Levocarnitine: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: amino-acid derivative, [[Antidote]] | *Type: amino-acid derivative, [[Antidote]] | ||
*Dosage Forms: IV | *Dosage Forms: Capsule 250mg, 330mg; Solution (PO) 1g/10mL; Solution (IV) 200mg/mL | ||
*Routes of Administration: IV, oral | *Routes of Administration: IV, oral | ||
*Common Trade Names: | *Common Trade Names: Carnitor | ||
==Adult Dosing== | ==Adult Dosing== | ||
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*Primary carnitine deficiency: 990mg tablet or 1g solution PO 1-3 times per day | *Primary carnitine deficiency: 990mg tablet or 1g solution PO 1-3 times per day | ||
*Carnitine deficiency due to inborn error of metabolism | *Carnitine deficiency due to inborn error of metabolism | ||
**Initial: 50 mg/kg (max 300mg) IV bolus, repeat daily | **Initial: 50 mg/kg (max 300mg) IV bolus, repeat daily PRN | ||
**Severe metabolic crisis: 50 mg/kg IV (max 300mg) IV bolus, then repeat 50mg/kg IV over 24h in divided doses. Repeat 50mg/kg IV daily | **Severe metabolic crisis: 50 mg/kg IV (max 300mg) IV bolus, then repeat 50mg/kg IV over 24h in divided doses. Repeat 50mg/kg IV daily PRN. | ||
**990mg tablet or 1g solution PO 1-3 times per day | **990mg tablet or 1g solution PO 1-3 times per day | ||
*Carnitine deficiency due to ESRD: 10 to 20 mg/kg (dry weight) after HD, subsequent dosing determent by pre-HD levels of levocarnitine | *Carnitine deficiency due to ESRD: 10 to 20 mg/kg (dry weight) after HD, subsequent dosing determent by pre-HD levels of levocarnitine | ||
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==Pharmacology== | ==Pharmacology== | ||
*Half-life: 17.4h | *Half-life: 17.4h | ||
*Metabolism: | *Metabolism: Hepatic | ||
*Excretion: Mostly renal | *Excretion: Mostly renal | ||
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<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:FEN]] | |||
[[Category:Toxicology]] | |||
Latest revision as of 22:53, 22 September 2019
Administration
- Type: amino-acid derivative, Antidote
- Dosage Forms: Capsule 250mg, 330mg; Solution (PO) 1g/10mL; Solution (IV) 200mg/mL
- Routes of Administration: IV, oral
- Common Trade Names: Carnitor
Adult Dosing
- Valproic acid toxicity: 100mg/kg IV bolus, followed by 50mg/kg Q8h or alternatively 50mg/kg/day IV in 3 divided doses
- Primary carnitine deficiency: 990mg tablet or 1g solution PO 1-3 times per day
- Carnitine deficiency due to inborn error of metabolism
- Initial: 50 mg/kg (max 300mg) IV bolus, repeat daily PRN
- Severe metabolic crisis: 50 mg/kg IV (max 300mg) IV bolus, then repeat 50mg/kg IV over 24h in divided doses. Repeat 50mg/kg IV daily PRN.
- 990mg tablet or 1g solution PO 1-3 times per day
- Carnitine deficiency due to ESRD: 10 to 20 mg/kg (dry weight) after HD, subsequent dosing determent by pre-HD levels of levocarnitine
Pediatric Dosing
- IV dosing: same as adult dosing
- PO dosing: 50 mg/kg PO
Special Populations
- Pregnancy Rating: B
- Lactation risk: Infant risk cannot be ruled out
- Renal dosing: dosing not established, may be more prone to accumulation of toxic metabolites
- Hepatic dosing: no adjustment
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Seizure
Common
- Nausea/vomiting, diarrhea, stomach cramps
Pharmacology
- Half-life: 17.4h
- Metabolism: Hepatic
- Excretion: Mostly renal
Mechanism of Action
- Amino-acid found normally in humans: facilitates entry of long-chain fatty acids into cellular mitochondria
- Increases valproate metabolism