Possible Interaction: Valproic Acid and Levocarnitine

“Administrations of D L-carnitine and albumin reduced VPA hepatotoxicity.”

“Lessons: Resolution of hyperammonemia caused by Valproic acid therapy may be enhanced with the administration of L-carnitine.”

“ L-carnitine acts as a cofactor for VPA metabolism, increasing beta-oxidation of VPA and limiting hepatotoxic metabolites.”

“ l-Carnitine uptake was inhibited in BBM vesicles by valproate , verapamil, tetraethylammonium, and pyrilamine and by structural analogs of l-carnitine, including d-carnitine, acetyl-d,l-carnitine, and propionyl-, butyryl-, octanoyl-, isovaleryl-, and palmitoyl-l-carnitine.”

“ l-carnitine uptake was inhibited (P < 0.05-0.01) by valproate and other organic cations.”

“In the first case, moreover, cortical blindness and severe hepatic failure occurred while receiving valproate , in spite of concomitant L-carnitine therapy.”

“This case suggests that enhanced drug excretion and L-carnitine supplementation may prevent potentially fatal hepatic dysfunction after VPA overdose.”

“ L-Carnitine supplementation has been recommended to prevent the fatal hepatotoxic effects associated with valproic acid.”

“The administration of VPA (300 mg/kg/day) together with L-carnitine (30 mg/kg/day) from day 8 to day 14 after birth increased Gad1 mRNA expression in the RVLM and reduced apnea counts in Mecp2-/y mice on postnatal day 15.”

“The long-term administration of valproic acid (VPA) may decrease the plasma concentrations of l-carnitine in epileptic patients.”