Usage
- L-Carnitine L-Tartrate is primarily used as a nutritional supplement to enhance athletic performance, particularly in endurance and high-intensity exercise. It may also be prescribed for medical conditions related to carnitine deficiency, such as primary carnitine deficiency, cardiomyopathy, and valproate-induced carnitine deficiency. It’s also used in hemodialysis patients to mitigate carnitine loss.
- Pharmacological Classification: Nutritional supplement, performance enhancer. It can also be classified as a metabolic agent.
- Mechanism of Action: L-Carnitine transports long-chain fatty acids into the mitochondria, where they are oxidized to produce energy. It also facilitates the removal of metabolic waste products from the mitochondria, preventing their accumulation.
Alternate Names
- L-Carnitine, Vitamin BT, L-3-hydroxy-4-N,N,N-trimethylaminobutyrate
- Brand Names: Numerous brands exist, and availability varies regionally.
How It Works
- Pharmacodynamics: L-Carnitine improves energy production by increasing fatty acid oxidation in mitochondria. It also has antioxidant properties, which may reduce exercise-induced muscle damage. It might also improve blood flow.
- Pharmacokinetics:
- Absorption: Readily absorbed in the small intestine after oral administration, particularly when taken with carbohydrates. L-Tartrate form has a rapid absorption rate.
- Metabolism: Metabolized in the liver.
- Elimination: Excreted primarily in urine, as free carnitine and acylcarnitines.
- Mode of Action: L-Carnitine acts as a carrier molecule, transporting long-chain fatty acids across the inner mitochondrial membrane. This process is crucial for fatty acid oxidation and energy production. This helps with energy production in heart and skeletal muscle tissues.
- Receptor Binding/Enzyme Inhibition/Neurotransmitter Modulation: No significant receptor binding, enzyme inhibition, or neurotransmitter modulation is associated with L-Carnitine L-Tartrate.
Dosage
Standard Dosage
Adults:
- 1000-4000 mg per day, divided into two doses, taken with carbohydrate-containing meals. The dose is typically taken before workouts to enhance athletic performance. For supporting recovery and weight loss, it can be taken after exercise.
- Maximum dosage limits vary but generally, doses up to 4000 mg/day are considered safe for most adults.
Children:
- Pediatric dosing should be determined by a physician based on the child’s weight and specific medical condition. Generally, 50-100 mg/kg/day, divided into doses, is used.
- Pediatric Safety Considerations: Close monitoring is essential.
Special Cases:
- Elderly Patients: Dosage adjustments may be needed. Start with a lower dose and titrate based on tolerability and clinical response.
- Patients with Renal Impairment: Dose reduction is necessary as L-Carnitine is primarily excreted by the kidneys.
- Patients with Hepatic Dysfunction: Caution is advised. Monitor liver function tests.
- Patients with Comorbid Conditions: Consult a physician for individual dose adjustment based on specific conditions.
Clinical Use Cases
- The use of L-Carnitine L-Tartrate in clinical settings, such as during intubation, surgical procedures, mechanical ventilation, and in the ICU, typically relates to managing carnitine deficiency in critically ill patients or patients on long-term total parenteral nutrition. Dosing should be individualized based on the patient’s needs and clinical condition.
Dosage Adjustments
- Dose adjustments are based on patient factors such as renal function, hepatic function, and other comorbid conditions. Genetic polymorphisms affecting drug metabolism should also be considered.
Side Effects
Common Side Effects:
- Nausea, vomiting, abdominal cramps, diarrhea, body odor.
Rare but Serious Side Effects:
- Seizures (particularly in individuals with pre-existing seizure disorders).
Long-Term Effects:
- Limited data on long-term effects are available.
Adverse Drug Reactions (ADR):
- Seizures, allergic reactions.
Contraindications
- Hypersensitivity to L-Carnitine or any of its components.
- Severe renal impairment.
- History of seizures (relative contraindication).
Drug Interactions
- Limited clinically significant drug interactions have been reported.
- Caution with anticoagulants (potential increased risk of bleeding).
- Potential interactions with thyroid hormone.
Pregnancy and Breastfeeding
- Consult a physician before use during pregnancy or breastfeeding. L-Carnitine is present in breast milk, and potential effects on infants are not fully known.
Drug Profile Summary
- Mechanism of Action: Facilitates fatty acid transport into mitochondria for energy production.
- Side Effects: Nausea, vomiting, abdominal cramps, diarrhea, body odor; rarely seizures.
- Contraindications: Hypersensitivity, severe renal impairment.
- Drug Interactions: Limited, monitor with anticoagulants.
- Pregnancy & Breastfeeding: Consult a physician before use.
- Dosage: Adults: 1000-4000 mg/day; Children: 50-100 mg/kg/day.
- Monitoring Parameters: Renal function in patients with renal impairment.
Popular Combinations
- Often combined with other athletic performance supplements.
Precautions
- Assess renal function in patients with kidney disease.
- Monitor for gastrointestinal side effects.
- Caution in patients with seizure disorders.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for L-Carnitine L-Tartrate?
A: 1000-4000 mg per day for adults, divided into doses and taken with meals. Pediatric dosing: 50-100 mg/kg/day, as directed by a physician.
Q2: What are the primary uses of L-Carnitine L-Tartrate?
A: Primarily used as a performance enhancer, and in some cases, for medical conditions related to carnitine deficiency.
A: By enhancing fatty acid transport into mitochondria for energy production.
Q4: Are there any serious side effects associated with L-Carnitine L-Tartrate?
A: Seizures are a rare but serious side effect, particularly in individuals with a history of seizures.
Q5: Can L-Carnitine L-Tartrate be used in patients with renal impairment?
A: Use with caution and adjust the dose based on renal function.
Q6: What are the contraindications for using L-Carnitine L-Tartrate?
A: Hypersensitivity to L-Carnitine and severe renal impairment are contraindications.
Q7: Is L-Carnitine L-Tartrate safe during pregnancy?
A: Consult a physician before use during pregnancy or breastfeeding.
Q8: What should be monitored in patients taking L-Carnitine L-Tartrate?
A: Renal function should be monitored in patients with renal impairment. Monitor for gastrointestinal side effects.
Q9: Does L-Carnitine L-Tartrate interact with other medications?
A: Limited clinically significant drug interactions have been reported. Caution with anticoagulants. Potential interactions with thyroid hormone.
Q10: How is L-Carnitine L-Tartrate absorbed?
A: Readily absorbed in the small intestine, particularly when taken with carbohydrates.
