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Transient nausea and vomiting have been observed. Less frequent adverse reactions are body odor, nausea, and gastritis. An incidence for these reactions is difficult to estimate due to the confounding effects of the underlying pathology.

Seizures have been reported to occur in patients, with or without pre-existing seizure activity, receiving either oral or intravenous levocarnitine. In patients with pre-existing seizure activity, an increase in seizure frequency and/or severity has been reported.

The table below lists the adverse events that have been reported in two double-blind, placebo-controlled trials in patients on chronic hemodialysis. Events occurring at ≥ 5% are reported without regard to causality.

Adverse Events with a Frequency ≥ 5% Regardless of Causality by Body System

  Placebo
(n=63)
Levocarnitine
10 mg (n=34)
Levocarnitine
20 mg (n=62)
Levocarnitine
40 mg (n=34)
Levocarnitine
10, 20 & 40 mg (n=130)
Body as Whole
  Abdominal pain 17 21 5 6 9
  Accidental injury 10 12 8 12 10
  Allergic reaction 5 6     2
  Asthenia 8 9 8 12 9
  Back pain 10 9 8 6 8
  Chest pain 14 6 15 12 12
  Fever 5 6 5 12 7
  Flu syndrome 40 15 27 29 25
  Headache 16 12 37 3 22
  Infection 17 15 10 24 15
  Injection site reaction 59 38 27 38 33
  Pain 49 21 32 35 30
Cardiovascular
  Arrhythmia 5 3   3 2
  Atrial fibrillation     2 6 2
  Cardiovascular disorder 6 3 5 6 5
  Electrocardiogram abnormal   3   6 2
  Hemorrhage 6 9 2 3 4
  Hypertension 14 18 21 21 20
  Hypotension 19 15 19 3 14
  Palpitations   3 8   5
  Tachycardia 5 6 5 9 6
  Vascular disorder 2   2 6 2
Digestive
  Anorexia 3 3 5 6 5
  Constipation 6 3 3 3 3
  Diarrhea 19 9 10 35 16
  Dyspepsia 10 9 6   5
  Gastrointestinal disorder 2 3   6 2
  Melena 3 6     2
  Nausea 10 9 5 12 8
  Stomach atony 5        
  Vomiting 16 9 16 21 15
Endocrine System
  Parathyroid disorder 2 6 2 6 4
Hemic/Lymphatic
  Anemia 3 3 5 12 6
Metabolic/Nutritional
  Hypercalcemia 3 15 8 6 9
  Hyperkalemia 6 6 6 6 6
  Hypervolemia 17 3 3 12 5
  Peripheral edema 3 6 5 3 5
  Weight decrease 3 3 8 3 5
  Weight increase 2 3   6 2
Musculo-Skeletal
  Leg cramps 13   8   4
  Myalgia 6        
Nervous
  Anxiety 5   2   1
  Depression 3 6 5 6 5
  Dizziness 11 18 10 15 13
  Drug dependence 2 6     2
  Hypertonia 5 3     1
  Insomnia 6 3 6   4
  Paresthesia 3 3 3 12 5
  Vertigo   6     2
Respiratory
  Bronchitis     5 3 3
  Cough increase 16   10 18 9
  Dyspnea 19 3 11 3 7
  Pharyngitis 33 24 27 15 23
  Respiratory disorder 5        
  Rhinitis 10 6 11 6 9
  Sinusitis 5   2 3 2
Skin and Appendages
  Pruritis 13   8 3 5
  Rash 3   5 3 3
Special Senses
  Amblyopia 2   6   3
  Eye disorder 3 6 3   3
  Taste perversion     2 9 3
Urogenital
  Urinary tract infect 6 3 3   2
  Kidney failure 5 6 6 6 6