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L-Carnitine Injection

Levocarnitine (L-3-hydroxy-4-N-trimethylaminobutyrate) is synthesized from the amino acids methionine and lysine in a process that takes place in the liver. L-carnitine occurs naturally in mammalian tissue, specifically in striated muscle, and forms an essential component of energy metabolism. This includes the oxidation of fatty acids, the metabolism of carbohydrates, and the excretion of organic acids. While only the L isomer is present in body systems, commercial synthesis of carnitine produces a D,L racemic mixture, from which the L-isomer is obtained. The D-isomer does not participate in lipid metabolism. Commercially, carnitine is available in both prescription and non-prescription forms. The prescription version is levocarnitine, while most dietary supplements contain D, L-carnitine which is sold in over the counter in stores.

Mechanism of Action

Levocarnitine supports the transport of long-chain fatty acids from the cytosol to the mitochondria, which in turn supports oxidation and cellular energy production. Levocarnitine can promote the excretion of excess fatty acids in patients with poor fatty acid metabolism or specific conditions that bioaccumulate acyl CoA esters. Levocarnitine clears the acyl CoA esters by forming acylcarnitine which is then excreted.

Carnitine acetyltransferases (CATs) catalyze the conversion of fatty acid esters of coenzyme A and carnitine, which are located in the cytosol and mitochondrial membranes. Translocases in mitochondrial membranes transport both free carnitine and its esters in and out of cells. Fatty acid esters of CoA inhibit the enzymes of the Krebs cycle, and contribute to oxidative phosphorylation. This means that fatty acid oxidation requires the formation of acylcarnitines and their translocation into mitochondria.

Pharmacokinetics
General Information
Contraindications/Precautions
Pregnancy/ Breastfeeding
Adverse Reactions/ Side Effects
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