L-Carnitine Injection Solution

L-Carnitine Injection Solution

Available presentation(s): 5, 10 mL. Verify the exact concentration and total active quantity on the prescription and dispensing label.

Introduction: Levocarnitine transports long-chain fatty acids into mitochondria. Injectable levocarnitine has recognised uses in selected deficiency states and dialysis-associated deficiency; compounded use must follow a defined diagnosis and monitoring plan.

Dosage: Dose is indication-, weight- and route-specific. Follow NZF or approved levocarnitine injection guidance for confirmed deficiency/dialysis use. The listed 200 mg/mL presentation must be prescribed in milligrams with route and administration rate; no standard ‘energy’ or weight-loss dose exists.

Mechanisms of Action: Facilitates mitochondrial fatty-acid beta-oxidation and buffers acyl-CoA through formation and export of acylcarnitines.

Contraindications & Precautions: Use caution in seizure disorders and severe renal impairment outside dialysis. Confirm the active is L-carnitine/levocarnitine and not D-carnitine. Monitor clinical and biochemical response.

Interactions: Warfarin INR increases have been reported; monitor when combined. Valproate increases carnitine demand and specialist protocols may apply.

Adverse Reactions / Side Effects: Nausea, vomiting, abdominal cramps, diarrhoea, fishy body odour, injection-site reactions and seizures in susceptible patients may occur. Hypersensitivity is possible.

Pregnancy & Breastfeeding: Use for confirmed deficiency only when clinically indicated. It is present in human milk; breastfeeding use should be individualised.

Storage: Store under the conditions stated on the Optimus dispensing label and product-specific worksheet. Protect from light where labelled. Do not freeze unless explicitly validated. Maintain cold chain if the label requires refrigeration. Do not use after the assigned beyond-use date or if there is visible particulate matter, precipitation, colour change, loss of container integrity or evidence of improper storage. Once entered, follow the validated in-use time; do not assume a compounded vial is multi-dose.

References

• New Zealand Formulary (NZF), current online edition; product-specific approved data sheets where available; USP Pharmaceutical Compounding—Sterile Preparations; and Optimus Healthcare validated formulation, sterility/endotoxin controls and assigned beyond-use date.
• DailyMed. Thiamine Hydrochloride, Pyridoxine Hydrochloride, Hydroxocobalamin and Levocarnitine injection labels, current editions. https://dailymed.nlm.nih.gov/
• US FDA. Compounding and the FDA: Questions and Answers. Updated 16 September 2025. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers