Therapy with a number of drugs may be associated with reduced levels of carnitine. Sometimes a patient may develop carnitine deficiency.
Drugs associated with reduced levels of carnitine:
(1) valproic acid
(2) pivampicillin or other antibiotics formulated with pivalic acid
(3) nucleoside analogues used to treat HIV
(4) chemotherapeutic agents
Diagnosis of drug-induced carnitine deficieny:
(1) presence of carnitine deficiency during therapy with the implicated drug
(2) reversal of the deficiency after discontinuation of the drug with or without carnitine replacement (normalization of the carnitine levels may take several months)
(3) absence of an alternative explanation
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