Possible Interaction: Levocarnitine and Doxorubicin Hydrochloride

“This mechanism can be proposed to explain the protective effects of L-carnitine against adriamycin cardiotoxicity, ammonium acetate and zidovudine-induced mitochondrial ultrastructural and functional alterations.”

“TO THE EDITOR: Missing from Shan and colleagues' interesting review of anthracycline-induced cardiotoxicity [1] is any reference to the potential use of L-carnitine to prevent adriamycin cardiotoxicity.”

“In conclusion, data from this study suggest that the reduction of antioxidant defense during doxorubicin administration resulted in hepatic injury could be prevented by L-carnitine supplementation by decreasing the oxidative stress and preserving both the activity and gene expression level of antioxidant enzymes.”

“Interestingly, L-carnitine supplementation completely reversed the biochemical and gene expression levels induced by doxorubicin to the control values.”

“The present study investigates whether L-carnitine , antioxidant agent, can reduce the hepatic damage induced by doxorubicin.”

“Biopharmacological evaluations suggest that L-carnitine can prevent cardiac metabolic damage caused by doxorubicin , as well as can inhibit cisplatin-induced injury in the kidney and in the small intestine, without any interference with the drug's antitumoral properties.”

“ ADR treatment resulted in elevation of plasma free and total CARN concentrations (p < 0.05).”

“Perfusion of the heart with L-carnitine after 10-min perfusion with DOX (0.5 mM) caused 88% reversal of DOX-induced inhibition of palmitate oxidation in cardiac cells.”

“However, the oxidation of a non-CPT 1 dependent substrate palmitoylcarnitine was unaffected by adriamycin except … than 1 mM. These data suggest that after in vitro or in vivo administration, adriamycin , inhibits fatty acid oxidation in part secondary to … 1 and/or depletion of its substrate, L-carnitine , in ….”

“Interestingly, medium- and short-chain fatty acid oxidation, which are independent of CPT 1, were also inhibited acutely by adriamycin and could be reversed by L-carnitine.”

“Incubation for 60 min with a mixture of L-carnitine and doxorubicin improved cellular respiration, oxygen uptake being only 9% less than that of the controls, and an even greater reversal characterized the propionyl carnitine mixture for which the recovery of endogenous cellular respiration was almost complete (93%).”

“ L-carnitine moreover acts to eliminate completely the Ca2+ increase induced by doxorubicin.”

“ L-carnitine pre-incubation significantly reduced (p less than 0.001) the metabolic cardiac impairment due to doxorubicin.”

“Thus, it appears L-carnitine may be useful in the prevention of doxorubicin-induced cardiac toxicity.”

“This would suggest that the reparatory effect of L-Carnitine against Doxorubicin cardiotoxicity is linked to the natural role played by this substance in metabolic processes.”