Carnitine Injection

Overview of Carnitine Injection

Dosage Strength

500 mg/mL 10 mL Vial
500 mg/mL 30 mL Vial

General Information

The amino acids methionine and lysine are used to make levocarnitine (L-3-hydroxy-4-N-trimethylaminobutyrate). This naturally occurring chemical is found in all mammalian tissues, particularly striated muscle, and is essential in energy metabolism, such as fatty acid oxidation, carbohydrate aerobic metabolism, and the excretion of certain organic acids. While only the L isomer exists in the biological system, commercial carnitine production yields a D,L racemic mixture from which the L-isomer is produced. The D-isomer has pharmacologic effects but is not involved in lipid metabolism. Carnitine is offered commercially as both a prescription and non-prescription substance. Levocarnitine is the prescription variant, but most dietary supplements contain D,L-carnitine, which is widely available at health food stores.

Levocarnitine has been used to treat primary and secondary carnitine deficiency in adults and neonates, Alzheimer’s disease, adult and pediatric dilated cardiomyopathy, valproic acid-induced hepatotoxicity, and hyperlipoproteinemia. It has been categorized as an orphan medication for a number of medical disorders. Its effectiveness in alcohol-induced fatty liver, Down’s syndrome, and chronic fatigue syndrome has been mixed. Carnitine supplements are used by some athletes to improve exercise performance; however, the notion of carnitine loading does not appear to be very beneficial. 1 Furthermore, D,L-carnitine inhibits levocarnitine competitively. This inhibition could result in a deficit. The FDA approved prescription formulations of levocarnitine in 1985 (tablets), 1986 (oral solution), and 1992. (injection).

References

1.Brass EP. Supplemental carnitine and exercise. Am J Clin Nutr 2000;72(suppl):618S-623S.
2.Carnitor (levocarnitine) injection package insert. Gaithersburg, MD: Sigma Tau Pharmaceuticals; 2015 Apr.
3.Carnitor (levocarnitine) tablets, oral solution, and sugar-free oral solution package insert. Gaithersburg, MD: Sigma Tau Pharmaceuticals; 2015 Apr.

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