwanted effects when there is a constant amount in the blood. If you are taking more than one dose a day, take the doses at evenly spaced times throughout the day. Doses should be spaced at least 3 to 4 hours apart. If you need help in planning the best times to take your medicine, check with your health care professional.
Dosing
The dose of levocarnitine will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of levocarnitine. If your dose is different, do not change it unless your doctor tells you to do so.
The number of tablets or of teaspoonfuls of solution that you take or the number of injections you receive depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking levocarnitine .
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 .
• For oral dosage form (solution):
o To prevent or treat carnitine deficiency:
§ Adults and teenagers-At first, 1 gram taken once a day with food. Your doctor may change the dose if needed.
§ Children-The dose is based on body weight and must be determined by your doctor. The usual dose at first is 50 mg per kg (22.7 mg per pound) of body weight a day, divided into smaller amounts with meals. Your doctor may change the dose if needed.
• For oral dosage form (tablets):
o To prevent or treat carnitine deficiency:
§ Adults and teenagers-990 milligrams taken two or three times a day with meals.
§ Children-The dose is based on body weight and must be determined by your doctor. The usual dose at first is 50 mg per kg (22.7 mg per pound) of body weight a day, divided into smaller amounts with meals. Your doctor may change the dose if needed.
• For injection dosage form:
o To treat carnitine deficiency:
§ Adults and children-The dose is based on body weight and must be determined by your doctor. The usual dose is 50 mg per kg (22.7 mg per pound) of body weight a day injected into a vein. Your doctor may change the dose if needed.
o To prevent and treat carnitine deficiency in kidney disease patients on hemodialysis:
§ Adults and children-10 to 20 mg per kg of body weight a day, after dialysis. The dose may be reduced based on laboratory test results, after 3 to 4 weeks of therapy.
Missed dose
If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Taking doses too close together may increase stomach upset.
Storage
To store this medicine:
• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Store at room temperature. Do not refrigerate.
• Do not keep outdated medicines or those no longer needed. Be sure that any discarded medicine is out of the reach of children.
Precautions
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.
Side Effects
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:
More common
High blood pressure.
Less common
Fast heartbeat; fever.
Rare
Seizures.
The following side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of these effects continue or are bothersome:
More common
Abdominal or stomach cramps; diarrhea; headache; nausea or vomiting.
Less common
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 above may also occur in some patients. If you notice any other effects, check with your doctor.
Additional Information
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, levocarnitine is used in certain patients with the following medical condition:
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use.
August 01, 2001 
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