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and Langan et al

Allergic reactions : Symptoms such as severe swelling, rash, or difficulty breathing require immediate medical attention

It has been widely used in anti-aging and cosmetic products in humans for decades without any adverse effects and can be easily incorporated in creams, liposomes, foams or subcutaneous injections

Chronic oral administration of high doses of levocarnitine in patients with severely impaired renal function or end-stage renal disease (ESRD) and dialysis patients may lead to accumulation of the potentially toxic metabolites trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), as these metabolites are normally excreted in the urine