Levocarnitine

Revision as of 21:26, 26 January 2019 by Bmurray990 (talk | contribs) (Administration)
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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