Administration of L-carnitine to diabetic patients receiving insulin or hypoglycemic oral treatment may cause hypoglycemia. In these patients, plasma glucose should be continuously monitored to control the hypoglycemic treatment.
In patients with severe renal impairment, prolonged oral administration of high doses of L-carnitine may increase concentrations of the potentially toxic metabolites such as trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), as these metabolites are usually excreted in the urine. In such a case, urine, breath, and sweat have an unpleasant odor.
Taking levocarnitine too quickly causes adverse reactions in the gastrointestinal tract. The dose should be divided and administered evenly during the course of the day to maximize tolerability.
Convulsive seizures have been reported in patients with and without previous seizure activity. The frequency and/or severity of convulsive seizures was increased in patients with previous seizure activity.
Drug Interactions
Prior to administration of the drug, you should inform your physician about taking other drugs.
Glucocorticoids increase carnitine levels in many tissues (except the liver). Excessive doses of choline inhibit carnitine synthesis and activity. Carnitine may be combined with various anabolic agents; with drugs with antioxidant or/and antihypoxant effects.
Special Warnings
The drug contains methylparahydroxybenzoate and propylparahydroxybenzoate which may cause delayed hypersensitivity.
Children
Children < 3 years of age should be treated under medical supervision.
Pregnancy and Lactation
Due to the lack of studies, as a precautionary measure, it is advisable to avoid using Elcar during pregnancy.