Levocarnitine (L-carnitine) is a substance produced by the liver from the amino acids methionine and lysine and found naturally in mammalian muscle. It is required in the conversion of macronutrients into cellular energy. Levocarnitine acts by transporting fatty acids to the location within the mitochondria to be broken down and used as energy.
Carnitine manufactured in the laboratory yields a D,L mixture, where D is the right hand and L is the left hand of the compound. Only the L form is present in the body. The D form exerts effects on the body but does not contribute to the metabolism of lipids. Since the D,L form is a competitive inhibitor of levocarnitine, supplementing with D,L-Carnitine may lead to levocarnitine deficiency.
Research suggests choline supplementation may increase the utilization of levocarnitine as well as the removal of fatty acids, thereby reducing serum and urinary carnitine levels.1 Therefore, those taking MIC injections may find benefit with the addition of L-carnitine as a means of maintaining adequate levels of the substance.
Levocarnitine is designated as an orphan drug by the FDA for the treatment in patients with end stage renal impairment who are undergoing dialysis, those with primary systemic carnitine deficiency, and those with secondary carnitine deficiency.
Levocarnitine has also been used clinically in the treatment of Alzheimer’s disease, dilated cardiomyopathy, valproic acid-induced hepatotoxicity, and hyperlipoproteinemia. Levocarnitine used for the treatment of alcohol induced fatty liver, Down’s syndrome, and chronic fatigue syndrome has shown varying results. Athletes have tried supplementing carnitine to increase performance, but the practice does not appear to be very effective.2
Levocarnitine is FDA approved as 100 mg/mL oral solution, 330 mg oral tablets, and 200 mg/mL injectable prescription products.3, 4 D,L-Carnitine is also available as a dietary supplement.
Patients that would benefit from its administration in a higher strength or when the commercial option is unavailable may be prescribed compounded Levocarnitine Injection as determined by a health care provider. The most popular formulation compounded at Galleria Medical Pharmacy is Levocarnitine 500 mg/mL Injectable Solution, though other strengths and formulations may be available upon request.
For best results, Levocarnitine Injection should be administered at regular intervals under professional supervision by a healthcare practitioner. As per FDA regulations, compounds prepared by a pharmacy are not intended for office use (e.g., office stock of a drug that is administered to multiple patients). As such, this preparation requires a prescription, which is then administered to the specified patient by a healthcare practitioner at their practice.
Store this medication at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.
- Hongu, N. and D.S. Sachan, Carnitine and choline supplementation with exercise alter carnitine profiles, biochemical markers of fat metabolism and serum leptin concentration in healthy women. J Nutr, 2003. 133(1): p. 84-9.
- Brass EP. Supplemental carnitine and exercise. Am J Clin Nutr 2000;72(suppl):618S-623S.
- Carnitor (levocarnitine) injection package insert. Gaithersburg, MD: Sigma Tau Pharmaceuticals; 2015 Apr.
- Carnitor (levocarnitine) tablets, oral solution, and sugar-free oral solution package insert. Gaithersburg, MD: Sigma Tau Pharmaceuticals; 2015 Apr.
Compounding Pharmacy Statement
This preparation is compounded with drug components whose suppliers are registered with the FDA. While Galleria Medical Pharmacy adheres to USP <797> guidelines and applicable state and federal regulations to meet the required quality standards, the statements made regarding this preparation have not been evaluated by the FDA for safety or clinical effectiveness. As such, this preparation is not intended to diagnose, treat, cure, or prevent any disease. For inquiries concerning this preparation, please contact (504) 267-9876.