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Administration of high doses of the oral formulations of levocarnitine for long periods of time is not recommended in patients with severely compromised renal function or in ESRD patients on dialysis due to the fact that major metabolites formed following oral administration trimethylamine (TMA) and trimethylamine-N-oxide (TMAO) will accumulate since they can not be efficiently removed by the kidneys. Moreover, increased levels of TMA in dialysis patients have been reported to be associated with possible neurophysiologic effects. Also, the inefficient removal of TMA may result in the development of 'fishy odor' syndrome.
Only the intravenous form of levocarnitine is indicated for use in ESRD patients on hemodialysis.
Oral Solution: L-Carnitine (Carnicor) 10% oral solution is for oral use only. Not for parental use.
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