Antidote: carnitine

The use of carnitine as an antidote for sodium valproate poisoning is not supported by strong evidence, but there is a reasonable biological basis for its use. It is inexpensive and has a low risk of harm.

Consider using carnitine in patients with sodium valproate poisoning complicated by:

  • significant metabolic acidosis
  • cerebral oedema
  • hyperammonaemia
  • hepatotoxicity.

If indicated, use:

carnitine 100 mg/kg intravenously, as an initial dose1 sodium valproate poisoning

FOLLOWED BY

carnitine 50 mg/kg intravenously, every 8 hours, until coma and metabolic acidosis have resolved1.

1 Carnitine is not registered for use in Australia but is available via the Special access scheme (SAS). Pharmacists or emergency staff should check the emergency and life-saving drugs register for their state. This register lists hospitals that hold specific SAS drugs that may be borrowed in an emergency.Return