May increase effects of certain anticoagulants eg, acenocoumarol, warfarin & heparin. Decreased effectiveness of thyroid hormone. Reduced plasma levels w/ cephalosporins. Decreased serum carnitine in childn w/ anticonvulsants eg, phenobarb, phenytoin, carbamazepine. May increase urinary excretion w/ cisplatin. May increase urinary loss w/ ifosfamide. Reduced levels of acetyl carnitine in patients w/ neuropathy induced by nucleosides. May reduce side effects associated w/ IL-2 or nortriptyline. May improve liver & muscular side effects associated w/ isotretinoin in acne patients. May reduce nerve damage symptoms associated w/ paclitaxel use.
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