Investigational Drug Details
| Drug ID: | D201 |
| Drug Name: | L-Carnitine |
| Synonyms: | (-)-Carnitine; (-)-L-Carnitine; (R)-Carnitine; 3-Carboxy-2-hydroxy-N,N,N-trimethyl-1-propanaminium hydroxide, inner salt; Carnitine; L-Carnitine; Levocarnitine; Vitamin BT |
| Type: | Supplement |
| DrugBank ID: | DB00583 |
| DrugBank Description: | Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. |
| PubChem ID: | 10917 |
| CasNo: | 541-15-1 |
| Repositioning for NAFLD: | Yes |
| SMILES: | C([N+](C)(C)C)[C@@H](CC(=O)[O-])O |
| Structure: |
|
| InChiKey: | PHIQHXFUZVPYII-ZCFIWIBFSA-N |
| Molecular Weight: | 161.201 |
| DrugBank Targets: | Solute carrier family 22 member 4; Solute carrier family 22 member 5; Carnitine O-acetyltransferase; Mitochondrial carnitine/acylcarnitine carrier protein CACL; Mitochondrial carnitine/acylcarnitine carrier protein; Peroxisomal carnitine O-octanoyltransfe |
| DrugBank MoA: | Levocarnitine can be synthesised within the body from the amino acids lysine or methionine. Vitamin C (ascorbic acid) is essential to the synthesis of carnitine. Levocarnitine is a carrier molecule in the transport of long chain fatty acids across the inner mitochondrial membrane. It also exports acyl groups from subcellular organelles and from cells to urine before they accumulate to toxic concentrations. Only the L isomer of carnitine (sometimes called vitamin BT) affects lipid metabolism. Levocarnitine is handled by several proteins in different pathways including carnitine transporters, carnitine translocases, carnitine acetyltransferases and carnitine palmitoyltransferases. |
| DrugBank Pharmacology: | Levocarnitine is a carrier molecule in the transport of long chain fatty acids across the inner mitochondrial membrane. It also exports acyl groups from subcellular organelles and from cells to urine before they accumulate to toxic concentrations. Lack of carnitine can lead to liver, heart, and muscle problems. Carnitine deficiency is defined biochemically as abnormally low plasma concentrations of free carnitine, less than 20 µmol/L at one week post term and may be associated with low tissue and/or urine concentrations. Further, this condition may be associated with a plasma concentration ratio of acylcarnitine/levocarnitine greater than 0.4 or abnormally elevated concentrations of acylcarnitine in the urine. Only the L isomer of carnitine (sometimes called vitamin BT) affects lipid metabolism. The "vitamin BT" form actually contains D,L-carnitine, which competitively inhibits levocarnitine and can cause deficiency. Levocarnitine can be used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. |
| DrugBank Indication: | For treatment of primary systemic carnitine deficiency, a genetic impairment of normal biosynthesis or utilization of levocarnitine from dietary sources, or for the treatment of secondary carnitine deficiency resulting from an inborn error of metabolism such as glutaric aciduria II, methyl malonic aciduria, propionic acidemia, and medium chain fatty acylCoA dehydrogenase deficiency. Used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. Parenteral levocarnitine is indicated for the prevention and treatment of carnitine deficiency in patients with end-stage renal disease. |
| Targets: | SLC22A4; SLC22A5; CRAT; MPO |
| Therapeutic Category: | -- |
| Clinical Trial Progress: | Phase 3 on-going (IRCT20170628034786N2) |
| Latest Progress: | Under clinical trials |
| Trial ID | Source ID | Phases | Status | Study Results | Start Date | Last Update Posted | |
|---|---|---|---|---|---|---|---|
| L0186 | NCT01617772 | Phase 2 | Unknown status | No Results Available | January 1, 2016 | May 11, 2018 | Details |
| L0482 | IRCT20170628034786N2 | Phase 3 | Recruiting | No Results Available | 16/01/2019 | 29 January 2019 | Details |
| L0644 | IRCT201212052602N8 | Not applicable | Not Recruiting | No Results Available | 04/02/2013 | 22 February 2018 | Details |
| L0659 | IRCT201111204092N2 | Phase 3 | Not Recruiting | No Results Available | 25/02/2012 | 22 February 2018 | Details |
| L0710 | IRCT20150706023083N3 | Phase 3 | Recruiting | No Results Available | 29/12/2019 | 13 January 2020 | Details |
| L0790 | NCT03604016 | Phase 4 | Not recruiting | No Results Available | 19/07/2018 | 12 December 2020 | Details |
| L0800 | NCT03439917 | Not applicable | Not recruiting | No Results Available | 14/02/2018 | 13 December 2021 | Details |
| L0810 | NCT03319199 | Not applicable | Not recruiting | No Results Available | 10/10/2017 | 12 December 2020 | Details |
| L0904 | IRCT2014020316348N2 | Not applicable | Not Recruiting | No Results Available | 10/03/2014 | 22 February 2018 | Details |
| L0915 | NCT01956825 | Phase 4 | Not recruiting | No Results Available | 12/09/2013 | 19 February 2015 | Details |
| L0952 | IRCT201102235893N1 | Not applicable | Not Recruiting | No Results Available | 30/07/2011 | 22 February 2018 | Details |
| Strategy ID | Strategy | Synonyms | Related Targets | Related Drugs | |
|---|---|---|---|---|---|
| S02 | Enhance lipid metabolism | triglyceride-lowering; lipid tolerance; lipid metabolism | 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) inhibitor; Decreases intestinal cholesterol absorption; FXR agonist; ACC inhibitor; FAS inhibitor; DGAT2 inhibitor; SCD-1 inhibitor | Atorvastatin; Ezetimibe; Obeticholic Acid; GS-9674; GS-0976; TVB-2640; IONIS-DGAT2rx; Aramchol; | Details |
| Article ID | PMID | Source | Title | |
|---|---|---|---|---|
| A00980 | 34911556 | BMC Biol | Enhanced hepatic respiratory capacity and altered lipid metabolism support metabolic homeostasis during short-term hypoxic stress. | Details |
| A01139 | 34857248 | Clin Nutr ESPEN | Effect of l-carnitine supplementation on liver fat content and cardiometabolic indices in overweight/obese women with polycystic ovary syndrome: A randomized controlled trial. | Details |
| A01587 | 34684533 | Nutrients | Supplementation with a Specific Combination of Metabolic Cofactors Ameliorates Non-Alcoholic Fatty Liver Disease, Hepatic Fibrosis, and Insulin Resistance in Mice. | Details |
| A01608 | 34680557 | Biomedicines | Combined Metabolic Activators Decrease Liver Steatosis by Activating Mitochondrial Metabolism in Hamsters Fed with a High-Fat Diet. | Details |
| A02290 | 34434943 | Front Med (Lausanne) | Role of Carnitine in Non-alcoholic Fatty Liver Disease and Other Related Diseases: An Update. | Details |
| A02474 | 34360538 | Int J Mol Sci | Diabetes Mellitus and Cardiovascular Diseases: Nutraceutical Interventions Related to Caloric Restriction. | Details |
| A03391 | 34019353 | Vopr Pitan | [Specialized products for dietary correction of the diet of patients with non-alcoholic steatohepatitis]. | Details |
| A03589 | 33939897 | J Pediatr Endocrinol Metab | Effect of l-carnitine supplementation on children and adolescents with nonalcoholic fatty liver disease (NAFLD): a randomized, triple-blind, placebo-controlled clinical trial. | Details |
| A04721 | 33529448 | Liver Int | Maternal high-fat diet disrupted one-carbon metabolism in offspring, contributing to nonalcoholic fatty liver disease. | Details |
| A04829 | 33491528 | J Diet Suppl | The Effects of Vitamin E, Silymarin and Carnitine on the Metabolic Abnormalities Associated with Nonalcoholic Liver Disease. | Details |
| A05068 | 33388736 | Orv Hetil | Sarcopenia - 2021: Pathophysiology, diagnosis, therapy | Details |
| A06273 | 32945305 | Food Funct | Lactobacillus fermentum CQPC06 in naturally fermented pickles prevents non-alcoholic fatty liver disease by stabilizing the gut-liver axis in mice. | Details |
| A06472 | 32866186 | PLoS One | Differences among patients with and without nonalcoholic fatty liver disease having elevated alanine aminotransferase levels at various stages of metabolic syndrome. | Details |
| A06890 | 32708036 | Nutrients | The Importance of the Fatty Acid Transporter L-Carnitine in Non-Alcoholic Fatty Liver Disease (NAFLD). | Details |
| A06984 | 32673798 | Mol Metab | Non-alcoholic fatty liver disease and steatohepatitis: State of the art on effective therapeutics based on the gold standard method for diagnosis. | Details |
| A07840 | 32337855 | Mol Syst Biol | The acute effect of metabolic cofactor supplementation: a potential therapeutic strategy against non-alcoholic fatty liver disease. | Details |
| A08426 | 32115853 | Diabetes Obes Metab | A metabolomics-based molecular pathway analysis of how the sodium-glucose co-transporter-2 inhibitor dapagliflozin may slow kidney function decline in patients with diabetes. | Details |
| A08451 | 32105727 | Gastroenterology | TMAVA, a Metabolite of Intestinal Microbes, Is Increased in Plasma From Patients With Liver Steatosis, Inhibits γ-Butyrobetaine Hydroxylase, and Exacerbates Fatty Liver in Mice. | Details |
| A09536 | 31705397 | J Endocrinol Invest | L-Carnitine counteracts in vitro fructose-induced hepatic steatosis through targeting oxidative stress markers. | Details |
| A09796 | 31607566 | Dig Liver Dis | L-carnitine supplementation attenuates NAFLD progression and cardiac dysfunction in a mouse model fed with methionine and choline-deficient diet. | Details |