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It is a quaternary amine (3-hydroxy-4- N -trimethylaminobutyrate) whose main function in mammalian cells is the transfer of long chain fatty acids across the inner mitochondrial membrane for - oxidation and generation of ATP energy

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Special Precautions Administration of high doses of the oral formulations of levocarnitine for long periods of time is not recommended in patients with severely compromised renal function or in ESRD patients on dialysis due to the fact that major metabolites formed following oral administration trimethylamine (TMA) and trimethylamine-N-oxide (TMAO) will accumulate since they can not be efficiently removed by the kidneys

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