Drug-induced nutrient depletion

Medications That May Deplete ACETYL-L-CARNITINE

See which medications carry a reported association, how strong the evidence is, and what to discuss with your pharmacist.

46Medications
46Depletion records
About ACETYL-L-CARNITINE

Acetyl-L-carnitine is a form of the amino acid carnitine that the body uses to help produce energy in cells. It is most studied for nerve pain and memory-related conditions, though the evidence is mixed and often limited. It is generally well tolerated for short-term use, but you should talk with your pharmacist or doctor before starting it.

Commonly used for: Memory and cognitive support, Nerve pain (neuropathy), Energy and fatigue, Age-related decline, Male fertility, Mood support.

HelloPharmacist pharmacist-reviewed education. The medication records below are licensed clinical data, shown as published.

Deep dive: Acetyl-l-carnitine — uses, safety & drug interactions

The evidence

Medications associated with ACETYL-L-CARNITINE depletion

Each record is shown as published in our licensed clinical database. Open a medication for its full nutrient report.

Adefovir

Insignificant Depletion

Brand names include Hepsera

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking adefovir dipivoxil.

Adefovir dipivoxil is a prodrug which is converted to adefovir and pivalate in the body. Pivalate combines with carnitine and is excreted in the urine, which increases L-carnitine losses from the body. Theoretically, losses of acetyl-L-carnitine could also be increased. Adefovir was formerly used for HIV infection at doses of 125-500 mg daily and was associated with significant dose- and duration-related decreases in blood carnitine. After 12 weeks of therapy with 125-250 mg daily, decreases of 42% to 62% were seen, while 500 mg daily was associated with a 66% decrease in L-carnitine after 2 weeks. Some studies used a supplement of L-carnitine 500 mg daily during adefovir therapy. Adefovir is now used at a lower dose of 10 mg daily for treatment of hepatitis B. There are no reports of significant reductions in carnitine blood levels at this dose, and supplements are not necessary.
Taking Adefovir? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help produce energy inside cells, and it's closely related to L-carnitine, which your muscles and heart depend on. Here's the interesting backstory: when adefovir is broken down in the body, it releases a byproduct called pivalate, which latches onto carnitine and gets flushed out through the kidneys, pulling carnitine along with it. That said, adefovir is now used at a much lower dose (10 mg daily) for hepatitis B than the high doses studied years ago for HIV, and at this lower dose there are no meaningful reports of carnitine dropping to concerning levels. Most people taking adefovir at today's standard dose don't need to do anything about this, but if you have questions, your pharmacist or doctor is a great place to start.

References (5)
  1. Brass EP. Pivalate-generating prodrugs and carnitine homeostasis in man. Pharmacol Rev 2002;54:589-98. PubMed
  2. Deeks SG, Collier A, Lalezari J, et al. The safety and efficacy of adefovir dipivoxil, a novel anti-human immunodeficiency virus (HIV) therapy, in HIV-infected adults: a randomized, double-blind, placebo-controlled trial. J Infect Dis 1997;176:1517-23. PubMed
  3. Barditch-Crovo P, Toole J, Hendrix CW, et al. Anti-human immunodeficiency virus (HIV) activitiy, safety, and pharmacokinetics of adefovir dipivoxyl (9-[2-(bis-pivaloyloxymethyl)-phosphonylmethoxyethyl]adenine) in HIV-infected patients. J Infect Dis 1997;1
  4. Kahn J, Lagakos S, Wulfsohn M, et al. Efficacy and safety of adefovir dipivoxil with antiretroviral therapy. J Am Med Assoc 1999;282:2305-12.
  5. Noble S, Goa KL. Adefovir dipivoxil. Drugs 1999;58:479-87.

Full nutrient report for Adefovir →

Brand names include Triple Barbital

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Aprobarbital, Butabarbital, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally that helps cells produce energy, and it plays a supporting role in nerve function. Some early research raised the question of whether phenobarbital might reduce carnitine levels over time, possibly by affecting how the body processes or uses it, but follow-up studies have given mixed results with no clear pattern. Given that the evidence is conflicting and the rating here is insignificant, most people taking these barbiturates do not need to worry about this or take a supplement. If you have been on one of these medications long term and have questions, your pharmacist or doctor is the right person to ask.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Aprobarbital, Butabarbital, Phenobarbital →

Brand names include Phenaphen

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Aspirin, Codeine Phosphate, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help convert fat into energy, and it also plays a role in nerve cell health. The phenobarbital component of this combination has been looked at in research to see whether it might interfere with how the body handles carnitines, though the studies so far have pointed in different directions, with some showing a modest reduction and others finding no meaningful change at all. Given that this is rated as an insignificant depletion, most people taking this medication do not need to worry about it or consider a supplement. If you have any concerns, your pharmacist or doctor can help you decide whether your situation warrants a closer look.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Aspirin, Codeine Phosphate, Phenobarbital →

Atropine, Hyoscyamine, Phenobarbital

Insignificant Depletion

Brand names include Hypnaldyne

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Atropine, Hyoscyamine, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy, and it also supports nerve cell function. The phenobarbital component of this combination has been studied in relation to carnitine levels, though the research is genuinely mixed, with some studies finding a modest reduction and others finding no meaningful change at all. Given that this is rated as an insignificant depletion, most people taking this medication do not need to worry about supplementing. That said, if you have questions or any concerns about long-term use, it is always worth a quick conversation with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Atropine, Hyoscyamine, Phenobarbital →

Brand names include Barbidonna No. 2, Belladonna Phenobarbital

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Atropine, Hyoscyamine, Phenobarbital, Scopolamine? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally that helps cells produce energy, particularly in nerve tissue. The phenobarbital component of this combination medication has shown up in some research as possibly interfering with how the body handles carnitine, though the studies are genuinely mixed and no clear mechanism has been pinned down. Given the conflicting data and the insignificant rating here, most people taking this medication do not need to worry about this or take a supplement. That said, if you have concerns or take phenobarbital long-term, it is worth a quick conversation with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Atropine, Hyoscyamine, Phenobarbital, Scopolamine →

Brand names include Barbeloid, Donnatal #2, Donphen

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Atropine, Hyoscyamine, Scopolamine, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help cells produce energy, especially in nerve tissue. The phenobarbital component of this combination medication has shown up in some research as possibly interfering with how the body handles carnitine, though other studies found no meaningful change at all. Because the evidence is genuinely mixed and the overall rating here is insignificant, most people taking this medication do not need to worry about supplementing. If you have concerns, it is worth a quick conversation with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Atropine, Hyoscyamine, Scopolamine, Phenobarbital →

Atropine, Phenobarbital

Insignificant Depletion

Brand names include Anthrocol

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Atropine, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally that helps cells produce energy, and it plays a role in nerve function. Some research has found that phenobarbital might be linked to lower carnitine levels in certain patients, though other studies have found no real effect, so the picture is genuinely mixed. Given that, this is considered an insignificant depletion, meaning routine supplementation is not something most people on phenobarbital need to worry about. If you have concerns, your pharmacist or doctor can take a closer look at your individual situation.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Atropine, Phenobarbital →

Belladona Extract, Phenobarbital

Insignificant Depletion

Brand names include Chardonna-2

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Belladona Extract, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support nerve cell function. Some research has looked into whether phenobarbital, the anticonvulsant in this combination product, might nudge levels of carnitine downward, possibly by affecting how the body processes it, but the studies done so far have come back with mixed results. Given that this is rated an insignificant depletion, most people taking this medication are not expected to have a meaningful concern here, and routine supplementation does not appear to be necessary. That said, if you have questions specific to your situation, your pharmacist or doctor is a great person to ask.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Belladona Extract, Phenobarbital →

Brand names include Bellaphen-S, Spastrin, Phenarbal S

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Belladonna Alkaloids, Ergotamine Tartrate, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help cells produce energy, particularly in the brain and muscles. The phenobarbital component of this combination may theoretically interfere with how the body handles carnitines, though studies have come back with mixed results, with some showing lower levels and others finding no real difference. Given that this is rated as an insignificant depletion, routine supplementation is not considered necessary for most people. If you have any concerns, your pharmacist or doctor is the right person to ask.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Belladonna Alkaloids, Ergotamine Tartrate, Phenobarbital →

Belladonna Alkaloids, Phenobarbital

Insignificant Depletion

Brand names include Barbidonna, Donnatal

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Belladonna Alkaloids, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support nerve cell function. The phenobarbital component of this medication has been studied for a possible connection to lower carnitine levels, though the research is mixed and some studies show no meaningful change at all. Given that this is rated as an insignificant depletion, most people taking this combination do not need to worry about it or reach for a supplement. That said, if you have any concerns, your pharmacist or doctor is always a good person to ask.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Belladonna Alkaloids, Phenobarbital →

Belladonna Extract, Phenobarbital

Insignificant Depletion

Brand names include Belap

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Belladonna Extract, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help cells produce energy, particularly in nerve and muscle tissue. Some research has looked at whether phenobarbital might nudge carnitine levels downward, possibly by affecting how the body processes or uses it over time, but the studies done so far have pointed in different directions, with no clear, consistent effect found. Given that the evidence is conflicting and the rating here is insignificant, most people taking this medication do not need to worry about supplementing. If you are a long-term user and have concerns, it is worth a quick conversation with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Belladonna Extract, Phenobarbital →

Belladonna, Ergotamine, Phenobarbital

Insignificant Depletion

Brand names include Bellergal-S

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Belladonna, Ergotamine, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help cells produce energy, particularly in the brain and muscles. The phenobarbital component of this combination may theoretically interfere with carnitine levels, though the research is genuinely mixed, with some studies showing a modest reduction and others finding no meaningful change at all. Given that rating of insignificant depletion, routine supplementation does not appear necessary for most people taking this medication. That said, if you have any concerns, a quick conversation with your pharmacist or doctor can give you peace of mind.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Belladonna, Ergotamine, Phenobarbital →

Belladonna, Phenobarbital

Insignificant Depletion

Brand names include Bellophen, Susano

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Belladonna, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support nerve cell health. Some research has suggested that phenobarbital might interfere with how the body handles carnitine, possibly affecting how it is stored or used, but the studies on this are mixed and many show no real change at all. Given that the evidence is conflicting and the overall rating here is insignificant, most people taking this medication do not need to worry about supplementing. If you have questions or take phenobarbital long-term, a quick conversation with your pharmacist or doctor can put your mind at ease.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Belladonna, Phenobarbital →

Bellafoline, Phenobarbital

Insignificant Depletion

Brand names include Belladenal, Belladenal-S

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Bellafoline, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help produce energy inside cells, and it plays a role in nerve function as well. Some research has looked at whether phenobarbital might interfere with how the body handles carnitines, possibly by affecting how they are processed or used, but the studies on this have given mixed results. Because the evidence is conflicting and the overall rating here is insignificant, most people taking this medication are unlikely to need a supplement. If you have specific concerns, it is worth a quick conversation with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Bellafoline, Phenobarbital →

Brand names include S.B.P.

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Butabarbital, Phenobarbital, Secobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help convert fat into energy, and it plays a supporting role in nerve cell function. Some research has found that phenobarbital may be linked to lower carnitine levels in certain patients, possibly because it affects how the body processes or holds onto these compounds, but other studies have found no meaningful difference at all. Given the conflicting data and the insignificant rating here, most people taking these barbiturates do not need to worry about this or take a supplement. If you have been on one of these medications long-term and have concerns, it is worth a quick conversation with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Butabarbital, Phenobarbital, Secobarbital →

Butalbital, Phenobarbital, Secobarbital

Insignificant Depletion

Brand names include Tribarb

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Butalbital, Phenobarbital, Secobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help convert fat into energy and support nerve cell function. Some research has looked at whether phenobarbital (one of the barbiturates in this group) might interfere with how the body handles carnitine, possibly by increasing how quickly it is used up or cleared, but the studies so far have pointed in different directions with no clear agreement. Given the conflicting data and the insignificant rating here, this is not something most people taking these medications need to worry about. If you have concerns, a quick conversation with your pharmacist or doctor is always a reasonable step.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Butalbital, Phenobarbital, Secobarbital →

Brand names include Nevrotose #3

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Camphor, Hyoscyamine, Passif, Phenobarbital, Scopolamine, Valerian? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally that helps cells produce energy, particularly in nerve tissue. The phenobarbital component of this combination product has shown up in some research as potentially lowering carnitine levels, possibly by interfering with how the body handles it at the cellular level, though other studies found no real change at all. Because the evidence is genuinely mixed and the overall rating here is insignificant, most people taking this medication are not expected to have a meaningful problem. No action is needed for the average patient, but if you have concerns, a quick conversation with your pharmacist or doctor can put your mind at ease.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Camphor, Hyoscyamine, Passif, Phenobarbital, Scopolamine, Valerian →

Carbamazepine

Insignificant Depletion

Brand names include Tegretol, Tegretol XR, Equetro

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking carbamazepine.

Data on the effect of carbamazepine on blood levels of carnitines are conflicting. Some studies have found reduced levels in some patients on the drug, while others have found no effect. Routine L-carnitine or acetyl-L-carnitine supplementation is not necessary. Preliminary data in patients treated with the related drug oxcarbazepine (Trileptal) suggest that it does not affect levels of carnitines.
Taking Carbamazepine? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support healthy nerve function. Some studies have found slightly lower carnitine levels in people taking carbamazepine, though other studies found no difference at all, and the research is genuinely mixed. Given that, this is rated as an insignificant depletion, meaning routine supplementation is not recommended for most people on this medication. If you have any concerns, your pharmacist or doctor can help you decide whether monitoring makes sense for your situation.

References (6)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. De Vivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy: Current perspectives. Epilepsia 1998;39:1216-25.
  3. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed
  6. Kurul S, Dirik E, Iscan A. Serum carnitine levels during oxcarbazepine and carbamazepine monotherapies in children with epilepsy. J Child Neurol 2003;18:552-4. PubMed

Full nutrient report for Carbamazepine →

Cisplatin

Insignificant Depletion

Brand names include Platinol-AQ

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking cisplatin.

Increased urinary losses of L-carnitine can occur during cisplatin therapy. Cisplatin might increase L-carnitine mobilization due to tissue injury and reduce renal tubular reabsorption due to kidney injury. Theoretically, cisplatin may also increase losses of acetyl-L-carnitine. Deficiency of carnitines is unlikely in people who can maintain adequate dietary intake.
Taking Cisplatin? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help cells produce energy, and it plays a role in protecting nerve function. Cisplatin can be hard on the kidneys, and when the kidneys are stressed, they may not recapture as much carnitine from the urine as they normally would, so some extra is lost. That said, this is considered a theoretical concern, and most people eating a normal diet are unlikely to develop a meaningful deficiency. This one is rated insignificant, so no action is needed for most patients, though if you have questions about your nutrition during cisplatin therapy, your care team is a great place to start.

References (1)
  1. Heuberger W, Berardi S, Jacky E, et al. Increased urinary excretion of carnitine in patients treated with cisplatin. Eur J Clin Pharmacol 1998;54:503-8. PubMed

Full nutrient report for Cisplatin →

Brand names include G.B.S.

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Dehydrocholic Acid, Homatropine Methylbromide, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support nerve cell function. The phenobarbital component of this medication has been looked at in studies for a possible connection to lower carnitine levels, though the research is genuinely mixed, with some studies finding a small effect and others finding none at all. Given that this is rated as an insignificant depletion, most people taking this combination do not need to worry about it or take a supplement. If you are a long-term user and have concerns, it is worth a quick conversation with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Dehydrocholic Acid, Homatropine Methylbromide, Phenobarbital →

Dicyclomine, Phenobarbital

Insignificant Depletion

Brand names include Bentyl w/ Pb

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Dicyclomine, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally that helps cells produce energy, particularly in the brain and muscles. Phenobarbital has shown up in some research as possibly interfering with how the body handles carnitine, though the studies on this are genuinely mixed, with some showing lower levels and others showing no real change at all. Given that this is rated as an insignificant depletion, most people taking phenobarbital do not need to worry about this or take a supplement. If you have any concerns, your pharmacist or doctor is the right person to ask.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Dicyclomine, Phenobarbital →

Brand names include Lufyllin-EPG

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Dyphylline, Ephedrine, Guaifenesin, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally that helps cells produce energy, especially in nerves and muscles. The phenobarbital in this combination has been studied for a possible link to lower carnitine levels, though the research is genuinely mixed, with some studies seeing a small effect and others finding none at all. Given the conflicting data and the insignificant rating, most people taking this medication do not need to worry about supplementing. That said, if you have been on phenobarbital long-term and have concerns, it is worth a quick conversation with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Dyphylline, Ephedrine, Guaifenesin, Phenobarbital →

Brand names include Mudrane GG

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Ephedrine, Guaifenesin, Phenobarbital, Theophylline? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally, and it helps cells produce energy, particularly in the brain and muscles. The phenobarbital in this combination has been looked at in a handful of studies to see whether it might interfere with carnitine levels, possibly by affecting how the body processes or holds onto it. The results, though, have been genuinely mixed, with some studies showing a small effect and others finding none at all. Given that, most people taking this medication do not need to worry about this or consider a supplement, but if you have questions, your pharmacist or doctor is a good place to start.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Ephedrine, Guaifenesin, Phenobarbital, Theophylline →

Brand names include Quadrinal, Mudrane

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Ephedrine, Phenobarbital, Potassium Iodide, Theophylline? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support healthy nerve function. Phenobarbital has been studied for a possible connection to lower carnitine levels, though the research is genuinely mixed, with some studies finding a modest reduction and others finding no difference at all. Given that rating of insignificant depletion, most people taking this medication do not need to worry about this or start any supplement. If you have been on phenobarbital long-term and are curious, it is worth a quick conversation with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Ephedrine, Phenobarbital, Potassium Iodide, Theophylline →

Ephedrine, Phenobarbital, Theophylline

Insignificant Depletion

Brand names include Tedral

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Ephedrine, Phenobarbital, Theophylline? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help convert fat into energy, particularly for brain and nerve function. Some research has looked at whether phenobarbital might interfere with how the body handles carnitines, possibly affecting how they are processed or stored, but the studies done so far have pointed in different directions with no clear agreement. Because the evidence is conflicting and the overall rating here is insignificant, most people taking this medication are unlikely to need a supplement. That said, if you have any concerns, a quick conversation with your pharmacist or doctor can give you personalized guidance.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Ephedrine, Phenobarbital, Theophylline →

Ergotamine, Belladonna, Phenobarbital

Insignificant Depletion

Brand names include Bellaspas, Bellamine, Eperbel-S

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Ergotamine, Belladonna, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support healthy nerve function. The phenobarbital component of this combination product has shown up in some research as possibly interfering with how the body handles carnitines, though the studies are mixed and no clear mechanism is firmly established. Given the insignificant rating here, most people taking this medication do not need to worry about this or take any extra supplement. If you have concerns, it is always reasonable to bring them up with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Ergotamine, Belladonna, Phenobarbital →

Hyoscyamine, Phenobarbital

Insignificant Depletion

Brand names include Levsin Pb, Levsinex Pb Timecaps

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Hyoscyamine, Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support nerve cell function. The phenobarbital component of this combination has shown up in some research as possibly affecting carnitine levels in the blood, though scientists are not fully agreed on this, and other studies found no real change at all. Given that rating of insignificant depletion, most people taking this medication do not need to worry about this or consider a supplement. That said, if you have any concerns, your pharmacist or doctor is always a good place to start.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Hyoscyamine, Phenobarbital →

Isotretinoin

Insignificant Depletion

Brand names include Accutane, Amnesteem, Claravis

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking isotretinoin.

Data on the effects of isotretinoin on carnitine levels are conflicting. Reduced carnitine blood levels have been reported with the use of isotretinoin, sometimes with symptoms of carnitine deficiency, such as myalgia and muscle stiffness. However, other studies have found no significant effect of isotretinoin on carnitine blood levels. There is not enough information to recommend routine use of L-carnitine or acetyl-L-carnitine supplements with isotretinoin.
Taking Isotretinoin? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your muscles and nerves use for energy, and some studies have found that isotretinoin may be linked to lower carnitine levels in the blood, sometimes with muscle aches or stiffness. That said, other research found no meaningful change at all, so the picture is genuinely mixed. Given that this is rated as an insignificant depletion, most people taking isotretinoin do not need to worry about this or reach for a supplement. If you do notice unusual muscle discomfort while on isotretinoin, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Georgala S, Schulpis KH, Georgala C, Michas T. L-carnitine supplementation in patients with cystic acne on isotretinoin therapy. J Eur Acad Dermatol Venereol 1999;13:205-9. DOI
  2. Laker MF, Green C, Bhuiyan AK, Shuster S. Isotretinoin and serum lipids: studies on fatty acid, apolipoprotein and intermediary metabolism. Br J Dermatol 1987;117:203-6. PubMed

Full nutrient report for Isotretinoin →

Mephenytoin

Insignificant Depletion

Brand names include Mesantoin

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenytoin.

Data on the effect of phenytoin on blood levels of carnitines are conflicting. Some studies have found reduced levels in some patients on phenytoin. However, other studies have found no effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Mephenytoin? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support nerve cell function. Mephenytoin is closely related to phenytoin, and some research has looked at whether phenytoin-type drugs might reduce carnitine levels, possibly by interfering with how the body processes or holds onto this compound. That said, the studies are mixed, with some showing lower levels and others showing no change at all. Given the insignificant rating here, most people on this medication do not need to worry about this or take a supplement, but if you have questions your pharmacist or doctor can help you sort it out.

References (3)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. De Vivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy: Current perspectives. Epilepsia 1998;39:1216-25.
  3. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Mephenytoin →

Phenobarbital

Insignificant Depletion

Brand names include Solfoton, Luminal

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Phenobarbital? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally that helps cells produce energy, particularly in the brain and muscles. Some early research raised the question of whether phenobarbital might interfere with how the body handles carnitines, possibly by affecting metabolism or how the body uses them over time, but studies on this have gone back and forth with no clear agreement. Given the insignificant rating here, most people taking phenobarbital do not need to worry about this or take a supplement for it. If you have any concerns, it is always fine to bring them up with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Phenobarbital →

Phenobarbital, Phenytoin

Insignificant Depletion

Brand names include Dilantin with PB

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenytoin.

Data on the effect of phenytoin on blood levels of carnitines are conflicting. Some studies have found reduced levels in some patients on phenytoin. However, other studies have found no effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Phenobarbital, Phenytoin? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support nerve cell function. Research on whether phenytoin actually lowers it in the blood is mixed, with some studies showing a modest reduction and others finding no change at all. Given that the evidence is conflicting and the rating here is insignificant, most people on phenytoin or phenobarbital do not need to worry about this or take a supplement. If you have concerns, it is always worth a quick conversation with your pharmacist or doctor.

References (3)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. De Vivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy: Current perspectives. Epilepsia 1998;39:1216-25.
  3. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Phenobarbital, Phenytoin →

Phenobarbital, Sodium Nitrate

Insignificant Depletion

Brand names include Soniphen

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenobarbital.

Data on the effect of phenobarbital on blood levels of carnitines are conflicting. Some studies have found reduced L-carnitine levels in some patients taking phenobarbital. However, other studies have found no significant effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Phenobarbital, Sodium Nitrate? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into usable energy, and it also supports healthy nerve function. Some research has found that phenobarbital might interfere with how the body processes carnitines, possibly by affecting how they are handled in metabolism, but other studies have found no meaningful change at all. Because the evidence is genuinely mixed and the overall rating here is insignificant, most people taking phenobarbital do not need to worry about this or consider a supplement. If you have been on phenobarbital long-term and have questions, it is always fine to bring it up with your pharmacist or doctor.

References (5)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  3. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Phenobarbital, Sodium Nitrate →

Phenytoin

Insignificant Depletion

Brand names include Dilantin Kapseals, Dilantin, Di-Phen

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking phenytoin.

Data on the effect of phenytoin on blood levels of carnitines are conflicting. Some studies have found reduced levels in some patients on phenytoin. However, other studies have found no effect. Routine L-carnitine or acetyl-L-carnitine supplementation does not seem to be necessary.
Taking Phenytoin? A supplement is not needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally that helps cells produce energy, particularly in the brain and muscles. Some research has found that phenytoin might reduce carnitine levels in certain patients, though other studies have found no change at all, and the evidence is genuinely mixed. Because of that uncertainty, this is rated as insignificant, meaning most people on phenytoin do not need to worry about supplementing it. If you have concerns, a quick conversation with your pharmacist or doctor can put your mind at ease.

References (3)
  1. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  2. De Vivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy: Current perspectives. Epilepsia 1998;39:1216-25.
  3. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed

Full nutrient report for Phenytoin →

Cefditoren Pivoxil

Moderate Depletion

Brand names include Spectracef

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking cefditoren pivoxil.

Cefditoren pivoxil is a prodrug which is converted to cefditoren and pivalate in the body. Pivalate combines with L-carnitine and is excreted in the urine, which increases L-carnitine losses from the body. Theoretically, losses of acetyl-L-carnitine could also be increased. Short courses of cefditoren can decrease blood concentrations of L-carnitine, but tissue levels are unlikely to be affected. Treatment for 1-2 months may cause a decrease in muscle L-carnitine, and treatment for 6 months or longer may cause symptoms of L-carnitine deficiency. Routine L-carnitine or acetyl-L-carnitine supplementation is not necessary unless therapy is prolonged or the patient has other factors contributing to low L-carnitine stores.
Taking Cefditoren Pivoxil? Monitor for depletion; a supplement is needed for some patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your muscles and nerves depend on for energy. Here is the interesting part about cefditoren pivoxil: when your body absorbs this antibiotic, it breaks down into a byproduct called pivalate, which latches onto L-carnitine and carries it out through your urine. Because acetyl-L-carnitine is closely related, its levels may also fall as a result. For a short course of treatment, this probably does not matter much, but if you are taking cefditoren for many weeks or months, it is worth asking your pharmacist or doctor whether monitoring or supplementation makes sense for you.

References (1)
  1. Brass EP. Pivalate-generating prodrugs and carnitine homeostasis in man. Pharmacol Rev 2002;54:589-98. PubMed

Full nutrient report for Cefditoren Pivoxil →

Pivampicillin

Moderate Depletion

Brand names include Pondicillin

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking pivampicillin.

This antibiotic is a prodrug which liberates the active antibiotic and pivalate in the body. Pivalate combines with L-carnitine and is excreted in the urine, which increases L-carnitine losses from the body. Theoretically, losses of acetyl-L-carnitine could also be increased. Short courses of pivampicillin decrease blood concentrations of L-carnitine, but tissue levels appear to be unaffected. Treatment for 1-2 months causes decrease in muscle L-carnitine, and treatment for 6 months or longer may cause symptoms of L-carnitine deficiency. Routine L-carnitine or acetyl-L-carnitine supplementation is not necessary unless therapy is prolonged, or the patient has other factors contributing to low L-carnitine stores.
Taking Pivampicillin? Monitor for depletion; a supplement is needed for some patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your muscles and nerves depend on for energy. Here is what makes pivampicillin a little unusual: when your body breaks it down, it releases a byproduct called pivalate, which latches onto carnitine and pulls it out through the urine. Short courses seem to affect mainly blood levels without touching muscle stores, but therapy lasting several months can actually draw down carnitine in the muscles and may eventually cause noticeable symptoms. Most people on a brief course do not need to worry, but if you are taking pivampicillin long-term, it is worth asking your pharmacist or doctor whether supplementation makes sense for you.

References (2)
  1. Holme E, Greter J, Jacobson CE, et al. Carnitine deficiency induced by pivampicillin and pivmecillinam therapy. Lancet 1989;2:469-73. PubMed
  2. Brass EP. Pivalate-generating prodrugs and carnitine homeostasis in man. Pharmacol Rev 2002;54:589-98. PubMed

Full nutrient report for Pivampicillin →

Pivmecillinam

Moderate Depletion

Brand names include Selexid

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking pivmecillinam.

This antibiotic is a prodrug which liberates the active antibiotic and pivalate in the body. Pivalate combines with L-carnitine and is excreted in the urine, which increases L-carnitine losses from the body. Theoretically, losses of acetyl-L-carnitine could also be increased. Short courses of pivmecillinam decrease blood concentrations of L-carnitine, but tissue levels appear to be unaffected. Treatment for 1-2 months causes decrease in muscle L-carnitine, and treatment for 6 months or longer may cause symptoms of carnitine deficiency. Routine L-carnitine or acetyl-L-carnitine supplementation is not necessary unless therapy is prolonged, or the patient has other factors contributing to low L-carnitine stores.
Taking Pivmecillinam? Monitor for depletion; a supplement is needed for some patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a natural compound your muscles and nerves depend on for energy. Here is the key with pivmecillinam: as your body breaks this antibiotic down, it releases a byproduct called pivalate, which latches onto carnitine and carries it out through the urine, gradually draining your body's supply. A short course likely does not cause a real problem, but therapy lasting many months has been linked to measurable drops in muscle carnitine levels and, in longer treatment, possible deficiency symptoms. If you are taking pivmecillinam for an extended period, it is worth asking your pharmacist or doctor whether your carnitine levels should be monitored.

References (2)
  1. Holme E, Greter J, Jacobson CE, et al. Carnitine deficiency induced by pivampicillin and pivmecillinam therapy. Lancet 1989;2:469-73. PubMed
  2. Brass EP. Pivalate-generating prodrugs and carnitine homeostasis in man. Pharmacol Rev 2002;54:589-98. PubMed

Full nutrient report for Pivmecillinam →

Sodium valproate

Moderate Depletion

Brand names include Epilim

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking valproate.

Valproic acid can reduce blood and tissue carnitine levels. Valproic acid interferes with L-carnitine biosynthesis in the liver and forms a valproylcarnitine ester, which is excreted in the urine, reducing tubular reabsorption of free carnitine. Reduced L-carnitine levels are not clinically significant in most people taking valproic acid. However, some patients may be at increased risk for L-carnitine deficiency with valproic acid, and this may contribute to the development of hyperammonemia and hepatotoxicity associated with the drug. Risk factors for symptomatic L-carnitine deficiency with valproic acid include age less than 2 years, severe neurological problems including mental retardation, taking multiple antiepileptic drugs, poor nutrition, and use of the ketogenic diet. Some experts recommend L-carnitine supplements for people with these risk factors who need to take valproic acid. There is one case report of successful use of acetyl-L-carnitine in a patient with asymptomatic hyperammonemia secondary to valproate. However, carnitine supplements aren't necessary for most people taking valproic acid who are otherwise healthy and consuming a diet adequate in L-carnitine.
Taking Sodium valproate? Monitor for depletion; a supplement is needed for some patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Carnitine is something your body makes and uses to help cells produce energy, and sodium valproate can pull levels down through two connected pathways: it interferes with the liver's ability to make carnitine, and it binds to carnitine to form a compound that gets flushed out in the urine instead of being recycled by the kidneys. For most adults on valproate, this does not cause a noticeable problem. That said, certain people, including very young children, those on multiple seizure medications, or those with poor nutrition, may be at greater risk, so if any of those apply to you or someone you care for, it is worth bringing up with your doctor or pharmacist.

References (17)
  1. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  2. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  3. Riva R, Albani F, Gobbi G, et al. Carnitine disposition before and during valproate therapy in patients with epilepsy. Epilepsia 1993;34:184-7. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed
  6. De Vivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy: Current perspectives. Epilepsia 1998;39:1216-25.
  7. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  8. Shapira Y, Gutman A. Muscle carnitine deficiency in patients using valproic acid. J Pediatrics 1991;118:646-9. PubMed
  9. Winter SC, Szabo-Aczel S, Curry CJR, et al. Plasma carnitine deficiency: Clinical observations in 51 pediatric patients. Am J Dis Child 1987;141:660-5. PubMed
  10. Coulter DL. Carnitine, valproate, and toxicity. J Child Neurol 1991;6:7-14.
  11. Raskind JY, El-Chaar GM. The role of carnitine supplementation during valproic acid therapy. Ann Pharmacother 2000;34:630-8. PubMed
  12. Coulter DL. Prevention of hepatotoxicity recurrence with valproate monotherapy and carnitine. Ann Neurol 1988;24:301.
  13. Vance CK, Vance H, Winter SC, et al. Control of valproate-induced hepatotoxicity with carnitine. Ann Neurol 1989;26:456.
  14. Hirose S, Mitsudome A, Yasumoto S, et al. Valproate therapy does not deplete carnitine levels in otherwise healthy children. Pediatrics 1998;101:E9 (abstract). PubMed
  15. Van Wouwe JP. Carnitine deficiency during valproic acid treatment. Int J Vitam Nutr Res 1995;65:211-4.
  16. Suzuki H, Hibino H, Inoue Y, Mikami A, Matsumoto H, Mikami K. Effect of acetyl-l-carnitine in elderly patient who presented with hyperammonemia associated with administration of sodium valproate. Asian J Psychiatr. 2017;30:179. PubMed
  17. Freeman JM, Vining EPG, Cost S, Singhi P. Does carnitine administration improve the symptoms attributed to anticonvulsant medications? A double-blinded, crossover study. Pediatrics 1994;93:893-5. DOI

Full nutrient report for Sodium valproate →

Valproic Acid

Moderate Depletion

Brand names include Depakene, Depacon, Valproate

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking valproate.

Valproic acid can reduce blood and tissue carnitine levels. Valproic acid interferes with L-carnitine biosynthesis in the liver and forms a valproylcarnitine ester, which is excreted in the urine, reducing tubular reabsorption of free carnitine. Reduced L-carnitine levels are not clinically significant in most people taking valproic acid. However, some patients may be at increased risk for L-carnitine deficiency with valproic acid, and this may contribute to the development of hyperammonemia and hepatotoxicity associated with the drug. Risk factors for symptomatic L-carnitine deficiency with valproic acid include age less than 2 years, severe neurological problems including mental retardation, taking multiple antiepileptic drugs, poor nutrition, and use of the ketogenic diet. Some experts recommend L-carnitine supplements for people with these risk factors who need to take valproic acid. There is one case report of successful use of acetyl-L-carnitine in a patient with asymptomatic hyperammonemia secondary to valproate. However, carnitine supplements aren't necessary for most people taking valproic acid who are otherwise healthy and consuming a diet adequate in L-carnitine.
Taking Valproic Acid? Monitor for depletion; a supplement is needed for some patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Carnitine is something your body uses to move fatty acids into cells for energy, and valproic acid can pull levels down through two routes: it slows the liver's ability to make carnitine on its own, and it binds to carnitine to form a compound that gets flushed out in the urine instead of being recycled by the kidneys. For most adults taking valproic acid, this does not cause a noticeable problem. That said, certain people, including very young children, those on multiple seizure medications, or those with poor nutrition, may be at higher risk, and some specialists do recommend a carnitine supplement for those groups. If any of that sounds like your situation, it is worth bringing up with your pharmacist or doctor.

References (17)
  1. Thom H, Carter PE, Cole GF, et al. Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs. Dev Med Child Neurol 1991;33:795-802. PubMed
  2. Hug G, McGraw CA, Bates SR, et al. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr 1991;119:799-802. PubMed
  3. Riva R, Albani F, Gobbi G, et al. Carnitine disposition before and during valproate therapy in patients with epilepsy. Epilepsia 1993;34:184-7. PubMed
  4. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Paediatr 1995;84:93-5. PubMed
  5. Opala G, Winter S, Vance C, et al. The effect of valproic acid on plasma carnitine levels. Am J Dis Child 1991;145:999-1001. PubMed
  6. De Vivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy: Current perspectives. Epilepsia 1998;39:1216-25.
  7. Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol 1998;13:546-9. PubMed
  8. Shapira Y, Gutman A. Muscle carnitine deficiency in patients using valproic acid. J Pediatrics 1991;118:646-9. PubMed
  9. Winter SC, Szabo-Aczel S, Curry CJR, et al. Plasma carnitine deficiency: Clinical observations in 51 pediatric patients. Am J Dis Child 1987;141:660-5. PubMed
  10. Coulter DL. Carnitine, valproate, and toxicity. J Child Neurol 1991;6:7-14.
  11. Raskind JY, El-Chaar GM. The role of carnitine supplementation during valproic acid therapy. Ann Pharmacother 2000;34:630-8. PubMed
  12. Coulter DL. Prevention of hepatotoxicity recurrence with valproate monotherapy and carnitine. Ann Neurol 1988;24:301.
  13. Vance CK, Vance H, Winter SC, et al. Control of valproate-induced hepatotoxicity with carnitine. Ann Neurol 1989;26:456.
  14. Hirose S, Mitsudome A, Yasumoto S, et al. Valproate therapy does not deplete carnitine levels in otherwise healthy children. Pediatrics 1998;101:E9 (abstract). PubMed
  15. Van Wouwe JP. Carnitine deficiency during valproic acid treatment. Int J Vitam Nutr Res 1995;65:211-4.
  16. Suzuki H, Hibino H, Inoue Y, Mikami A, Matsumoto H, Mikami K. Effect of acetyl-l-carnitine in elderly patient who presented with hyperammonemia associated with administration of sodium valproate. Asian J Psychiatr. 2017;30:179. PubMed
  17. Freeman JM, Vining EPG, Cost S, Singhi P. Does carnitine administration improve the symptoms attributed to anticonvulsant medications? A double-blinded, crossover study. Pediatrics 1994;93:893-5. DOI

Full nutrient report for Valproic Acid →

Ifosfamide

Insufficient Evidence

Brand names include Ifex

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking ifosfamide.

Increased urinary losses of L-carnitine can occur during ifosfamide therapy. This might be due to binding of L-carnitine with a metabolite of ifosfamide. Theoretically, ifosfamide may also increase losses of acetyl-L-carnitine. The clinical significance of this and the role of carnitine supplements in people treated with ifosfamide are unknown.
Taking Ifosfamide? Insufficient evidence to rate; clinical significance is not known. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help cells produce energy, and it plays a role in nerve health. Ifosfamide may cause the kidneys to spill more L-carnitine into the urine, possibly because a breakdown product of the drug binds to carnitine and carries it out of the body. Whether this meaningfully affects acetyl-L-carnitine levels in practice is simply not known yet, so right now this is considered theoretical. If you are on ifosfamide and are curious about carnitine, it is worth raising with your care team rather than acting on your own.

References (2)
  1. Marthaler NP, Visarius T, Kupfer A, Lauterburg BH. Increased urinary losses of carnitine during ifosfamide chemotherapy. Cancer Chemother Pharmacol 1999;44:170-2. PubMed
  2. Schlenzig JS, Charpentier C, Rabier D, et al. L-carnitine: a way to decrease cellular toxicity of ifosfamide? Eur J Pediatr 1995;154:686-7. DOI

Full nutrient report for Ifosfamide →

Lamivudine, Zidovudine

Insufficient Evidence

Brand names include Combivir

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking zidovudine.

Low L-carnitine blood levels are found in some people with HIV infection. Zidovudine seems to exacerbate this, and can also lower muscle carnitine levels, which is linked to symptoms of myopathy. Zidovudine interferes with mitochondrial transport of L-carnitine into muscle cells. In vitro data suggest L-carnitine supplements might improve functioning of muscle cells affected by zidovudine, but there is not enough data to recommend routine use of L-carnitine or acetyl-L-carnitine supplements for patients taking zidovudine.
Taking Lamivudine, Zidovudine? Insufficient evidence to rate; clinical significance is not known. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your muscles and nerves depend on for energy production at the cellular level. Zidovudine appears to interfere with how L-carnitine gets transported into muscle cells, and some people living with HIV already tend to have lower carnitine levels to begin with, so the combination may compound this. That said, the current evidence is simply not strong enough to know whether this matters clinically for most patients. If you have concerns, bring it up with your pharmacist or doctor before reaching for any supplement.

References (4)
  1. Mintz M. Carnitine in human immunodeficiency virus type 1 infection/acquired immune deficiency syndrome. J Child Neurol 1995;10:S40-4. DOI
  2. Dalakas MC, Leon-Monzon ME, Bernardini I, et al. Zidovudine-induced mitochondrial myopathy is associated with muscle carnitine deficiency and lipid storage. Ann Neurol 1994;35:482-7. PubMed
  3. Campos Y, Arenas J. Muscle carnitine deficiency associated with zidovudine-induced mitochondrial myopathy. Ann Neurol 1994;36:680-1. PubMed
  4. Georges B, Galland S, Rigault C, et al. Beneficial effects of L-carnitine in myoblastic C2C12 cells. Interaction with zidovudine. Biochem Pharmacol 2003;65:1483-8.. PubMed

Full nutrient report for Lamivudine, Zidovudine →

Pyrimethamine

Insufficient Evidence

Brand names include Daraprim

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking pyrimethamine.

A single case report describes symptomatic L-carnitine deficiency in a patient treated with pyrimethamine plus sulfadiazine, which reversed when both drugs were stopped. The mechanism of this effect is not known and further data is needed before L-carnitine or acetyl-L-carnitine depletion can be linked to these drugs.
Taking Pyrimethamine? Insufficient evidence to rate; clinical significance is not known. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses for energy production and nerve function, particularly in the brain. There is one old case report suggesting pyrimethamine might somehow interfere with carnitine in the body, but the mechanism is unknown and that single report involved a second drug as well. With an 'insufficient evidence' rating, this is more of a theoretical curiosity than a practical concern right now. If you have questions about carnitine while taking pyrimethamine, it is worth bringing up with your doctor or pharmacist.

References (1)
  1. Sekas G, Paul HS. Hyperammonemia and carnitine deficiency in a patient receiving sulfadiazine and pyrimethamine. Am J Med 1993;95:112-3. PubMed

Full nutrient report for Pyrimethamine →

Pyrimethamine, Sulfadoxine

Insufficient Evidence

Brand names include Fansidar

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking pyrimethamine.

A single case report describes symptomatic L-carnitine deficiency in a patient treated with pyrimethamine plus sulfadiazine, which reversed when both drugs were stopped. The mechanism of this effect is not known and further data is needed before L-carnitine or acetyl-L-carnitine depletion can be linked to these drugs.
Taking Pyrimethamine, Sulfadoxine? Insufficient evidence to rate; clinical significance is not known. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support nerve function. There is one old case report suggesting pyrimethamine might somehow interfere with carnitine in the body, though nobody has pinned down exactly why or how. The evidence here is really thin, just that single report, so this is considered theoretical at this point. If you are taking pyrimethamine long-term and have concerns, it is worth bringing up with your doctor or pharmacist.

References (1)
  1. Sekas G, Paul HS. Hyperammonemia and carnitine deficiency in a patient receiving sulfadiazine and pyrimethamine. Am J Med 1993;95:112-3. PubMed

Full nutrient report for Pyrimethamine, Sulfadoxine →

Sulfadiazine

Insufficient Evidence
Theoretically, acetyl-L-carnitine levels may be reduced in patients taking sulfadiazine.

A single case report describes symptomatic L-carnitine deficiency in a patient treated with pyrimethamine plus sulfadiazine, which reversed when both drugs were stopped. The mechanism of this effect is not known and further data is needed before L-carnitine or acetyl-L-carnitine depletion can be linked to these drugs.
Taking Sulfadiazine? Insufficient evidence to rate; clinical significance is not known. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body makes naturally that helps cells produce energy, especially in nerves and muscles. There is one case report of carnitine levels dropping in a patient taking sulfadiazine alongside another antibiotic, but how or whether sulfadiazine itself caused that is genuinely unknown. Because the evidence here is quite thin, this is more of a heads-up than a concern for most people. If you are on sulfadiazine long-term and have questions about carnitine, it is worth bringing up with your pharmacist or doctor.

References (1)
  1. Sekas G, Paul HS. Hyperammonemia and carnitine deficiency in a patient receiving sulfadiazine and pyrimethamine. Am J Med 1993;95:112-3. PubMed

Full nutrient report for Sulfadiazine →

Brand names include Triple Sulfoid, Terfonyl

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking sulfadiazine.

A single case report describes symptomatic L-carnitine deficiency in a patient treated with pyrimethamine plus sulfadiazine, which reversed when both drugs were stopped. The mechanism of this effect is not known and further data is needed before L-carnitine or acetyl-L-carnitine depletion can be linked to these drugs.
Taking Sulfadiazine, Sulfamerazine, Sulfamethazine? Insufficient evidence to rate; clinical significance is not known. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help turn fat into energy and support nerve function. There is one old case report suggesting that a combination of sulfadiazine with another drug was linked to carnitine deficiency, but how or whether sulfadiazine alone plays a role is genuinely unknown. The evidence here is too thin to draw any real conclusions, so most people taking these sulfonamide antibiotics do not need to worry about this. If you have concerns, it is worth a quick conversation with your pharmacist or doctor.

References (1)
  1. Sekas G, Paul HS. Hyperammonemia and carnitine deficiency in a patient receiving sulfadiazine and pyrimethamine. Am J Med 1993;95:112-3. PubMed

Full nutrient report for Sulfadiazine, Sulfamerazine, Sulfamethazine →

Sulfadiazine, Trimethoprim

Insufficient Evidence

Brand names include Coptin

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking sulfadiazine.

A single case report describes symptomatic L-carnitine deficiency in a patient treated with pyrimethamine plus sulfadiazine, which reversed when both drugs were stopped. The mechanism of this effect is not known and further data is needed before L-carnitine or acetyl-L-carnitine depletion can be linked to these drugs.
Taking Sulfadiazine, Trimethoprim? Insufficient evidence to rate; clinical significance is not known. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your body uses to help convert fat into energy, and it supports healthy nerve function. There is one published case report of a patient developing carnitine deficiency while on sulfadiazine combined with another drug, but why that happened is not understood, and there is not enough evidence yet to say this combination reliably causes a problem. For most people taking sulfadiazine, this is something researchers are still looking into rather than a confirmed concern. That said, if you have questions about your energy levels or nerve symptoms while on this medication, it is worth bringing up with your pharmacist or doctor.

References (1)
  1. Sekas G, Paul HS. Hyperammonemia and carnitine deficiency in a patient receiving sulfadiazine and pyrimethamine. Am J Med 1993;95:112-3. PubMed

Full nutrient report for Sulfadiazine, Trimethoprim →

Zidovudine

Insufficient Evidence

Brand names include Retrovir, Retrovir Injection

Theoretically, acetyl-L-carnitine levels may be reduced in patients taking zidovudine.

Low L-carnitine blood levels are found in some people with HIV infection. Zidovudine seems to exacerbate this, and can also lower muscle carnitine levels, which is linked to symptoms of myopathy. Zidovudine interferes with mitochondrial transport of L-carnitine into muscle cells. In vitro data suggest L-carnitine supplements might improve functioning of muscle cells affected by zidovudine, but there is not enough data to recommend routine use of L-carnitine or acetyl-L-carnitine supplements for patients taking zidovudine.
Taking Zidovudine? Insufficient evidence to rate; clinical significance is not known. ⓘ
Dr. Brian Staiger, Pharm.D explains

Acetyl-L-carnitine is a compound your muscle cells use for energy, and there is some early research suggesting zidovudine may interfere with how carnitine gets transported into muscle tissue, potentially lowering levels there. People living with HIV can already have lower carnitine levels, and zidovudine may add to that. Even so, the evidence right now is considered insufficient, meaning researchers do not yet know whether this has a real impact on how patients feel or function. If you have been on zidovudine long-term and have concerns about muscle symptoms, it is worth bringing up with your doctor or pharmacist.

References (4)
  1. Mintz M. Carnitine in human immunodeficiency virus type 1 infection/acquired immune deficiency syndrome. J Child Neurol 1995;10:S40-4. DOI
  2. Dalakas MC, Leon-Monzon ME, Bernardini I, et al. Zidovudine-induced mitochondrial myopathy is associated with muscle carnitine deficiency and lipid storage. Ann Neurol 1994;35:482-7. PubMed
  3. Campos Y, Arenas J. Muscle carnitine deficiency associated with zidovudine-induced mitochondrial myopathy. Ann Neurol 1994;36:680-1. PubMed
  4. Georges B, Galland S, Rigault C, et al. Beneficial effects of L-carnitine in myoblastic C2C12 cells. Interaction with zidovudine. Biochem Pharmacol 2003;65:1483-8.. PubMed

Full nutrient report for Zidovudine →

Important

This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.

Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.

© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
Understand the basics

What drug-induced nutrient depletion means

Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.

Association is not deficiency

An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.

Evidence varies by pair

Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.

When to ask about labs

If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.

Don't self-supplement blindly

Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.

Never stop a medication over this

These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.

Food first, usually

For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.

Common questions

ACETYL-L-CARNITINE & medications: FAQs

Which medications can lower ACETYL-L-CARNITINE?
In our licensed clinical database, 46 medications have been associated with ACETYL-L-CARNITINE depletion, including Adefovir, Aprobarbital, Butabarbital, Phenobarbital, Aspirin, Codeine Phosphate, Phenobarbital and Atropine, Hyoscyamine, Phenobarbital. Each entry above shows the evidence rating and the published details. An association is not a guarantee — dose, duration, diet, and your own health all matter.
I take one of these medications — am I deficient in ACETYL-L-CARNITINE?
Not necessarily. These entries describe reported associations, not certainties. Many people take these medications without developing a meaningful ACETYL-L-CARNITINE problem. If you take one long-term, the reasonable step is to ask your healthcare provider whether checking your ACETYL-L-CARNITINE status is appropriate for you.
Should I start a ACETYL-L-CARNITINE supplement?
Not without checking first. Supplements are not risk-free — some interact with medications, and for certain nutrients (like potassium or magnesium) supplementation can be genuinely risky with kidney disease or particular drug combinations. Food-first strategies and clinician-guided testing usually come before a supplement.
Where does this information come from?
The depletion records come from the Natural Medicines (Therapeutic Research Center) database — an evidence-graded clinical reference — and are displayed as published, with their citations. The plain-English education is written and reviewed by licensed HelloPharmacist pharmacists.

Wondering about your ACETYL-L-CARNITINE levels?

Ask a licensed pharmacist — free, no appointment needed.

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Sources

Sources & How We Checked

Medication associations with ACETYL-L-CARNITINE are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.