Carnitine

Treatment of primary carnitine deficiency and deficiency secondary to complications of several inborn errors of metabolism, such as organic acidemia and fatty acid oxidation defects in children and adults, and acquired medical or iatrogenic conditions such as valproate and zidovudine treatment, cirrhosis, chronic renal failure on dialysis, etc.

Treatment of valproic acid poisoning and/or overdosing and prevention of valproic acid–induced hepatotoxicity.

Used for ADHD, erectile dysfunction and male infertility, cardiomyopathy, PVD, CHF, chronic cardiac dysrhythmias, senile dementia, metabolic nerve diseases, HIV infection, tuberculosis, myopathies, renal failure–induced anemia, neuropathy, and neuropathic pain, etc. However, additional studies are needed to confirm these potential benefits.

Experimental data indicated that carnitine might have neuronal protective effects against hypoxia/ischemia and neuronal inflammation. Clinical applications of these finding are unknown.

Periop risks are related to carnitine deficiency rather than carnitine itself.

Hypoglycemia, lactic acidosis, and muscle weakness related to carnitine deficiencies and discontinuation of carnitine supplement.

Case report indicates that pts with carnitine deficiencies may develop symptoms similar to those assoc with propofol infusion syndrome. Periop usage of carnitine as a metabolic supplement might be related to periop outcome.