Romanian Society of Pharmaceutical Sciences
 

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FAVOURABLE RESULTS FOR L-CARNITINE USE IN VALPROIC ACID ACUTE POISONING

RADU CIPRIAN ŢINCU 1,2#*, CRISTIAN COBILINSCHI 3#, DANA TOMESCU 4,5#, LAURENŢIU COMAN 6#, IULIA ŢINCU 7#, CAMELIA DIACONU 8#, RADU ALEXANDRU MACOVEI 1,2#

1.Clinical Emergency Hospital Bucharest, Critical Care Toxicology Unit, 8 Floreasca Way, 014451, Bucharest, Romania
2 .“Carol Davila” University of Medicine and Pharmacy, Faculty of Medicine, Department of Orthopaedics – Anaesthesiology and Intensive Care, Discipline of Pharmacology, Toxicology and Clinical Psychopharmacology, 8 Floreasca Way, 014451, Bucharest, Romania
3 .Clinical Emergency Hospital Bucharest, Anaesthesiology Intensive Care Unit, 8 Floreasca Way, 014451, Bucharest, Romania
4 .“Fundeni” Clinical Institute, Anaesthesiology Intensive Care Unit, 258 Fundeni Street, 022328, Bucharest, Romania
5 .“Carol Davila” University of Medicine and Pharmacy, Faculty of Medicine, Department of Orthopaedics – Anaesthesiology and Intensive Care, Discipline Anaesthesiology and Intensive Care, 258 Fundeni Street, 022328, Bucharest, Romania
6 .“Carol Davila” University of Medicine and Pharmacy, Faculty of Pharmacy, Physiology Department, 6 Traian Vuia Street, 020956, Bucharest, Romania
7 .“Grigore Alexandrescu” Emergency Children Hospital, Emergency Department, 30-32 Iancu de Hunedoara Avenue, 11743, Bucharest, Romania
8 .“Carol Davila” University of Medicine and Pharmacy, Clinical Emergency Hospital Bucharest, Internal Medicine Unit, Bucharest, Romania

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Valproic acid (VPA) is a fatty acid with anticonvulsant properties. The aim of our present study was to investigate the effect of levo-carnitine supplementation on serum NH3 and clinical recovery in patients with VPA intoxication. This study included all patients admitted for acute VPA poisoning (VPA > 100 µg/mL), in 2014, in our clinic. Blood samples were obtained in order to analyse NH3, VPA concentrations and biochemical status. The patients were allocated to receive standard therapy (Group 1) or 1800 mg of L-carnitine/day together with standard therapy (Group 2) for 3 days. A total of 62 patients were finally enrolled in the study. The median (IQR) ingested dose of VPA was 1000 mg (800 mg, 1200 mg [range; 800 - 6000 mg]). L-Carnitine supplementation resulted in significant reductions in ammonemia (47.9 ± 6 vs. 61.9 ± 11.39 μmol/L), determined after 24 hours, levels compared with baseline (p < 0.001). The trend was similar for plasma VPA levels. The use of L-carnitine accelerates the elimination of VPA and facilitates the decrease in ammonia plasma levels.