Veterinary Drug Handbook (VDH) is the reference veterinarians turn to when they want an independent source of information on the drugs that are used in veterinary medicine today.


Chemistry - Levocarnitine (the L-isomer of carnitine) is an amino acid derivative, synthesized invivo from methionine and lysine. It is required for energy metabolism and has a molecular weightof 161.

Storage, Stability, Compatibility

Levocarnitine capsules, tablets and powder should be stored inwell-closed containers at room temperature. The oral solution should be kept in tight containers atroom temperature. The injection should be stored at room temperature in the original carton. Afteropening, discard any unused portion as the injection contains no preservative.


Levocarnitine is required for normal fat utilization and energy metabolism inmammalian species. It serves to facilitate entry of long-chain fatty acids into cellular mitochondria, where they can be used during oxidation and energy production.
Severe chronic deficiency is a generally a result of an inborn genetic defect where levocarnitineutilization is impaired and not the result of dietary insufficiency in normal individuals. Effects seenin levocarnitine deficiency may include hypoglycemia, progressive myasthenia, hepatomegaly, CHF, cardiomegaly, hepatic coma, neurologic disturbances, encephalopathy, hypotonia and lethargy.
Uses, Indications - Levocarnitine may be useful as adjunctive therapy of dilated cardiomyopathy indogs. Up to 90% of dogs with dilated cardiomyopathy may have a carnitine deficiency.
Levocarnitine may also protect against doxorubicin-induced cardiomyopathy and reduce risks ofmyocardial infarction. It may be beneficial in the adjunctive treatment of valproic acid toxicity.
In cats, levocarnitine has been recommended as being useful as adjunctive therapy in feline hepaticlipidosis by facilitating hepatic lipid metabolism. Its use for this indication is controversial.


In humans, levocarnitine is absorbed via the GI with a bioavailability of about15%. Levocarnitine is distributed in milk naturally. Exogenously administered levocarnitine iseliminated by both renal and fecal routes. Plasma levocarnitine levels may be increased in patientswith renal failure.

Contraindications, Precautions, Reproductive Safety

Levocarnitine may also be known as
Vitamin BT. Products labeled as such may have both D and L racemic forms. Use only Levo-forms as the D- form may competitively inhibit L- uptake with a resulting deficiency. Studies donein rats and rabbits have demonstrated no teratogenic effects and it is generally believed thatlevocarnitine is safe to use in pregnancy though documented safety during pregnancy has not beenestablished.

Adverse Effects, Warnings

Adverse effect profile is minimal. Gastrointestinal upset is the mostlikely effect that may be noted. It is usually mild and limited to loose stools or possibly diarrhea;nausea and vomiting are also possible. Human patients have reported increased body odor.

Overdosage, Acute Toxicity

Levocarnitine is a relatively safe drug. Minor overdoses need onlyto be monitored; with massive overdoses consider gut emptying. Refer to a poison control centerfor more information.

Drug Interactions

Patients receiving valproic acid may require higher dosages of levocarnitine.
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