VIGOSINE

Indications

• Primary carnitine deficiency
• Secondary carnitine deficiency (e.g., due to certain metabolic disorders)
• Certain conditions associated with impaired fatty acid oxidation
• Supportive treatment in patients with heart disease or metabolic syndrome

Dosage

Children: Refer to BNF for Children for specific dosing recommendations based on the child's condition and age.

Adults: Refer to BNF for specific dosing recommendations based on the condition being treated.

Mechanism of action

Carnitine facilitates the transport of long-chain fatty acids across the mitochondrial membrane by forming acyl-carnitine derivatives. This process is essential for the β-oxidation of fatty acids, enabling their conversion into acetyl-CoA, which enters the citric acid cycle to produce ATP. Additionally, carnitine plays a role in the removal of toxic acyl groups from the mitochondria, thus helping to detoxify the cell.

Pharmacodynamics

Carnitine enhances fatty acid oxidation and energy production in tissues that rely heavily on fat as a fuel source. It helps maintain cellular energy homeostasis, supports metabolic functions, and may have protective effects against oxidative stress by improving mitochondrial function.

Pharmacokinetics

Carnitine is absorbed in the gastrointestinal tract, with peak plasma concentrations typically occurring within 3-5 hours post-ingestion. It is distributed widely in body tissues, with high concentrations found in skeletal and cardiac muscle. Carnitine is primarily excreted in the urine as free carnitine and acyl-carnitine derivatives. The half-life of carnitine in plasma is approximately 2-3 hours, and its levels can be influenced by dietary intake and renal function.

Adverse effects

• Nausea
• Vomiting
• Abdominal cramps
• Diarrhea
• Fishy body odor

Precautions

• Use with caution in patients with renal impairment
• Monitor for changes in renal function

Pregnancy

Safety in pregnancy has not been established.

Breast-feeding

Carnitine is excreted in breast milk; use caution.

Storage

Store in a cool, dry place, protected from light.

Formulations

• Carnitine oral solution
• Carnitine tablets