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Chemistry

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Also known as: L-carnitine, 541-15-1, (r)-carnitine, Vitamin bt, Carnitor, (-)-carnitine
Molecular Formula
C7H15NO3
Molecular Weight
161.20  g/mol
InChI Key
PHIQHXFUZVPYII-ZCFIWIBFSA-N
FDA UNII
0G389FZZ9M

Levocarnitine
A constituent of STRIATED MUSCLE and LIVER. It is an amino acid derivative and an essential cofactor for fatty acid metabolism.
Levocarnitine is a Carnitine Analog.
1 2D Structure

Levocarnitine

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
(3R)-3-hydroxy-4-(trimethylazaniumyl)butanoate
2.1.2 InChI
InChI=1S/C7H15NO3/c1-8(2,3)5-6(9)4-7(10)11/h6,9H,4-5H2,1-3H3/t6-/m1/s1
2.1.3 InChI Key
PHIQHXFUZVPYII-ZCFIWIBFSA-N
2.1.4 Canonical SMILES
C[N+](C)(C)CC(CC(=O)[O-])O
2.1.5 Isomeric SMILES
C[N+](C)(C)C[C@@H](CC(=O)[O-])O
2.2 Other Identifiers
2.2.1 UNII
0G389FZZ9M
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Bicarnesine

2. Carnitine

3. L Carnitine

4. L-carnitine

5. Vitamin Bt

2.3.2 Depositor-Supplied Synonyms

1. L-carnitine

2. 541-15-1

3. (r)-carnitine

4. Vitamin Bt

5. Carnitor

6. (-)-carnitine

7. (-)-l-carnitine

8. Karnitin

9. L-(-)-carnitine

10. Carnitene

11. Levocarnitina

12. Metina

13. Carnitine, (-)-

14. L-carnitine Inner Salt

15. Levocarnitinum

16. Carniking

17. Carnilean

18. Levocarnitinum [latin]

19. Levocarnitina [spanish]

20. Carniking 50

21. (3r)-3-hydroxy-4-(trimethylammonio)butanoate

22. Gamma-trimethyl-beta-hydroxybutyrobetaine

23. Bicarnesine

24. Gamma-trimethyl-ammonium-beta-hydroxybutirate

25. 1-carnitine

26. (3r)-3-hydroxy-4-(trimethylazaniumyl)butanoate

27. 3-carboxy-2-hydroxy-n,n,n-trimethyl-1-propanaminium Hydroxide, Inner Salt

28. Drg-0211

29. Carnitine, L-

30. (r)-3-hydroxy-4-(trimethylammonio)butanoate

31. (r)-(3-carboxy-2-hydroxypropyl)trimethylammonium Hydroxide

32. 44985-71-9

33. R-(-)-3-hydroxy-4-trimethylaminobutyrate

34. (l-3-carboxy-2-hydroxypropyl)trimethylammonium Hydroxide, Inner Salt

35. 3-carboxy-2-hydroxy-n,n,n-trimethyl-1-propanaminium

36. L-gamma-trimethyl-beta-hydroxybutyrobetaine

37. Levocarnitine Hcl

38. 1-propanaminium, 3-carboxy-2-hydroxy-n,n,n-trimethyl-, Inner Salt, (r)-

39. 1-propanaminium, 3-carboxy-2-hydroxy-n,n,n-trimethyl-, Hydroxide, Inner Salt, (r)-

40. Nsc-759132

41. (3-carboxy-2-hydroxypropyl)trimethyl-ammonium Hydroxide, Inner Salt

42. Chembl1149

43. Ammonium, (3-carboxy-2-hydroxypropyl)trimethyl-, Hydroxide, Inner Salt, L-

44. Carnicor

45. 0g389fzz9m

46. Carnitolo

47. Carnovis

48. Carrier

49. Chebi:16347

50. Lefcar

51. (-)-(r)-3-hydroxy-4-(trimethylammonio)butyrate

52. L-carnitine Base

53. 1-propanaminium, 3-carboxy-2-hydroxy-n,n,n-trimethyl-, Hydroxide, Inner Salt

54. 1-propanaminium, 3-carboxy-2-hydroxy-n,n,n-trimethyl-, Inner Salt, (2r)-

55. Oristar Lch

56. 1-propanaminium,3-carboxy-2-hydroxy-n,n,n-trimethyl-

57. Carnitine Hcl

58. Levocarnitine [usan:inn]

59. Vitamin B T

60. Carnitor (tn)

61. Smr000112475

62. Carnitine (l-form)

63. (r)-3-hydroxy-4-(trimethylammonio)butyrate

64. Gamma-trimethyl-hydroxybutyrobetaine

65. 3-hydroxy-4-trimethylammoniobutanoate

66. Einecs 208-768-0

67. Unii-0g389fzz9m

68. Carnipass

69. Delta-carnitine

70. Levocarnitine (jan/usp/inn)

71. L-carnitin

72. Mfcd00038747

73. Hsdb 7588

74. Carnipass 20

75. L-carnitine,(s)

76. Levocarnitine [usan:usp:inn:ban]

77. (r)-3-hydroxy-4-trimethylammoniobutyrate

78. Carnitine [mi]

79. Bmse000211

80. L-carnitine [fcc]

81. C-1985

82. L-carnitin 100 Microg/ml In Acetonitrile

83. Levocarnitine [inn]

84. Levocarnitine [jan]

85. L-carnitine (levocarnitine)

86. L-carnitine [vandf]

87. Levocarnitine [hsdb]

88. Levocarnitine [usan]

89. Schembl21970

90. Levocarnitine [vandf]

91. Mls001332549

92. Mls001332550

93. Bidd:gt0603

94. Levocarnitine [mart.]

95. Levocarnitine [usp-rs]

96. Levocarnitine [who-dd]

97. Gtpl4780

98. Dtxsid4023208

99. Hms2093j13

100. Hms2267h24

101. Pharmakon1600-01505437

102. Levocarnitine [orange Book]

103. Hy-b0399

104. Levocarnitine [ep Monograph]

105. (2r)-3-carboxy-2-hydroxy-n,n,n-trimethyl-1-propanaminium Inner Salt

106. (r)-(3-carboxy-2-hydroxypropyl)trimethylammonium Hydroxide, Inner Salt

107. Ammonium, (3-carboxy-2-hydroxypropyl)trimethyl-, Hydroxide,inner Salt

108. Bdbm50037268

109. C0049

110. Levocarnitine [usp Monograph]

111. Nsc741806

112. Nsc759132

113. S2388

114. Akos005267245

115. Bcp9000830

116. Ccg-213241

117. Db00583

118. Ks-1422

119. Nsc 759132

120. Nsc-741806

121. 6-chloro-3-hydroxy(1h)indazole

122. 3-hydroxy-4-trimethylammoniobutanoic Acid

123. As-11974

124. Gamma-l-trimethyl-beta-hydroxybutyrobetaine

125. L-carnitine Inner Salt, Synthetic, >=98%

126. N1935

127. C00318

128. D02176

129. Ab00919083_05

130. Ab00919083_06

131. A829968

132. (3r)-(-)-3-hydroxy-4-(trimethylammonio)butanoate

133. Q20735709

134. (3r)-(-)-3-hydroxy-4-(trimethylammonio)butanoate 99+%

135. (3r)-3-hydroxy-4-(trimethylammonio)butanoate;l-carnitine

136. (-)-(r)-3-hydroxy-4-(trimethylammonio)butyrate, Vitamin Bt

137. Levocarnitine, European Pharmacopoeia (ep) Reference Standard

138. Levocarnitine, United States Pharmacopeia (usp) Reference Standard

139. 1-propanaminium, 3-carboxy-2-hydroxy-n,n,n-trimethyl-, Inner Salt, (2r)- (9ci)

140. Ammonium, (3-carboxy-2-hydroxypropyl)trimethyl-, Hydroxide, Inner Salt, L- (8ci)

141. Levocarnitine, Pharmaceutical Secondary Standard; Certified Reference Material

2.4 Create Date
2005-06-01
3 Chemical and Physical Properties
Molecular Weight 161.20 g/mol
Molecular Formula C7H15NO3
XLogP3-0.2
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count3
Rotatable Bond Count3
Exact Mass161.10519334 g/mol
Monoisotopic Mass161.10519334 g/mol
Topological Polar Surface Area60.4 Ų
Heavy Atom Count11
Formal Charge0
Complexity134
Isotope Atom Count0
Defined Atom Stereocenter Count1
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 4  
Drug NameCarnitor
PubMed HealthLevocarnitine
Drug LabelCARNITOR (levocarnitine) is a carrier molecule in the transport of long-chain fatty acids acrob the inner mitochondrial membrane.The chemical name of levocarnitine is 3-carboxy-2(R)-hydroxy-N,N,N-trimethyl-1-propanaminium, inner salt. Levocarnitin...
Active IngredientLevocarnitine
Dosage FormInjectable; Tablet; Solution
RouteInjection; Oral
Strength330mg; 1gm/10ml; 200mg/ml
Market StatusPrescription
CompanySigma Tau

2 of 4  
Drug NameLevocarnitine
PubMed HealthLevocarnitine
Drug LabelLevocarnitine is a carrier molecule in the transport of long-chain fatty acids acrob the inner mitochondrial membrane.The chemical name of levocarnitine is 3-carboxy- 2(R)-hydroxy- N , N , N - t r i m e t h y l - 1 - propanaminium, inner salt. Levoc...
Active IngredientLevocarnitine
Dosage FormTablet; Injectable; Solution
RouteInjection; Oral
Strength330mg; 1gm/10ml; 200mg/ml
Market StatusPrescription
CompanyCorepharma; Teva Pharms Usa; Lyne; Hi Tech Pharma; Luitpold; Eurohlth Intl

3 of 4  
Drug NameCarnitor
PubMed HealthLevocarnitine
Drug LabelCARNITOR (levocarnitine) is a carrier molecule in the transport of long-chain fatty acids acrob the inner mitochondrial membrane.The chemical name of levocarnitine is 3-carboxy-2(R)-hydroxy-N,N,N-trimethyl-1-propanaminium, inner salt. Levocarnitin...
Active IngredientLevocarnitine
Dosage FormInjectable; Tablet; Solution
RouteInjection; Oral
Strength330mg; 1gm/10ml; 200mg/ml
Market StatusPrescription
CompanySigma Tau

4 of 4  
Drug NameLevocarnitine
PubMed HealthLevocarnitine
Drug LabelLevocarnitine is a carrier molecule in the transport of long-chain fatty acids acrob the inner mitochondrial membrane.The chemical name of levocarnitine is 3-carboxy- 2(R)-hydroxy- N , N , N - t r i m e t h y l - 1 - propanaminium, inner salt. Levoc...
Active IngredientLevocarnitine
Dosage FormTablet; Injectable; Solution
RouteInjection; Oral
Strength330mg; 1gm/10ml; 200mg/ml
Market StatusPrescription
CompanyCorepharma; Teva Pharms Usa; Lyne; Hi Tech Pharma; Luitpold; Eurohlth Intl

4.2 Therapeutic Uses

Levocarnitine is indicated for treatment of primary systemic carnitine deficiency, a genetic impairment of normal biosynthesis or utilization of levocarnitine from dietary sources, or for the treatment of secondary carnitine deficiency resulting from an inborn error of metabolism. /Included in US product labeling/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007., p. 1819


Parenteral levocarnitine is indicated for the prevention and treatment of carnitine deficiency in patients with end-stage renal disease supported on hemodialysis. /Included in US product labeling/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007., p. 1819


Levocarnitine oral solution is used for the prevention and treatment of carnitine deficiency secondary to valproic acid toxicity. /NOT included in US product labeling/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007., p. 1820


L-Carnitine, acetyl-L-carnitine, and/or propionyl-L-carnitine may be used for replacement therapy to restore normal carnitine concn and/or a normal nonesterified-to-esterified carnitine ratio ... For primary and some secondary carnitine deficiencies ... L-carnitine is used for replacement therapy.

Coates, P.M., Blackman, M.R., Cragg, G.M., Levine, M., Moss, J., White, J.D. (Ed), Encyclopedia of Dietary Supplements. Marcel Dekker, New York, NY, p. 76 (2005)


For more Therapeutic Uses (Complete) data for L-CARNITINE (29 total), please visit the HSDB record page.


4.3 Drug Warning

Various mild gastrointestinal complaints have been reported during the long-term administration of oral L- or D,L-carnitine; these include transient nausea and vomiting, abdominal cramps, and diarrhea. Mild myasthenia has been described only in uremic patients receiving D,L-carnitine. Gastrointestinal adverse reactions with carnitor (levocarnitine) Oral Solution or carnitor SF (levocarnitine) Sugar-Free Oral Solution dissolved in liquids might be avoided by a slow consumption of the solution or by a greater dilution. Decreasing the dosage often diminishes or eliminates drug-related patient body odor or gastrointestinal symptoms when present. Tolerance should be monitored very closely during the first week of administration, and after any dosage increases. Seizures have been reported to occur in patients with or without pre-existing seizure activity receiving either oral or intravenous levocarnitine. In patients with pre-existing seizure activity, an increase in seizure frequency and/or severity has been reported.

Physicians Desk Reference 61st ed, Thomson PDR, Montvale, NJ 2007., p. 3189


... Oral L-carnitine at a dose of 1 g daily was administered for twelve days to six patients with end-stage renal disease undergoing hemodialysis thrice weekly. Pre-dialysis plasma concentrations of L-carnitine (mean +/- SD) increased significantly (P < 0.05) from day 1 (baseline; 32.4 +/- 6.1 uM) to day 8 (66.1 +/- 13.8 uM) remaining constant thereafter. Although plasma levels of trimethylamine remained unaltered, the pre-dialysis plasma concentrations of trimethylamine-N-oxide increased significantly (P < 0.05) from day 1 (289.1 +/- 236.1 microM) to day 12 (529.0 +/- 237.9 uM). The hemodialysis clearances for L-carnitine, trimethylamine and trimethylamine-N-oxide were 14.3 +/- 8.2, 14.1 +/- 10.6 and 12.4 +/- 5.4 L/h, respectively, indicating their efficient removal by dialysis. Oral administration of L-carnitine at a dose of 1 g daily increases plasma concentrations of this substance to physiological levels in patients with end-stage renal disease who are undergoing hemodialysis. However, concerns about the possible deleterious consequences of such a dosage regimen still remain given that plasma concentrations of trimethylamine-N-oxide were continually rising and approximately doubled in a two-week period.

PMID:17073580 Bain MA et al; Curr Drug Metab 7 (7): 811-6 (2006)


... Patients with primary carnitine deficiency display alterations in the renal handling of L-carnitine and/or the transport of the compound into muscle tissue. Similarly, many forms of secondary carnitine deficiency, including some drug-induced disorders, arise from impaired renal tubular reabsorption. Patients with end-stage renal disease undergoing dialysis can develop a secondary carnitine deficiency due to the unrestricted loss of L-carnitine through the dialyser ...

PMID:12908852 Evans AM et al; Clin Pharmacokinet 42 (11): 941-67 (2003)


The aim of our work was to test the influence of L-carnitine supplementation on secondary hyperparathyroidism and bone metabolism in hemodialyzed patients in a randomized study. Eighty-three chronically hemodialyzed patients were observed; 44 were supplemented with L-carnitine (15 mg/kg iv after each hemodialysis for 6 months), while 39 took placebo. Levels of free carnitine (CAR), calcium (Ca), inorganic phosphate (P), Ca x P product, parathormone (PTH), bone-specific alkaline phosphatase (b-ALP), osteocalcin (OC), and osteoprotegerin (OPG) were monitored. In comparison with pretreatment values, changes of some selected parameters occurred in the supplemented patients after 6 months (data are expressed as medians; NS, nonsignificant change): PTH, 186.0 vs. 135.5 ng/L (NS); b-ALP, 13.9 vs. 13.2 ug/L (P < 0.05); OC, 78.3 vs. 68.8 ug/L (NS); OPG, 144.0 vs. 182.0 ng/L (P < 0.05). In the controls, there were the following changes: PTH, 148.0 vs. 207.0 ng/L (NS); b-ALP, 15.2 vs. 13.2 ug/L (P < 0.05); OC, 62.7 vs. 79.8 ug/L (P < 0.05); OPG, 140.0 vs. 164.0 ng/L (NS). A significant correlation was found between CAR and OPG changes (r = 0.51, P < 0.001) in the supplemented patients. The supplementation led to a significant increase of serum OPG concentration. Nevertheless, ...only nonsignificant tendencies to correction of secondary hyperparathyroidism and reduction of bone turnover in hemodialyzed patients supplemented with L-carnitine /were observed/ in contrast to controls. At this point, the use of L-carnitine does not seem to be justified.

PMID:17622482 Cibulka R et al; Calcif Tissue Int 81 (2): 99-106 (2007)


For more Drug Warnings (Complete) data for L-CARNITINE (9 total), please visit the HSDB record page.


4.4 Drug Indication

For treatment of primary systemic carnitine deficiency, a genetic impairment of normal biosynthesis or utilization of levocarnitine from dietary sources, or for the treatment of secondary carnitine deficiency resulting from an inborn error of metabolism such as glutaric aciduria II, methyl malonic aciduria, propionic acidemia, and medium chain fatty acylCoA dehydrogenase deficiency. Used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. Parenteral levocarnitine is indicated for the prevention and treatment of carnitine deficiency in patients with end-stage renal disease.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Levocarnitine is a carrier molecule in the transport of long chain fatty acids across the inner mitochondrial membrane. It also exports acyl groups from subcellular organelles and from cells to urine before they accumulate to toxic concentrations. Lack of carnitine can lead to liver, heart, and muscle problems. Carnitine deficiency is defined biochemically as abnormally low plasma concentrations of free carnitine, less than 20 µmol/L at one week post term and may be associated with low tissue and/or urine concentrations. Further, this condition may be associated with a plasma concentration ratio of acylcarnitine/levocarnitine greater than 0.4 or abnormally elevated concentrations of acylcarnitine in the urine. Only the L isomer of carnitine (sometimes called vitamin BT) affects lipid metabolism. The "vitamin BT" form actually contains D,L-carnitine, which competitively inhibits levocarnitine and can cause deficiency. Levocarnitine can be used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias.


5.2 FDA Pharmacological Classification
5.2.1 Active Moiety
LEVOCARNITINE
5.2.2 FDA UNII
0G389FZZ9M
5.2.3 Pharmacological Classes
Carnitine [CS]; Carnitine Analog [EPC]
5.3 ATC Code

A16AA01

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


A - Alimentary tract and metabolism

A16 - Other alimentary tract and metabolism products

A16A - Other alimentary tract and metabolism products

A16AA - Amino acids and derivatives

A16AA01 - Levocarnitine


5.4 Absorption, Distribution and Excretion

Absorption

Absolute bioavailability is 15% (tablets or solution). Time to maximum plasma concentration was found to be 3.3 hours.


Route of Elimination

Following a single intravenous dose, 73.1 +/- 16% of the dose was excreted in the urine during the 0-24 hour interval. Post administration of oral carnitine supplements, in addition to a high carnitine diet, 58-65% of the administered radioactive dose was recovered from urine and feces in 5-11 days.


Volume of Distribution

The steady state volume of distribution (Vss) of an intravenously administered dose, above endogenous baseline levels, was calculated to be 29.0 +/- 7.1L. However this value is predicted to be an underestimate of the true Vss.


Clearance

Total body clearance was found to be a mean of 4L/h.


L-Carnitine is a naturally occurring compound that facilitates the transport of fatty acids into mitochondria for beta-oxidation. ... In humans, the endogenous carnitine pool, which comprises free L-carnitine and a range of short-, medium- and long-chain esters, is maintained by absorption of L-carnitine from dietary sources, biosynthesis within the body and extensive renal tubular reabsorption from glomerular filtrate. In addition, carrier-mediated transport ensures high tissue-to-plasma concentration ratios in tissues that depend critically on fatty acid oxidation. The absorption of L-carnitine after oral administration occurs partly via carrier-mediated transport and partly by passive diffusion. After oral doses of 1-6 g, the absolute bioavailability is 5-18%. In contrast, the bioavailability of dietary L-carnitine may be as high as 75%. Therefore, pharmacological or supplemental doses of L-carnitine are absorbed less efficiently than the relatively smaller amounts present within a normal diet. L-Carnitine and its short-chain esters do not bind to plasma proteins and, although blood cells contain L-carnitine, the rate of distribution between erythrocytes and plasma is extremely slow in whole blood. After iv administration, the initial distribution volume of L-carnitine is typically about 0.2-0.3 L/kg, which corresponds to extracellular fluid volume. There are at least three distinct pharmacokinetic compartments for L-carnitine, with the slowest equilibrating pool comprising skeletal and cardiac muscle. L-Carnitine is eliminated from the body mainly via urinary excretion. Under baseline conditions, the renal clearance of L-carnitine (1-3 mL/min) is substantially less than glomerular filtration rate (GFR), indicating extensive (98-99%) tubular reabsorption. The threshold concentration for tubular reabsorption (above which the fractional reabsorption begins to decline) is about 40-60 umol/L, which is similar to the endogenous plasma L-carnitine level. Therefore, the renal clearance of L-carnitine increases after exogenous administration, approaching GFR after high iv doses. ...

PMID:12908852 Evans AM et al; Clin Pharmacokinet 42 (11): 941-67 (2003)


In mammals, the carnitine pool consists of nonesterified L-carnitine and many acylcarnitine esters. Of these esters, acetyl-L-carnitine is quantitatively and functionally the most significant. Carnitine homeostasis is maintained by absorption from diet, a modest rate of synthesis, and efficient renal reabsorption. Dietary L-carnitine is absorbed by active and passive transfer across enterocyte membranes. Bioavailability of dietary L-carnitine is 54-87% and is dependent on the amount of L-carnitine in the meal. Absorption of L-carnitine dietary supplements (0.5-6 g) is primarily passive; bioavailability is 14-18% of dose. Unabsorbed L-carnitine is mostly degraded by microorganisms in the large intestine. Circulating L-carnitine is distributed to two kinetically defined compartments: one large and slow-turnover (presumably muscle), and another relatively small and rapid-turnover (presumably liver, kidney, and other tissues). At normal dietary L-carnitine intake, whole-body turnover time in humans is 38-119 hr. In vitro experiments suggest that acetyl-L-carnitine is partially hydrolyzed in enterocytes during absorption. In vivo, circulating acetyl-L-carnitine concentration was increased 43% after oral acetyl-L-carnitine supplements of 2 g/day, indicating that acetyl-L-carnitine is absorbed at least partially without hydrolysis. After single-dose intravenous administration (0.5 g), acetyl-L-carnitine is rapidly, but not completely hydrolyzed, and acetyl-L-carnitine and L-carnitine concentrations return to baseline within 12 h. At normal circulating l-carnitine concentrations, renal l-carnitine reabsorption is highly efficient (90-99% of filtered load; clearance, 1-3 mL/min), but displays saturation kinetics. Thus, as circulating L-carnitine concentration increases (as after high-dose intravenous or oral administration of L-carnitine), efficiency of reabsorption decreases and clearance increases, resulting in rapid decline of circulating L-carnitine concentration to baseline. Elimination kinetics for acetyl-L-carnitine are similar to those for L-carnitine. There is evidence for renal tubular secretion of both L-carnitine and acetyl-L-carnitine. ...

PMID:15591001 Rebouche CJ; Ann N Y Acad Sci 1033:30-41 (2004)


The pharmacokinetics of L-carnitine and its metabolites were investigated in 7 healthy subjects following the oral administration of 0, 0.5, 1, and 2 g 3 times a day for 7 days. Mean plasma concentrations of L-carnitine across an 8-hour dose interval increased significantly (P < 0.05) from a baseline of 54.2 +/- 9.3 uM to 80.5 +/- 12.5 uM following the 0.5-g dose; there was no further increase at higher doses. There was a significant increase (P <0.001) in the renal clearance of L-carnitine indicating saturation of tubular reabsorption. Trimethylamine plasma levels increased proportionately with L-carnitine dose, but there was no change in renal clearance. A significant increase in the plasma concentrations of trimethylamine-N-oxide from baseline was evident only for the 2-g dose of L-carnitine (from 34.5 +/- 2.0 to 149 +/- 145 uM), and its renal clearance decreased with increasing dose (P <0.05). There was no evidence for nonlinearity in the metabolism of trimethylamine to trimethylamine-N-oxide. In conclusion, the pharmacokinetics of oral L-carnitine display nonlinearity above a dose of 0.5 g 3 times a day.

PMID:16988205 Bain MA et al; J Clin Pharmacol 46 (10): 1163-70 (2006)


Evidence indicates L-carnitine is absorbed in the intestine by a combination of active transport and passive diffusion. Reports of bioavailability following an oral dose have varied substantially, with estimates as low as 16 to 18% and as high as 54 to 87% ... The mucosal absorption of carnitine appears to be saturated at about a 2-g dose. Max blood concn is reached approx 3.5 hr after an oral dose and slowly decr, with a half-life of about 15 hr. Elimination of carnitine occurs primarily through the kidneys. The heart, skeletal muscle, liver, kidneys, and epididymis have specific transport systems for carnitine that concentrate carnitine within these tissues. Despite evidence indicating incr levels of free carnitine and carnitine metabolites in the blood and urine following an oral dose, no significant change in RBC carnitine levels was noted in healthy subjects, suggesting either a slow repletion of tissue stores of carnitine following an oral dose or a low capability to transport carnitine into tissues under normal conditions.

Thorne Research, Inc.; Monograph on L-Carnitine; Alternative Medicine Review 10(1) p.42 (2005). Available from, as of February 22, 2008: https://www.thorne.com/altmedrev/.fulltext/10/1/42.pdf


For more Absorption, Distribution and Excretion (Complete) data for L-CARNITINE (11 total), please visit the HSDB record page.


5.5 Metabolism/Metabolites

After oral administration L-carnitine which is unabsorbed is metabolized in the gastrointestinal tract by bacterial microflora. Major metabolites include trimethylamine N-oxide and [3H]-gamma-butyrobetaine.


In mammals, L-carnitine is synthesized from epsilon-N-trimethyllysine, which is derived from post-translationally methylated lysine residues in proteins, and protein turnover. In normal humans, the rate of synth is est to be ca 1.2 umol/kg/day. The rate of L-carnitine biosynth is regulated by the avail of epsilon-N-trimethyllysine. Thus, conditions that incr protein methylation and/or protein turnover may incr the rate of L-carnitine biosynth.

Coates, P.M., Blackman, M.R., Cragg, G.M., Levine, M., Moss, J., White, J.D. (Ed), Encyclopedia of Dietary Supplements. Marcel Dekker, New York, NY, p. 75 (2005)


Synthesis of carnitine begins with methylation of the amino acid L-lysine by S-adenosylmethionine (SAMe). Magnesium, vitamin C, iron, vitamins B3 and B6, and alpha-ketoglutarate - along with the cofactors responsible for creating SAMe (methionine, folic acid, vitamin B12, and betaine) - are all required for endogenous carnitine synthesis.

Thorne Research, Inc.; Monograph on L-Carnitine; Alternative Medicine Review 10(1) p.42 (2005). Available from, as of February 22, 2008: https://www.thorne.com/altmedrev/.fulltext/10/1/42.pdf


Unabsorbed L-carnitine is degraded by micro-organisms in the large intestine. Major metabolites identified are trimethylamine oxide in urine and gamma-butyrobetaine in feces.

Coates, P.M., Blackman, M.R., Cragg, G.M., Levine, M., Moss, J., White, J.D. (Ed), Encyclopedia of Dietary Supplements. Marcel Dekker, New York, NY, p. 75 (2005)


Carnitine plays an indispensable role in fatty acid oxidation. Previous studies revealed that fetal carnitine is derived from the mother via transplacental transfer. Recent studies demonstrated the presence and importance of an active fatty acid oxidation system in the human placenta and in the human fetus. In view of these findings ... carnitine metabolism /was studied/ in the fetal-placental unit by measuring carnitine metabolites, intermediary metabolites of carnitine biosynthesis, as well as the activity of carnitine biosynthesis enzymes in human term placenta, cord blood and selected embryonic and fetal tissues (5-20 weeks of development). Placenta contained low but detectable activity of gamma-butyrobetaine dioxygenase. This enzyme, which was considered to be expressed only in kidney, liver and brain, catalyzes the last step in the carnitine biosynthesis pathway. In addition, ... human fetal kidney, liver and spinal cord already have the capacity to synthesize carnitine. The ability of the placenta and fetus to synthesize carnitine suggests that in circumstances when maternal carnitine supply is limited, carnitine biosynthesis by the fetal-placental unit may supply sufficient carnitine for placental and fetal metabolism. /Carnitine/

PMID:16300828 Oey NA et al; Placenta 27 (8): 841-6 (2006)


For more Metabolism/Metabolites (Complete) data for L-CARNITINE (7 total), please visit the HSDB record page.


5.6 Biological Half-Life

17.4 hours (elimination) following a single intravenous dose.


Distribution: 0.585 hours; Elimination: 17.4 hours

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007., p. 1820


... Half-life /in blood/ ca 15 hr ...

Thorne Research, Inc.; Monograph on L-Carnitine; Alternative Medicine Review 10(1) p.42 (2005). Available from, as of February 22, 2008: https://www.thorne.com/altmedrev/.fulltext/10/1/42.pdf


5.7 Mechanism of Action

Levocarnitine can be synthesised within the body from the amino acids lysine or methionine. Vitamin C (ascorbic acid) is essential to the synthesis of carnitine. Levocarnitine is a carrier molecule in the transport of long chain fatty acids across the inner mitochondrial membrane. It also exports acyl groups from subcellular organelles and from cells to urine before they accumulate to toxic concentrations. Only the L isomer of carnitine (sometimes called vitamin BT) affects lipid metabolism. Levocarnitine is handled by several proteins in different pathways including carnitine transporters, carnitine translocases, carnitine acetyltransferases and carnitine palmitoyltransferases.


L-Carnitine is a peripheral antagonist of thyroid hormone action in some tissues. It inhibits thyroid hormone entry into cell nuclei. In a controlled clinical trial, L-carnitine was shown to reverse or prevent some symptoms of hyperthyroidism.

Coates, P.M., Blackman, M.R., Cragg, G.M., Levine, M., Moss, J., White, J.D. (Ed), Encyclopedia of Dietary Supplements. Marcel Dekker, New York, NY, p. 75 (2005)


... Mortality and metabolic consequences of acute ammonium intoxication in mice are reduced by pharmacologic admin of L-carnitine. The mechanism for this effect may have 2 components. L-Carnitine admin normalizes the redox state of the brain (perhaps by incr the avail of beta-hydroxybutyrate and/or acetyl-L-carnitine to the brain), and it incr the rate of urea synth in the liver, perhaps in part by activation of the glucocorticoid receptor. At least part of the protective effect is associated with flux through the carnitine acyltransferases, as analogs of L-carnitine that are competitive inhibitors of carnitine acyltransferases enhance the toxicity of acute ammonium admin. Thus, it has been proposed that L-carnitine incr urea synth in the liver by facilitating fatty acid entry into mitochondria, leading to incr flux through the beta-oxidation pathway, an incr of intramitochondrial reducing equivalents, and enhancement of ATP production. ...

Coates, P.M., Blackman, M.R., Cragg, G.M., Levine, M., Moss, J., White, J.D. (Ed), Encyclopedia of Dietary Supplements. Marcel Dekker, New York, NY, p. 78 (2005)


Levocarnitine is necessary for normal mammalian fat utilization and energy metabolism. It facilitates entry of long-chain fatty acids into cellular mitochondria, where they are used during oxidation and energy production. It also exports acyl groups from subcellular organelles and from cells to urine before they accumulate to toxic concentrations.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007., p. 1820


Carnitine's primary mechanism of action is apparently attributable to its role as a cofactor in the transformation of free long-chain fatty acids into acylcarnitines for subsequent transport into the mitochondrial matrix. Carnitine is involved in the metabolism of ketones for energy and the conversion of branched-chain amino acids - valine, leucine, and isoleucine - into energy. /Carnitine/

Thorne Research, Inc.; Monograph on L-Carnitine; Alternative Medicine Review 10(1) p.43 (2005). Available from, as of February 22, 2008: https://www.thorne.com/altmedrev/.fulltext/10/1/42.pdf


L-Carnitine participates in a reversible transesterification reaction, in which an acyl group is transferred from coenzyme A to the hydroxyl group of L-carnitine ... /This reaction facilitates the/ transfer of long-chain fatty acids from cytoplasm ... /and/ chain-shortened /very-long-chain/ fatty acids from peroxisomes to mitochondria /and the/ modulation of the acyl-CoA/CoA ratio in cellular compartments.

Coates, P.M., Blackman, M.R., Cragg, G.M., Levine, M., Moss, J., White, J.D. (Ed), Encyclopedia of Dietary Supplements. Marcel Dekker, New York, NY, p. 73 (2005)


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CO.LTD","supplierCountry":"CHINA","foreign_port":"SHANGHAI","customer":"BIOEXTRACT","customerCountry":"INDIA","quantity":"3000.00","actualQuantity":"3000","unit":"KGS","unitRateFc":"16.3","totalValueFC":"49285.8","currency":"USD","unitRateINR":"1380.4","date":"25-Oct-2024","totalValueINR":"4141312.5","totalValueInUsd":"49285.8","indian_port":"Bangalore ICD","hs_no":"29239000","bill_no":"6335941","productDescription":"API","marketType":"REGULATED MARKET","country":"CHINA","selfForZScoreResived":"Non Pharma","supplierPort":"SHANGHAI","supplierAddress":"ROOM 3-304, NO.448 HEPING WEST ROAD XINHUA DISTRICT SHIJIAZHUANG 050057 CHINA CHINA","customerAddress":"NO.5\/1, NEW BBMP NO.9,3RD FLOOR"},{"dataSource":"API Import","activeIngredients":"","year":"2024","qtr":"Q4","strtotime":1730745000,"product":"L-CARNITINE BASE (NOT FOR MEDICINAL USE).","address":"CABIN NO 4, GALA NO 106, 1st Floor, KAILASH COMPLEX, House No 374","city":"THANE","supplier":"HEBEI RUNKEN IMPORT & EXPORT TRADING CO., LTD.","supplierCountry":"CHINA","foreign_port":"SHANGHAI","customer":"HIYA HEALTHCARE PRIVATE LIMITED","customerCountry":"INDIA","quantity":"2000.00","actualQuantity":"2000","unit":"KGS","unitRateFc":"15","totalValueFC":"30199.7","currency":"USD","unitRateINR":"1274.3","date":"05-Nov-2024","totalValueINR":"2548500","totalValueInUsd":"30199.7","indian_port":"JNPT","hs_no":"29239000","bill_no":"6510126","productDescription":"API","marketType":"REGULATED MARKET","country":"CHINA","selfForZScoreResived":"Non Pharma","supplierPort":"SHANGHAI","supplierAddress":"Room 3-304, No. 448 Heping West Roa d, Xinhua District, Shijiazhuang 05 0057, China ., ., China China","customerAddress":"CABIN NO 4, GALA NO 106, 1st Floor, KAILASH COMPLEX, House No 374"},{"dataSource":"API Import","activeIngredients":"","year":"2024","qtr":"Q4","strtotime":1731954600,"product":"L-CARNITINE TARTRATE","address":"B-7, LAXMI TOWER, L.S.C. BLOCK-C","city":"DELHI","supplier":"WUHAN PHOENIX SCIENCE & TECHNOLOGY CO., LIMITED","supplierCountry":"CHINA","foreign_port":"SHANGHAI","customer":"MAXCURE NUTRAVEDICS LIMITED","customerCountry":"INDIA","quantity":"1500.00","actualQuantity":"1500","unit":"KGS","unitRateFc":"19.5","totalValueFC":"29566","currency":"USD","unitRateINR":"1663.4","date":"19-Nov-2024","totalValueINR":"2495025","totalValueInUsd":"29566","indian_port":"JNPT","hs_no":"29239000","bill_no":"6753475","productDescription":"API","marketType":"REGULATED MARKET","country":"CHINA","selfForZScoreResived":"Pharma Grade","supplierPort":"SHANGHAI","supplierAddress":"B817, S3 BUILDING, TAZIHU UNIT, JIA NGAN DISTRICT, WUHAN CITY, HUBEI 43 0024, CHINA China","customerAddress":"B-7, LAXMI TOWER, L.S.C. BLOCK-C"}]
23-Mar-2021
26-Nov-2024
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Drugs in Development

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Details:

Levocarnitine is a carrier molecule in the transport of long-chain fatty acids across the inner mitochondrial membrane, which is indicated in the treatment of primary systemic carnitine deficiency.


Lead Product(s): Levocarnitine

Therapeutic Area: Rare Diseases and Disorders Brand Name: Carnitor-Generic

Study Phase: ApprovedProduct Type: Small molecule

Sponsor: Not Applicable

Deal Size: Not Applicable Upfront Cash: Not Applicable

Deal Type: Not Applicable October 10, 2023

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01

Duphat
Not Confirmed
Duphat
Not Confirmed

Details : Levocarnitine is a carrier molecule in the transport of long-chain fatty acids across the inner mitochondrial membrane, which is indicated in the treatment of primary systemic carnitine deficiency.

Brand Name : Carnitor-Generic

Molecule Type : Small molecule

Upfront Cash : Not Applicable

October 10, 2023

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Details:

ANI’s Levocarnitine Tablets are the generic version of the Reference Listed Drug (RLD) Carnitor®. The launch of Levocarnitine Tablets is another example of ANI’s commitment to increasing patient access to affordable, high-quality medicines.


Lead Product(s): Levocarnitine

Therapeutic Area: Rare Diseases and Disorders Brand Name: Levocarnitine-Generic

Study Phase: ApprovedProduct Type: Small molecule

Sponsor: Not Applicable

Deal Size: Not Applicable Upfront Cash: Not Applicable

Deal Type: Not Applicable December 19, 2022

blank

02

Duphat
Not Confirmed
Duphat
Not Confirmed

Details : ANI’s Levocarnitine Tablets are the generic version of the Reference Listed Drug (RLD) Carnitor®. The launch of Levocarnitine Tablets is another example of ANI’s commitment to increasing patient access to affordable, high-quality medicines.

Brand Name : Levocarnitine-Generic

Molecule Type : Small molecule

Upfront Cash : Not Applicable

December 19, 2022

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DRUG PRODUCT COMPOSITIONS

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DOSAGE - TABLET;ORAL - 330MG

USFDA APPLICATION NUMBER - 18948

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DOSAGE - SOLUTION;ORAL - 1GM/10ML

USFDA APPLICATION NUMBER - 19257

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DOSAGE - INJECTABLE;INJECTION - 200MG/ML

USFDA APPLICATION NUMBER - 20182

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ABOUT THIS PAGE

Levocarnitine Manufacturers

A Levocarnitine manufacturer is defined as any person or entity involved in the manufacture, preparation, processing, compounding or propagation of Levocarnitine, including repackagers and relabelers. The FDA regulates Levocarnitine manufacturers to ensure that their products comply with relevant laws and regulations and are safe and effective to use. Levocarnitine API Manufacturers are required to adhere to Good Manufacturing Practices (GMP) to ensure that their products are consistently manufactured to meet established quality criteria.

click here to find a list of Levocarnitine manufacturers with USDMF, JDMF, KDMF, CEP, GMP, COA and API Price related information on PhamaCompass.

Levocarnitine Suppliers

A Levocarnitine supplier is an individual or a company that provides Levocarnitine active pharmaceutical ingredient (API) or Levocarnitine finished formulations upon request. The Levocarnitine suppliers may include Levocarnitine API manufacturers, exporters, distributors and traders.

click here to find a list of Levocarnitine suppliers with USDMF, JDMF, KDMF, CEP, GMP, COA and API Price related information on PharmaCompass.

Levocarnitine USDMF

A Levocarnitine DMF (Drug Master File) is a document detailing the whole manufacturing process of Levocarnitine active pharmaceutical ingredient (API) in detail. Different forms of Levocarnitine DMFs exist exist since differing nations have different regulations, such as Levocarnitine USDMF, ASMF (EDMF), JDMF, CDMF, etc.

A Levocarnitine DMF submitted to regulatory agencies in the US is known as a USDMF. Levocarnitine USDMF includes data on Levocarnitine's chemical properties, information on the facilities and procedures used, and details about packaging and storage. The Levocarnitine USDMF is kept confidential to protect the manufacturer’s intellectual property.

click here to find a list of Levocarnitine suppliers with USDMF on PharmaCompass.

Levocarnitine JDMF

The Pharmaceuticals and Medical Devices Agency (PMDA) established the Japan Drug Master File (JDMF), also known as the Master File (MF), to permit Japanese and foreign manufacturers of drug substances, intermediates, excipients, raw materials, and packaging materials (‘Products’) to voluntarily register confidential information about the production and management of their products in Japan.

The Levocarnitine Drug Master File in Japan (Levocarnitine JDMF) empowers Levocarnitine API manufacturers to present comprehensive information (e.g., production methods, data, etc.) to the review authority, i.e., PMDA (Pharmaceuticals & Medical Devices Agency).

PMDA reviews the Levocarnitine JDMF during the approval evaluation for pharmaceutical products. At the time of Levocarnitine JDMF registration, PMDA checks if the format is accurate, if the necessary items have been included (application), and if data has been attached.

click here to find a list of Levocarnitine suppliers with JDMF on PharmaCompass.

Levocarnitine KDMF

In Korea, the Ministry of Food and Drug Safety (MFDS) is in charge of regulating pharmaceutical products and services.

Pharmaceutical companies submit a Levocarnitine Drug Master File in Korea (Levocarnitine KDMF) to the MFDS, which includes comprehensive information about the production, processing, facilities, materials, packaging, and testing of Levocarnitine. The MFDS reviews the Levocarnitine KDMF as part of the drug registration process and uses the information provided in the Levocarnitine KDMF to evaluate the safety and efficacy of the drug.

After submitting a Levocarnitine KDMF to the MFDS, the registered manufacturer can provide importers or distributors with the registration number without revealing confidential information to Korean business partners. Applicants seeking to register their Levocarnitine API can apply through the Korea Drug Master File (KDMF).

click here to find a list of Levocarnitine suppliers with KDMF on PharmaCompass.

Levocarnitine CEP

A Levocarnitine CEP of the European Pharmacopoeia monograph is often referred to as a Levocarnitine Certificate of Suitability (COS). The purpose of a Levocarnitine CEP is to show that the European Pharmacopoeia monograph adequately controls the purity of Levocarnitine EP produced by a given manufacturer. Suppliers of raw materials can prove the suitability of Levocarnitine to their clients by showing that a Levocarnitine CEP has been issued for it. The manufacturer submits a Levocarnitine CEP (COS) as part of the market authorization procedure, and it takes on the role of a Levocarnitine CEP holder for the record. Additionally, the data presented in the Levocarnitine CEP (COS) is managed confidentially and offers a centralized system acknowledged by numerous nations, exactly like the Levocarnitine DMF.

A Levocarnitine CEP (COS) is recognised by all 36 nations that make up the European Pharmacopoeia Convention. Levocarnitine CEPs may be accepted in nations that are not members of the Ph. Eur. at the discretion of the authorities there.

click here to find a list of Levocarnitine suppliers with CEP (COS) on PharmaCompass.

Levocarnitine NDC

National Drug Code is a comprehensive database maintained by the FDA that contains information on all drugs marketed in the US. This directory includes information about finished drug products, unfinished drug products, and compounded drug products, including those containing Levocarnitine as an active pharmaceutical ingredient (API).

Finished drug products

The FDA updates the NDC directory daily. The NDC numbers for Levocarnitine API and other APIs are published in this directory by the FDA.

Unfinished drugs

The NDC unfinished drugs database includes product listing information submitted for all unfinished drugs, such as active pharmaceutical ingredients (APIs), drugs intended for further processing and bulk drug substances for compounding.

Pharmaceutical companies that manufacture Levocarnitine as an active pharmaceutical ingredient (API) must furnish the FDA with an updated record of all drugs that they produce, prepare, propagate, compound, or process for commercial distribution in the US at their facilities.

Compounded drug products

The NDC directory also contains data on finished compounded human drug products that contain Levocarnitine and are produced by outsourcing facilities. While these outsourcing facilities are not mandated to assign a Levocarnitine NDC to their finished compounded human drug products, they may choose to do so.

click here to find a list of Levocarnitine suppliers with NDC on PharmaCompass.

Levocarnitine GMP

Levocarnitine Active pharmaceutical ingredient (API) is produced in GMP-certified manufacturing facility.

GMP stands for Good Manufacturing Practices, which is a system used in the pharmaceutical industry to make sure that goods are regularly produced and monitored in accordance with quality standards. The FDA’s current Good Manufacturing Practices requirements are referred to as cGMP or current GMP which indicates that the company follows the most recent GMP specifications. The World Health Organization (WHO) has its own set of GMP guidelines, called the WHO GMP. Different countries can also set their own guidelines for GMP like China (Chinese GMP) or the EU (EU GMP).

PharmaCompass offers a list of Levocarnitine GMP manufacturers, exporters & distributors, which can be sorted by USDMF, JDMF, KDMF, CEP (COS), WC, API price, and more, enabling you to easily find the right Levocarnitine GMP manufacturer or Levocarnitine GMP API supplier for your needs.

Levocarnitine CoA

A Levocarnitine CoA (Certificate of Analysis) is a formal document that attests to Levocarnitine's compliance with Levocarnitine specifications and serves as a tool for batch-level quality control.

Levocarnitine CoA mostly includes findings from lab analyses of a specific batch. For each Levocarnitine CoA document that a company creates, the USFDA specifies specific requirements, such as supplier information, material identification, transportation data, evidence of conformity and signature data.

Levocarnitine may be tested according to a variety of international standards, such as European Pharmacopoeia (Levocarnitine EP), Levocarnitine JP (Japanese Pharmacopeia) and the US Pharmacopoeia (Levocarnitine USP).

Inform the supplier about your product requirements, specifying if you need a product with particular monograph like EP (Ph. Eur.), USP, JP, BP, or any other quality. In addition, clarify whether you need hydrochloride (HCl), anhydricum, base, micronisatum or a specific level of purity. To find reputable suppliers, utilize the filters and select those certified by GMP, FDA, or any other certification as per your requirement.
For your convenience, we have listed synonyms and CAS numbers to help you find the best supplier. The use of synonyms and CAS numbers can be helpful in identifying potential suppliers, but it is crucial to note that they might not always indicate the exact same product. It is important to confirm the product details with the supplier before making a purchase to ensure that it meets your requirements.
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