I am a facility manager for a hemodialysis unit in the South. I read about the FDA Alert concerning oral administration of Carnitor and how it "causes increased amounts of nitrogenous waste to be removed in the dialysis procedure, possible neurophysiologic effects, and the development of 'fishy odor' syndrome. This does not occur to the same extent following IV administration."

What exactly does that mean? Several of our patients are on Carnitor IV post dialysis; I have seen these symptoms in 5 patients. These patients were taken off Carnitor and appear to be doing better.

One thing I did notice with these patients is their iron sat. was 100% at the time they were experiencing these symptoms. Also, they would have uncontrolled HTN, and the HCT would drop very low even though iron sat% was high. When Carnitor was stopped everything appeared to return to normal for that patient. Has anyone else experienced this? How much is too much? Is there a lab test to do besides Carnitine levels to evaluate this situation better?

Ed:

This is a totally new one for me! My first thought was iron overload, but as I read on, I don't think that is the case.

Here is the Carnitor web page:
http://www.carnitor.com/

You may wish to call their clinical specialists at Sigma-Tau Pharmaceuticals, Inc. at (800) 447-0169. They may be better able to answer these questions.

I would, however, love to hear what they say, and other input from folks out there!

Interesting question! Sorry I couldn't be of more help,
Carol