Carnitine (Solution, Concentrate) Instructions for Use

ATC Code

A16AA01 (Levocarnitine)

Active Substance

Carnitine (Rec.INN registered by WHO)

Clinical-Pharmacological Group

A drug that improves tissue metabolism and energy supply

Pharmacotherapeutic Group

Metabolic agent

Pharmacological Action

A means for the correction of metabolic processes. It has an anabolic, antihypoxic, and antithyroid effect, activates fat metabolism, stimulates regeneration, and increases appetite.

Carnitine is a natural substance related to B vitamins. It is a co-factor of metabolic processes that maintain the activity of coenzyme A. It reduces the basal metabolic rate and slows down the breakdown of protein and carbohydrate molecules.

It promotes the penetration through mitochondrial membranes and the breakdown of long-chain fatty acids with the formation of acetyl-CoA (necessary for ensuring the activity of pyruvate carboxylase in the process of gluconeogenesis, the formation of ketone bodies, the synthesis of choline and its esters, oxidative phosphorylation, and the formation of ATP).

It mobilizes fat (due to the presence of 3 labile methyl groups) from fat depots. By competitively displacing glucose, it activates the fatty acid metabolic shunt, the activity of which is not limited by oxygen (unlike aerobic glycolysis), which is why the drug is effective in conditions of acute hypoxia (including cerebral hypoxia) and other critical conditions.

It has a neurotrophic effect, inhibits apoptosis, limits the area of damage, and restores the structure of nervous tissue. It normalizes protein and fat metabolism, and the increased basal metabolism in thyrotoxicosis (being a partial antagonist of thyroxine). It restores the alkaline reserve of the blood.

It reduces the formation of keto acids, increases tissue resistance to the influence of toxic breakdown products, activates anaerobic glycolysis, and stimulates and accelerates reparative processes.

It increases the threshold of resistance to physical exertion, reduces the degree of lactate acidosis, and restores working capacity after prolonged physical exertion. At the same time, it promotes economical consumption of glycogen and increases its reserves in the liver and muscles.

It does not affect the blood coagulation system.

Pharmacokinetics

After intravenous administration, it is almost completely eliminated from the blood within 3 hours. It easily penetrates the liver and myocardium, and more slowly into the muscles. It is excreted by the kidneys mainly in the form of acyl esters.

Indications

As part of complex therapy: ischemic stroke (in the acute, recovery periods), transient cerebrovascular accident, dyscirculatory encephalopathy, traumatic and toxic brain lesions.

Primary and secondary carnitine deficiency.

As a cardioprotector during treatment with cytostatics, especially those of the anthracycline series.

ICD codes

Dosage Regimen

Administer intravenously by slow drip infusion only. Do not administer by rapid intravenous injection.

For adult patients, the typical daily dose is 0.5-1 g. Adjust the exact dosage based on the specific indication and individual patient response.

For the treatment of primary carnitine deficiency, administer a dose of 50 mg/kg/day. Titrate the dose based on clinical response and tolerance, with a maximum dose of 300 mg/kg/day.

When used as a cardioprotector during anthracycline-based chemotherapy, administer a single dose of 1-2 g/m² prior to the cytostatic infusion.

For pediatric patients with growth retardation, base the dose on body weight. The typical dose is 50-100 mg/kg/day.

Determine the duration of treatment individually based on the underlying condition and therapeutic goals. For acute conditions, the course may be shorter; for chronic deficiencies, long-term therapy may be required.

Dilute the required dose in a suitable volume of 0.9% Sodium Chloride or 5% Dextrose solution prior to administration. Inspect the final solution for particulate matter or discoloration; discard if present.

Monitor patients for signs of efficacy and potential adverse reactions, particularly during dose titration and long-term use.

Adverse Reactions

Possible allergic reactions, muscle weakness in patients with uremia.

Contraindications

Hypersensitivity to carnitine.

Use in Pregnancy and Lactation

No specific studies on the safety of use during pregnancy and lactation have been conducted. If it is necessary to use in this category of patients, the expected benefit of therapy for the mother should be weighed against the potential risk to the fetus or breastfed infant.

Pediatric Use

Can be used for growth retardation in children.

Special Precautions

Can be used for anorexia, hypotrophy, growth retardation in children.

Drug Interactions

Corticosteroids promote the accumulation of carnitine in tissues (except the liver).

Other anabolic agents enhance the effect of carnitine.

Storage Conditions

Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Rx Only

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.