Difference between revisions of "Levocarnitine"

(Created page with "==Administration== *Type: amino-acid derivative, Antidote *Dosage Forms: IV, tablet, oral solution *Routes of Administration: IV, oral *Common Trade Names: ==Adult Dosin...")
 
(Administration)
 
(2 intermediate revisions by 2 users not shown)
Line 1: Line 1:
 
==Administration==
 
==Administration==
 
*Type: amino-acid derivative, [[Antidote]]
 
*Type: amino-acid derivative, [[Antidote]]
*Dosage Forms: IV, tablet, oral solution
+
*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==
Line 9: Line 9:
 
*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 prn
+
**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.  
+
**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
Line 34: Line 34:
 
==Pharmacology==
 
==Pharmacology==
 
*Half-life: 17.4h
 
*Half-life: 17.4h
*Metabolism:  
+
*Metabolism: Hepatic
 
*Excretion: Mostly renal
 
*Excretion: Mostly renal
  

Latest revision as of 21:26, 26 January 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

Comments

See Also

References