Home Drug Guide Levocarnitine

Drug Guide

Generic Name

Levocarnitine

Brand Names Carnitor, Carnitor Sf, Levocarnitine Sf

Classification

Therapeutic: Nutritional supplement / Amino acid metabolism modifier

Pharmacological: Carnitine analog, Acyl-CoA dehydrogenase substrate

FDA Approved Indications

  • Treatment of primary systemic carnitine deficiency
  • Secondary carnitine deficiency (e.g., resulting from inborn errors of metabolism, dialysis, or certain medications)

Mechanism of Action

Levocarnitine facilitates the transport of long-chain fatty acids into mitochondria for beta-oxidation, thus aiding in energy production, and helps to remove accumulated acyl groups in cases of deficiency or toxicity.

Dosage and Administration

Adult: Typically 50-100 mg/kg/day divided into 2-4 doses; doses may vary based on indication and clinical response.

Pediatric: Dose is usually 50-100 mg/kg/day divided into 2-4 doses, adjusted based on weight and response.

Geriatric: No specific dose adjustment unless renal or hepatic impairment is present.

Renal Impairment: Adjust dose based on severity of renal impairment; cautious use recommended.

Hepatic Impairment: Use with caution; no specific guidelines established.

Pharmacokinetics

Absorption: Good oral absorption.

Distribution: Widely distributed in tissues, especially muscle and heart.

Metabolism: Minimal hepatic metabolism.

Excretion: Renal excretion of unchanged drug.

Half Life: Approximately 17 hours in healthy individuals.

Contraindications

  • Hypersensitivity to levocarnitine.

Precautions

  • Caution in patients with renal impairment, as clearance may be reduced.
  • Use with caution in hepatic impairment.
  • Monitor for potential hypersensitivity reactions.

Adverse Reactions - Common

  • Gastrointestinal disturbances (nausea, vomiting, diarrhea) (Common)
  • Body odor and skin odor (Less common)

Adverse Reactions - Serious

  • Allergic reactions including rash, urticaria, and anaphylaxis (Rare)
  • Seizures (in overdose or when administered with other medications lowering seizure threshold) (Rare)

Drug-Drug Interactions

  • Valproic acid – may enhance risk of seizures or alter levocarnitine levels

Drug-Food Interactions

  • No significant interactions reported

Drug-Herb Interactions

  • Limited data; consult clinical guidance

Nursing Implications

Assessment: Monitor for signs of deficiency, adverse reactions, and efficacy (improvement in symptoms).

Diagnoses:

  • Impaired nutritional status
  • Risk for hypersensitivity reactions

Implementation: Administer as prescribed; monitor serum levels if indicated; monitor renal function.

Evaluation: Assess for improvement in energy metabolism and reduction of symptoms related to deficiency.

Patient/Family Teaching

  • Take levocarnitine exactly as prescribed.
  • Report any signs of allergic reactions or unusual body odor.
  • Maintain regular follow-up appointments to monitor treatment response.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: Consider genetic testing in cases of suspected primary carnitine deficiency.

Lab Test Interference: May alter serum lipid profiles; interpret with clinical context.

Overdose Management

Signs/Symptoms: Nausea, vomiting, diarrhea, hypoglycemia, potential seizures

Treatment: Supportive care; dialysis in severe cases; no specific antidote.

Storage and Handling

Storage: Store at room temperature between 20-25°C (68-77°F), protected from light.

Stability: Stable for the duration of the labeled shelf life when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.