Q: I am a 65-year-old man on CAPD dialysis for the past one year. My nephrologist has prescribed me L Carnitor (laevocarnitine) 500 mg tablets. What's the use of this drug? I have heard that prolonged use of this drug is harmful for peritoneal dialysis patients, is it true? I have not been tested for carnitine deficiency

A:Carnitor is the brand name; the name of the medicine is laevocarnitine. Carnitine deficiency can occur in patients on dialysis. Hence its plasma level should be determined and if found low, supplementation is required. It is given intravenously after each dialysis session and the dose is to be decided based on blood levels. A maintenance dose by mouth of 1 g daily may be considered keeping in view its possible side effects: nausea, vomiting, diarrhoea, abdominal cramps, body odour, etc. The US authorities advise that laevocarnitine should not be given by mouth to patients with severe renal impairment for long periods because of the accumulation of breakdown metabolites.